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Review
. 2023 Mar 23:17:1085173.
doi: 10.3389/fnhum.2023.1085173. eCollection 2023.

On closed-loop brain stimulation systems for improving the quality of life of patients with neurological disorders

Abdelkader Nasreddine Belkacem  1 , Nuraini Jamil  2 , Sumayya Khalid  2 , Fady Alnajjar  2   3
Affiliations
Review

On closed-loop brain stimulation systems for improving the quality of life of patients with neurological disorders

Abdelkader Nasreddine Belkacem et al. Front Hum Neurosci. .

Abstract

Emerging brain technologies have significantly transformed human life in recent decades. For instance, the closed-loop brain-computer interface (BCI) is an advanced software-hardware system that interprets electrical signals from neurons, allowing communication with and control of the environment. The system then transmits these signals as controlled commands and provides feedback to the brain to execute specific tasks. This paper analyzes and presents the latest research on closed-loop BCI that utilizes electric/magnetic stimulation, optogenetic, and sonogenetic techniques. These techniques have demonstrated great potential in improving the quality of life for patients suffering from neurodegenerative or psychiatric diseases. We provide a comprehensive and systematic review of research on the modalities of closed-loop BCI in recent decades. To achieve this, the authors used a set of defined criteria to shortlist studies from well-known research databases into categories of brain stimulation techniques. These categories include deep brain stimulation, transcranial magnetic stimulation, transcranial direct-current stimulation, transcranial alternating-current stimulation, and optogenetics. These techniques have been useful in treating a wide range of disorders, such as Alzheimer's and Parkinson's disease, dementia, and depression. In total, 76 studies were shortlisted and analyzed to illustrate how closed-loop BCI can considerably improve, enhance, and restore specific brain functions. The analysis revealed that literature in the area has not adequately covered closed-loop BCI in the context of cognitive neural prosthetics and implanted neural devices. However, the authors demonstrate that the applications of closed-loop BCI are highly beneficial, and the technology is continually evolving to improve the lives of individuals with various ailments, including those with sensory-motor issues or cognitive deficiencies. By utilizing emerging techniques of stimulation, closed-loop BCI can safely improve patients' cognitive and affective skills, resulting in better healthcare outcomes.

Keywords: brain computer interface (BCI); brain stimulation; closed-loop BCI; neurodegenerative diseases; psychiatric diseases.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The closed-loop system based on brain stimulation with feedback.
Figure 2
Figure 2
A brain-computer interface (BCI)-based control/communication of closed-loop brain feedback or stimulation: methods, applications, and effects.
Figure 3
Figure 3
The PRISMA flowchart. EC, exclusion criteria; IC, inclusion criteria; n, number of publications.
Figure 4
Figure 4
Yearly publication trend based on the research keywords.
Figure 5
Figure 5
Publication trend based on brain stimulation. DBS, deep brain stimulation; TMS, transcranial magnetic stimulation; tDCS, transcranial direct current stimulation; tACS, transcranial alternating current stimulation.
Figure 6
Figure 6
Distribution of articles selected according to the brain stimulation and type of disease. DBS, deep brain stimulation; TMS, transcranial magnetic stimulation; tDCS, transcranial direct current stimulation; tACS, transcranial alternating current stimulation.
Figure 7
Figure 7
Bibliometric analysis of the appearance of keywords for closed-loop BCI based brain stimulation.
See this image and copyright information in PMC

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