In an effort to create a more personalized approach to treating depression and to better understand its underlying circuitry, Amit Etkin of Stanford University is studying the use
of repetitive transcranial magnetic stimulation (rTMS) in combination with whole-brain EEG and functional MRI. According to Etkin:
By stimulating brain activity and assessing circuit-level changes as they happen, we can garner important insight into what is wrong in depression and how to fix it in an optimized, personalized matter.
I’ll give you one concrete example: It matters whether stimulation is done to an area in the patient’s brain that is abnormal or normal. For any treatment in any psychiatric disorder, we don’t actually know whether the goal of treatment is to normalize abnormal brain activity or to engage compensatory circuitry. It’s a fundamental question that we cannot answer without a direct tool for manipulating brain systems and assessing the effects.