title: Cyborg psychiatry to ensure agency and autonomy in mental disorders. A proposal for neuromodulation therapeutics.
abstract: Neuromodulation therapeutics-as repeated Transcranial Magnetic Stimulation (rTMS) and neurofeedback-are valuable tools for psychiatry. Nevertheless, they currently face some limitations: rTMS has confounding effects on neural activation patterns, and neurofeedback fails to change neural dynamics in some cases. Here we propose how coupling rTMS and neurofeedback can tackle both issues by adapting neural activations during rTMS and actively guiding individuals during neurofeedback. An algorithmic challenge then consists in designing the proper recording, processing, feedback, and control of unwanted effects. But this new neuromodulation technique also poses an ethical challenge: ensuring treatment occurs within a biopsychosocial model of medicine, while considering both the interaction between the patients and the psychiatrist, and the maintenance of individuals' autonomy. Our solution is the concept of Cyborg psychiatry, which embodies the technique and includes a self-engaged interaction between patients and the neuromodulation device.
authors.affiliation: Unité de Neurophysiologie, Psychophysiologie et Neurophénoménologie, Solaris, Pôle de Psychiatrie Universitaire, Hôpital Sainte-Marguerite Marseille, France ; Laboratoire de Neurosciences Cognitives, UMR CNRS 7291, 31 Aix-Marseille Université, Site St Charles Marseille, France.
authors.forename: Jean-Arthur
authors.initials: JA
authors.lastname: Micoulaud-Franchi
authors.forename: Guillaume
authors.initials: G
authors.lastname: Fond
authors.forename: Guillaume
authors.initials: G
authors.lastname: Dumas
keywords: brain computer interface; brain-state-dependent stimulation; mental disorder; neurocognitive networks; neurofeedback; non-invasive brain stimulation; psychiatry; transcranial magnetic stimulation
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