title: Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases.
abstract: Brain stimulation, a therapy increasingly used for neurological and psychiatric disease, traditionally is divided into invasive approaches, such as deep brain stimulation (DBS), and noninvasive approaches, such as transcranial magnetic stimulation. The relationship between these approaches is unknown, therapeutic mechanisms remain unclear, and the ideal stimulation site for a given technique is often ambiguous, limiting optimization of the stimulation and its application in further disorders. In this article, we identify diseases treated with both types of stimulation, list the stimulation sites thought to be most effective in each disease, and test the hypothesis that these sites are different nodes within the same brain network as defined by resting-state functional-connectivity MRI. Sites where DBS was effective were functionally connected to sites where noninvasive brain stimulation was effective across diseases including depression, Parkinson's disease, obsessive-compulsive disorder, essential tremor, addiction, pain, minimally conscious states, and Alzheimer's disease. A lack of functional connectivity identified sites where stimulation was ineffective, and the sign of the correlation related to whether excitatory or inhibitory noninvasive stimulation was found clinically effective. These results suggest that resting-state functional connectivity may be useful for translating therapy between stimulation modalities, optimizing treatment, and identifying new stimulation targets. More broadly, this work supports a network perspective toward understanding and treating neuropsychiatric disease, highlighting the therapeutic potential of targeted brain network modulation.
authors.affiliation: Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114; Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA 02129; foxmdphd@gmail.com.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Fox
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA 02129; Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114; Department of Psychology, Center for Brain Science, Harvard University, Cambridge, MA 02138;
authors.forename: Randy L
authors.initials: RL
authors.lastname: Buckner
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA 02129;
authors.forename: Hesheng
authors.initials: H
authors.lastname: Liu
authors.affiliation: Cerebral Imaging Centre, Douglas Mental Health Institute, Verdun, QC, Canada H4H 1R3; Departments of Psychiatry and Biomedical Engineering, McGill University, Montreal, QC, Canada H3A 2B4;
authors.forename: M Mallar
authors.initials: MM
authors.lastname: Chakravarty
authors.affiliation: Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, ON, Canada M5T 2S8; and Krembil Neuroscience Center, University of Toronto, Toronto, ON, Canada M5T 2S8.
authors.forename: Andres M
authors.initials: AM
authors.lastname: Lozano
authors.affiliation: Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215;
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual-Leone
mesh_terms: D001921:Brain / Q000503:physiopathology*; D046690:Deep Brain Stimulation; D006801:Humans; D001523:Mental Disorders / Q000503:physiopathology*; D009415:Nerve Net / Q000503:physiopathology*; D009422:Nervous System Diseases / Q000503:physiopathology*; D012146:Rest
keywords: TMS; clinical application; human connectome project; neurosurgery; tDCS