Brain StimulationPub Date : 2025-09-01DOI: 10.1016/j.brs.2025.08.019
Christos Galanis , Nicholas Hananeia , Maximilian Lenz , Mohammadreza Vasheghani Farahani , Peter Jedlicka , Andreas Vlachos
{"title":"Repetitive magnetic stimulation induces plasticity of excitatory synapses through cooperative pre- and postsynaptic activity","authors":"Christos Galanis , Nicholas Hananeia , Maximilian Lenz , Mohammadreza Vasheghani Farahani , Peter Jedlicka , Andreas Vlachos","doi":"10.1016/j.brs.2025.08.019","DOIUrl":"10.1016/j.brs.2025.08.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcranial magnetic stimulation (TMS) is a widely used non-invasive technique, yet its cellular and molecular mechanisms remain incompletely understood. Current protocols are largely heuristic, based on system-level observations. This study explores how 10 Hz repetitive magnetic stimulation (rMS) induces synaptic plasticity by integrating <em>in vitro</em> models with computational simulations.</div></div><div><h3>Materials and methods</h3><div>Mouse organotypic brain tissue cultures were exposed to 10 Hz rMS (900 pulses). Electrophysiology, optogenetic and chemogenetic tools assessed synaptic plasticity mechanisms. Computational modeling based on spike-timing-dependent plasticity (STDP) predicted stimulation outcomes, and pharmacological interventions tested the role of brain-derived neurotrophic factor (BDNF)/tropomyosin receptor kinase B (TrkB) signaling.</div></div><div><h3>Results</h3><div>Unlike electrical or optogenetic stimulation, 10 Hz rMS enhanced excitatory neurotransmission via coordinated pre- and postsynaptic activation, with BDNF playing a crucial role. Computational modeling accurately predicted frequency-dependent effects. Blocking BDNF/TrkB signaling prevented rMS-induced potentiation, while TrkB activation converted electrically induced LTD into LTP.</div></div><div><h3>Conclusion</h3><div>These findings support a mechanistic contribution of STDP and BDNF/TrkB signaling to rMS-induced synaptic changes, providing a foundation for future experimental, computational and potentially clinical investigations.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"18 5","pages":"Pages 1641-1650"},"PeriodicalIF":8.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain StimulationPub Date : 2025-09-01DOI: 10.1016/j.brs.2025.08.026
Bin Liu , Zhebin Feng , Guizhi Wu , Ningfei Li , Yanyang Zhang , Zaixu Cui , Junpeng Xu , Hong Tian , Jun Yang , Zhiqi Mao
{"title":"Optimal stimulation site and fiber tracts in subthalamic deep brain stimulation for Meige syndrome","authors":"Bin Liu , Zhebin Feng , Guizhi Wu , Ningfei Li , Yanyang Zhang , Zaixu Cui , Junpeng Xu , Hong Tian , Jun Yang , Zhiqi Mao","doi":"10.1016/j.brs.2025.08.026","DOIUrl":"10.1016/j.brs.2025.08.026","url":null,"abstract":"<div><h3>Background</h3><div>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has emerged as an effective therapy for Meige syndrome (MS). However, the optimal stimulation site within STN and the most effective stimulation fiber tracts have not been investigated.</div></div><div><h3>Methods</h3><div>Based on the discovery cohort (<em>n</em> = 65), we first identified the optimal stimulation site within the STN using the sweet spot mapping method. Second, we screened for the fiber tracts accounting for optimal clinical outcomes by the fiber filtering approach. Third, based on the above findings, we constructed outcome prediction models and estimated their predictive performance in the discovery cohort and an independent validation cohort (<em>n</em> = 20). Finally, we introduced two prospective cases to illustrate if and how the optimal stimulation site and fiber tracts could facilitate precise electrode targeting and postoperative programming.</div></div><div><h3>Results</h3><div>The optimal stimulation site was mapped to the anterodorsal portion of the STN-motor subregion. Superior STN-DBS outcomes were positively correlated with stimulation of the fibers projecting to the primary motor cortices, the supplementary motor areas, and the globus pallidus internus. Notably, spatial overlap between individual stimulation volumes and the resultant sweet spot or fiber filtering models could cross-predict symptom improvement in out-of-model patients. Moreover, the models could guide electrode implantation and active contact selection in prospective cases.</div></div><div><h3>Conclusion</h3><div>Our study underscores the potential of optimizing stimulation sites and fibers to predict clinical improvement, and provides new insights into the ongoing efforts of precise surgical targeting and computer-assisted DBS programming.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"18 5","pages":"Pages 1686-1694"},"PeriodicalIF":8.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain StimulationPub Date : 2025-09-01DOI: 10.1016/j.brs.2025.08.021
Morteza Salimi , Milad Nazari , Jonathan Mishler , Jyoti Mishra , Dhakshin S. Ramanathan
{"title":"Divergent responses of glutamatergic and GABAergic prefrontal neurons underlie changes in excitability following low and high frequency repetitive brain stimulation","authors":"Morteza Salimi , Milad Nazari , Jonathan Mishler , Jyoti Mishra , Dhakshin S. Ramanathan","doi":"10.1016/j.brs.2025.08.021","DOIUrl":"10.1016/j.brs.2025.08.021","url":null,"abstract":"<div><h3>Background</h3><div>Repetitive brain stimulation is hypothesized to bidirectionally modulate excitability, with low-frequency trains decreasing and high-frequency (>5 Hz) trains increasing excitability in the brain. However, most insights on the neuroplastic effects of repetitive stimulation protocols stem from non-invasive human studies (TMS/EEG) or from rodent slice physiology. Here, we developed a rodent experimental preparation enabling imaging of cellular activity during repetitive stimulation protocols in vivo to understand the mechanisms by which brain stimulation modulates excitability of prefrontal cortical neurons.</div></div><div><h3>Methods</h3><div>Repetitive trains of intracortical stimulation were applied to the medial prefrontal cortex using current parameters (100 μA, 400 μs pulses) guided by prior rodent studies of intracortical microstimulation. Calcium imaging of glutamatergic (CamKII) and GABAergic (mDLX) neurons was performed before, during, and after stimulation in awake rodents (n = 9 females). Protocols included low-frequency (1 Hz, 1100 pulses) and high-frequency (10 Hz, 3000 pulses), with sham stimulation as a control.</div></div><div><h3>Results</h3><div>Glutamatergic neurons were differentially modulated by stimulation frequency, with 10 Hz increasing and 1 Hz decreasing activity during stimulation. Post-stimulation, 1 Hz stimulation resulted in a long-term inhibition of glutamatergic and increased activity of GABAergic neurons, resulting in a net decrease in the excitation/inhibition ratio. 10 Hz selectively suppressed GABAergic neurons with no long-term change in glutamatergic neuronal activity, resulting in a net increase in the excitation/inhibition ratio.</div></div><div><h3>Conclusions</h3><div>These findings provide direct evidence that repetitive brain stimulation protocols used clinically can induce long-term modulation of prefrontal cortical excitability, with low-frequency stimulation inhibiting glutamatergic neurons and high-frequency stimulation inhibiting GABAergic neurons.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"18 5","pages":"Pages 1675-1685"},"PeriodicalIF":8.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain StimulationPub Date : 2025-09-01DOI: 10.1016/j.brs.2025.09.002
Xuanjun Guo , Alek Pogosyan , Jean Debarros , Shenghong He , Laura Wehmeyer , Fernando Rodriguez Plazas , Karen Wendt , Zixiao Yin , Ahmed Raslan , Thomas Hart , Francesca Morgante , Tim Denison , Erlick A. Pereira , Keyoumars Ashkan , Shouyan Wang , Huiling Tan
{"title":"Flexible and stable cycle-by-cycle phase-locked deep brain stimulation system targeting brain oscillations in the management of movement disorders","authors":"Xuanjun Guo , Alek Pogosyan , Jean Debarros , Shenghong He , Laura Wehmeyer , Fernando Rodriguez Plazas , Karen Wendt , Zixiao Yin , Ahmed Raslan , Thomas Hart , Francesca Morgante , Tim Denison , Erlick A. Pereira , Keyoumars Ashkan , Shouyan Wang , Huiling Tan","doi":"10.1016/j.brs.2025.09.002","DOIUrl":"10.1016/j.brs.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Precisely timed brain stimulation, such as phase-locked deep brain stimulation (PLDBS), offers a promising approach to modulating dysfunctional neural networks by enhancing or suppressing specific oscillations. However, its clinical application has been hindered by the lack of user-friendly systems and the challenge of real-time phase estimation amid stimulation artifacts.</div></div><div><h3>Material and method</h3><div>In this work, we developed a clinically translatable PLDBS framework that enables real-time, cycle-by-cycle stimulation using standard amplifiers and a computer-in-the-loop system. Our approach integrates Kalman filter-based artifact suppression and non-resonant oscillators for accurate phase tracking. We tested this system in a small clinical trial (<span><math><mrow><mi>n</mi><mo>=</mo><mn>4</mn></mrow></math></span>) targeting subthalamic nucleus (STN) stimulation at specific phases of cortical alpha and STN beta rhythms in patients with movement disorders during acute lead externalization following deep brain stimulation surgery.</div></div><div><h3>Result</h3><div>The system delivered stimulation with over <span><math><mrow><mn>90</mn><mo>%</mo></mrow></math></span> accuracy, within <span><math><mrow><mo>±</mo><mi>π</mi><mo>/</mo><mn>2</mn></mrow></math></span> for STN beta and <span><math><mrow><mo>±</mo><mi>π</mi><mo>/</mo><mn>4</mn></mrow></math></span> for cortical alpha. Stimulations delivered at different STN beta phases led to a significant difference in evoked potentials in STN local field potentials in all participants. STN beta-triggered stimulation showed potential phase-dependent modulation of finger-tapping velocity and amplitude in Parkinson's disease.</div></div><div><h3>Conclusion</h3><div>This study presents a flexible and stable pipeline for precise PLDBS with CE-marked devices and a computer-in-the-loop. Using this pipeline, we showed that PLDBS at different STN beta phases differentially modulates the evoked action potentials in the STN and motor behavior used to quantify bradykinesia, paving the way for further studies and clinical trials for PLDBS.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"18 5","pages":"Pages 1705-1717"},"PeriodicalIF":8.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain StimulationPub Date : 2025-09-01Epub Date: 2025-07-09DOI: 10.1016/j.brs.2025.07.006
Tapasi Brahma, Alexander Guillen, Jeffrey Moreno, Abhishek Datta, Yu Huang
{"title":"On the need of individually optimizing temporal interference stimulation of human brains due to inter-individual variability.","authors":"Tapasi Brahma, Alexander Guillen, Jeffrey Moreno, Abhishek Datta, Yu Huang","doi":"10.1016/j.brs.2025.07.006","DOIUrl":"10.1016/j.brs.2025.07.006","url":null,"abstract":"<p><strong>Introduction: </strong>Transcranial temporal interference stimulation (TI, TIS, or tTIS), also known as interferential stimulation (IFS), is able to focally stimulate deep brain regions, provided it is properly optimized. We previously presented an algorithm for optimizing TI using two arrays of electrodes and showed that it can achieve more focal stimulation compared to optimized high-definition transcranial electrical stimulation (HD-TES) and conventional optimized TI using two pairs of electrodes, especially in the deep brain areas such as the hippocampus. However, those modeling studies were only performed on an averaged head (MNI152 template) and three individual heads without exploring inter-individual variability. Existing TI works in the literature mostly utilize a common (possibly optimized) montage of two pairs of electrodes on different individual heads without considering inter-individual variability.</p><p><strong>Material and method: </strong>Here we aim to study the inter-individual variability of optimized TI by applying the same optimization algorithms on N = 25 heads using their individualized head models. Specifically, we compared the focality achieved by different stimulation techniques at six different regions of interest (ROI; right hippocampus, left dorsolateral prefrontal cortex, left motor cortex, right amygdala, right caudate, and left thalamus) under both individually optimized and unoptimized montages. We also conducted numerical sensitivity analysis on the individual optimization and performed phantom recordings to test our models.</p><p><strong>Results: </strong>As expected, there is a variability in focality achieved by TI of up to 1.2 cm at the same ROI across subjects due to inter-individual differences in the head anatomy and tissue conductivity. We show that optimized TI using two arrays of electrodes achieves higher focality than that from optimized HD-TES at the same level of modulation intensity at 5 of the 6 ROIs. Compared to using a common montage either optimized from the MNI152 template or from the literature, individually optimized TI using two pairs of electrodes improves the focality by up to 4.4 cm, and by up to 1.1 cm if using two arrays of electrodes. Focality achieved by the individual optimization is sensitive to random changes and can vary up to 9.3 cm due to the non-lienarity of TI physics. Experimental recordings on a head phantom confirms the drop in TI stimulation strength when using unoptimized montages as predicted by our in silico models.</p><p><strong>Conclusion: </strong>This work demonstrates the need of individually optimizing TI to target deep brain areas, and advocates against using a common head model and montage for TI modeling and experimental studies.</p>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":" ","pages":"1373-1388"},"PeriodicalIF":8.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain StimulationPub Date : 2025-09-01DOI: 10.1016/j.brs.2025.08.012
Benjamin Davidson , Kristiana Xhima , Rees Cosgrove , Clement Hamani , Renana Eitan , Ali Rezai , Suzanne LeBlang , Noah S. Philip , Nir Lipsman
{"title":"A roadmap for focused ultrasound applications in psychiatry: Proceedings of the 2024 symposium on focused ultrasound in psychiatry (FUS-PULSE)","authors":"Benjamin Davidson , Kristiana Xhima , Rees Cosgrove , Clement Hamani , Renana Eitan , Ali Rezai , Suzanne LeBlang , Noah S. Philip , Nir Lipsman","doi":"10.1016/j.brs.2025.08.012","DOIUrl":"10.1016/j.brs.2025.08.012","url":null,"abstract":"<div><div>Transcranial focused ultrasound (FUS) is an emerging neuromodulation modality that enables incisionless, spatially precise targeting of deep brain structures implicated in neuropsychiatric conditions. Growing clinical applications in FUS psychiatry encompass both transient and permanent bioeffects, including focal lesioning, neurostimulation, and targeted drug delivery.</div><div>In response to rapid advances in the field, an in-person multidisciplinary symposium, FUS-PULSE, was held in Toronto, Canada from June 5–7 2024. The meeting convened over 70 international experts across neurosurgery, psychiatry, neurology, psychology, radiology, neuroimaging, physics, and industry to evaluate critical challenges and chart a strategic path forward for the field of FUS psychiatry.</div><div>Key themes from FUS-PULSE are highlighted, including the need to integrate circuit-based precision psychiatry, navigating the evolving landscape of FUS devices and parameters, and advancing clinical applications across lesioning, neuromodulation, and drug delivery.</div><div>FUS-based interventions can complement existing behavioral, pharmacological and neuromodulatory treatments to expand options for patients with refractory psychiatric conditions. However, significant barriers remain in optimizing the technology including treatment parameters and developing clinical protocols. The field must prioritize standardized reporting methodologies, protocol harmonization and real-time monitoring of target engagement. High-intensity FUS lesioning, particularly targeting the anterior limb of the internal capsule, shows promise for major depressive disorder and obsessive-compulsive disorder. Advancements in microbubble-assisted lesioning techniques and target mapping for optimal clinical response will further expand targeting possibilities and improve treatment efficacy. FUS neuromodulation and drug delivery applications remain at an early stage of development with promising potential. A deeper understanding of bioeffects across devices, parameters, and brain targets will be critical for successful clinical translation.</div></div>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"18 5","pages":"Pages 1651-1662"},"PeriodicalIF":8.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain StimulationPub Date : 2025-09-01Epub Date: 2025-08-05DOI: 10.1016/j.brs.2025.07.019
Meng-Nan Liu, Xiao-Yu Tian, Wen-Can Fang, Rui Song, Fei Li, Zhi-Yuan Wang, Guan-Yi Lu, Ning Wu, Jin Li, Hong Li
{"title":"Magnetogenetics inspired by animal Magnetoreception: ΔTRPV4<sup>MagR</sup> as a novel magnetogenetic actuator enabling remote neuromodulation of brain circuits.","authors":"Meng-Nan Liu, Xiao-Yu Tian, Wen-Can Fang, Rui Song, Fei Li, Zhi-Yuan Wang, Guan-Yi Lu, Ning Wu, Jin Li, Hong Li","doi":"10.1016/j.brs.2025.07.019","DOIUrl":"10.1016/j.brs.2025.07.019","url":null,"abstract":"<p><strong>Introduction: </strong>The discovery of a novel magnetic actuator is critical for the application of magnetogenetic technique. However, whether MagR can perceive magnetic fields is ambiguous in previous studies that evoked great interest and debate.</p><p><strong>Material and method: </strong>Here, the fusion protein ΔTRPV4<sup>MagR</sup> is constructed by genetically linking MagR to the C-terminus of truncated TRPV4, and the magnetic perception capacity of MagR is read out by TRPV4 cation channel characteristics in vitro and in vivo.</p><p><strong>Results and conclusion: </strong>Upon magnetic stimulation, ΔTRPV4<sup>MagR</sup> expressing HEK293T cells exhibited calcium influx in a strength-dependent manner examined by the Fluo-4 experiment. While under 40 mT, 0.1 Hz magnetic stimulation, ΔTRPV4<sup>MagR</sup> induced calcium influx was more potent than Magneto 2.0 (ΔTRPV4<sup>Ferritin</sup>). Interestingly, the MagR of pigeon (cMagR) or human origin has superior magnetic sensitivity to that of drosophila origin (dMagR). Moreover, for the freely moving mice, ΔTRPV4<sup>cMagR</sup> expression successfully raises the intracellular calcium level of brain neurons and operates dopamine release from VTA dopaminergic neurons under magnetic stimulation. Remarkably, the effectiveness of ΔTRPV4<sup>cMagR</sup> is further validated by magnetic control of mice rotating around the body-axis and freezing-of-gait. This work not only witnesses the magnetoperceptive capacity of MagR, but also provides a promising effective means to manipulate specific neuron populations in brain circuits temporally and remotely.</p>","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":" ","pages":"1455-1469"},"PeriodicalIF":8.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}