“Closed Loop Enhancement and Neural Decoding of Human Cognitive Control”, Ishita Basu, Ali Yousefi, Britni Crocker, Rina Zelmann, Angelique C. Paulk, Noam Peled, Kristen K. Ellard, Daniel S. Weisholtz, G. Rees Cosgrove, Thilo Deckersbach, Uri T. Eden, Emad N. Eskandar, Darin D. Dougherty, Sydney S. Cash, Alik S. Widge2020-09-16 (, ; similar)⁠:

Cognitive control is the ability to withhold a default, prepotent response in favor of a more adaptive choice. Control deficits are common across mental disorders, including depression, anxiety, and addiction. Thus, a method for improving cognitive control could be broadly useful in disorders with few effective treatments.

Here, we demonstrate closed-loop enhancement of one aspect of cognitive control by direct brain stimulation in humans. We stimulated internal capsule/striatum in participants undergoing intracranial epilepsy monitoring as they performed a cognitive control/conflict task. Stimulation enhanced performance, with the strongest effects from dorsal capsule/striatum stimulation.

We then developed a framework to detect control lapses and stimulate in response. This closed-loop approach produced larger behavioral changes than open-loop stimulation, with a slight improvement in performance change per unit of energy delivered. Finally, we decoded task performance directly from activity on a small number of electrodes, using features compatible with existing closed-loop brain implants.

Our findings are proof of concept for a new approach to treating severe mental disorders, based on directly remediating underlying cognitive deficits.