Challenges and future trends in wearable closed-loop neuromodulation to efficiently treat methamphetamine addiction

Abstract

Achieving abstinence from drugs is a long journey and can be particularly challenging in the case of methamphetamine, which has a higher relapse rate than other drugs. Therefore, real-time monitoring of patients’ physiological conditions before and when cravings arise to reduce the chance of relapse might help to improve clinical outcomes. Conventional treatments, such as behavior therapy and peer support, often cannot provide timely intervention, reducing the efficiency of these therapies. To more effectively treat methamphetamine addiction in real-time, we propose an intelligent closed-loop transcranial magnetic stimulation (TMS) neuromodulation system based on multimodal electroencephalogram–functional near-infrared spectroscopy (EEG-fNIRS) measurements. This review summarizes the essential modules required for a wearable system to treat addiction efficiently. First, the advantages of neuroimaging over conventional techniques such as analysis of sweat, saliva, or urine for addiction detection are discussed. The knowledge to implement wearable, compact, and user-friendly closed-loop systems with EEG and fNIRS are reviewed. The features of EEG and fNIRS signals in patients with methamphetamine use disorder are summarized. EEG biomarkers are categorized into frequency and time domain and topography-related parameters, whereas for fNIRS, hemoglobin concentration variation and functional connectivity of cortices are described. Following this, the applications of two commonly used neuromodulation technologies, transcranial direct current stimulation and TMS, in patients with methamphetamine use disorder are introduced. The challenges of implementing intelligent closed-loop TMS modulation based on multimodal EEG-fNIRS are summarized, followed by a discussion of potential research directions and the promising future of this approach, including potential applications to other substance use disorders.

Monte Carlo-Based Optical Simulation of Optical Distribution in Deep Brain Tissues Using Sixteen Optical Sources

“…These techniques have the benefit of high specificity and non-radiative safety for the purposes of diagnosis and therapy, and they have been used in brain imaging applications. Optical imaging, such as functional near-infrared spectroscopy (fNIRS) with lights in and out, has been used for the detection of brain functions [ 2 ]. Photoacoustic imaging (PAI), with light in and sound out, has achieved the brain imaging of large and small animals, as well as of human brains [ 3 ].…”

Uncovering transcriptomic biomarkers for enhanced diagnosis of methamphetamine use disorder: a comprehensive review

“…Biomarker-level changes can indicate an increased likelihood of relapse, enabling clinicians to implement suitable interventions, such as behavioral therapy or medication, to prevent or attenuate the risk of relapse. Therefore, the real-time monitoring of a patient’s physiological status before and during cravings can help reduce the risk of relapse and improve clinical outcomes ( 28 ).…”