Controllable stimulation and Advanced brain models for Enhancing Rehabilitation from Unconscious States

Disorders of consciousness (DoC) such as coma, and unresponsive wakefulness syndrome, affect individuals, their families, and society. Every year, 2.5 million people suffer from DoC caused by traumatic brain injury, and up to 80% die from premature interruption of life-supporting therapies. It is estimated that 25% of these patients could be conscious even without observable behavioral responses. Medical practitioners today can use brain stimulation as a means to assess the presence of consciousness and facilitate recovery. However, the high variability in brain stimulation effects challenges effective diagnosis, prognosis, and treatment. The absence of guiding principles leaves us with empirical decisions about where, how, and when to stimulate. CAERUS is an innovative initiative that aims to enhance consciousness readout and rehabilitation strategies by designing a new and more controllable stimulation protocol. Synergizing my profile as a theoretical physicist and neuroscientist, with the excellence of the host supervisor Prof. Deco in the field of computational neuroscience, and the secondment supervisor Prof. Massimini in the neurophysiology of consciousness, CAERUS will bridge the gap between theory and bedside applications. By establishing a theory-driven approach, I will characterize the principal sources of variability of stimulus effects, and provide a blueprint for precisely identifying where, how, and when it is more convenient to stimulate. Exploiting the predictive power of advanced brain models, I will test in silico a circuit-level stimulation protocol, that is expected to significantly reduce the variability of stimulus effects. Finally, I will validate the enhanced controllability of the new stimulation protocol in experimental tests in the laboratory. CAERUS's interdisciplinary approach and cutting-edge technology will pave the way for a novel strategy to stimulate the brain, aiming to translate our findings into tangible clinical applications.