Goals of the Research Network
In response, the GCBS brings together leading experts in the field of brain stimulation from basic neuroscience, neurophysiology and clinical psychiatry to establish a cooperative research network. The consortium aims to translate preclinical findings from animal and human models into clinical proof-of-principle and proof-of-efficacy studies and to generate the following deliverables:
i) a catalogue of improved brain stimulation interventions for therapeutic application in common psychiatric disorders.
ii) a basic research strategy that allows identifying areas that have potential for brain stimulation application based on an advanced understanding of the mechanisms of action as well as on clinical trials.
The GCBS Consortium consists of 7 leading experts in brain stimulation across Germany who together are responsible for the implementation of the different workpackages of the GCBS Project. To provide you a better overview you will find here more information about each leading professor.
Data from animal experimental, structural and functional imaging as well as neurophysiological studies converge to indicate that psychiatric disorders exhibit more or less reversible changes in neural networks. Several key regions and hubs within networks involved in the pathophysiology of common psychiatric disorders are located in the prefrontal cortex (PFC). Targeted stimulation of PFC subregions and closely connected areas by non-invasive and invasive brain stimulation (BS) allows modulation within dependent networks that translate into functional and behavioural modifications. BS methods balancing deregulated neural network connectivity may therefore provide a new causative therapeutic paradigm for the treatment of psychiatric disorders. There is a clear need for such novel principles of effective treatment as nearly every fourth patient with a psychiatric disorder does not tolerate or sufficiently respond to standard interventions, leading to impaired quality of life, significant morbidity and mortality, as well as high socioeconomic costs.
Strong preclinical and clinical evidence suggests that non-invasive as well as invasive BS is therapeutically effective in defined common psychiatric disorders. For instance, in major depressive disorders (MDD) the clinical evidence includes the application of electroconvulsive therapy (ECT), which is still the most effective antidepressant intervention to date, three large randomised controlled trials (RCT) with prefrontal repetitive transcranial magnetic stimulation (rTMS), one large RCT with prefrontal transcranial direct current stimulation (tDCS) and recent deep brain stimulation (DBS) trials. Methodologically, there is great potential for further developing BS towards individualized and efficacious high-end approaches, e.g. closed loop BS. Such development, however, requires the advanced understanding of
Examining the effects of PFC BS at different levels of their neurobiological interaction will therefore allow developing BS towards a new array of safe and efficacious therapeutic interventions for common psychiatric disorders.
A translational research strategy will be implemented to direct preclinical research towards clinical applications (= forward translation) and providing clinical information to preclinical scientists (= reverse translation) – by bringing together experienced researchers in this field. This strategy will be based on interactive preclinical subprojects and clinical trials.
The overarching aim of the proposed consortium that includes several specifc aims is therefore to improve acute and long-term health care in patients suffering from common psychiatric disorders by developing and implementing Brain Stimulation (BS) strategies as novel neural network-based array of therapeutic interventions. The consortium responds to the limitation of current treatment strategies in psychiatric disorders by establishing the GCBS to develop novel BS-based treatment and health care strategies for difficult-to-treat conditions.
Following an integrative approach we understand our research project as an epistemological process which encompasses basic research, clinical research and applied research.
Basic research strategies focus on the investigation of fundamental physiological mechanisms and neurobiological effects of Brain Stimulation on different levels of network physiology, neural activity, neurotransmission and synaptic plasticity. Furthermore investigations regarding the cortex physiology in humans will be push forward in order to provide novel insights in the interaction of Brain stimulation and functional states of neural circuits in health and disease (= state dependency of Brain Stimulation effects) .
Clinical research investigates the dynamics of Brain Stimulation on specific psychiatric symptoms e.g. reduced cognitive control. In parallel disorder-directed Brain stimulation strategies will be developed using comparatives fMRI studies. Moreover research efforts target on the modification of current Brain Stimulation protocols and clinical applications based on preclinical data in order to achieve improved efficacy (= enhanced Brain Stimulation therapy).
Applied research activities include investigations regarding safety aspects of Brain Stimulation and its efficacy in treatment of psychiatric disorders (e.g. Major depression) by translating preclinical approaches into clinical applications by Proof-of-Principle (PoP) or Proof-of-Efficacy (PoE) studies. Optimization processes towards enhanced Brain Stimulation therapy will be initiated, for instance the potential of Brain Stimulation to augment current forms of psychiatric treatments like psychotherapy or pharmacotherapy.
The following questions will be addressed by the GCBS throughout all Work Packages (WP) with different emphasis.
The answers to this question will allow adopting the respective strategy into clinical practice, or lead to rejecting the approach for a wider clinical application, respectively.
The GCBS will be advised and annually evaluated by an international Scientific Advisory Board (SAB).
The following internationally reputable experts have already agreed to serve on the SAB