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Four dimensions of individualization in brain stimulation for psychiatric disorders: context, target, dose, and timing

Neuropsychopharmacology volume 50, pages 857–870 (2025)Cite this article

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A Correction to this article was published on 18 June 2025

This article has been updated

Abstract

Non-invasive Brain Stimulation (NIBS) technologies, including transcranial electrical (tES) and magnetic (TMS) stimulation, have emerged as promising interventions for various psychiatric disorders. FDA-approved TMS protocols in depression, OCD and nicotine use disorder provide a meaningful improvement. Treatment efficacy however remains inconsistent across individuals, and one relevant reason is intervention effect variability based on individual factors. There is a growing effort to develop individualized interventions, reinforced recently by FDA approval of a new TMS protocol that includes individualized fMRI-based targeting along with other modifications with higher reported effect size than previous “one size fits all” protocols. This paper discusses the dimensions for individualizing tES/TMS protocols to enhance therapeutic efficacy. We propose a multifaceted approach to personalizing NIBS, considering four levels: (1) context, (2) target, (3) dose, and (4) timing. By addressing inter- and intra-individual variability, we highlight a path toward precision medicine using individualized Brain Stimulation to treat psychiatric diseases. Despite challenges and limitations, this approach encourages broader and more systematic adoption of personalized Brain Stimulation techniques to improve clinical outcomes.

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Fig. 1: NIBS individualization.

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Change history

  • 19 May 2025

    The original online version of this article was revised: The copyright holder for this article was incorrectly given as ‘This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025’ but should have been ‘The Author(s), under exclusive licence to American College of Neuropsychopharmacology 2025’.

  • 18 June 2025

    A Correction to this paper has been published: https://doi.org/10.1038/s41386-025-02134-y

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Funding

Research reported in this publication was supported by the University of Minnesota’s MnDRIVE (Minnesota’s Discovery, Research and Innovation Economy) initiative awarded to GS and the University of Minnesota’s Medical Discovery Team on Addiction (MDTA). AO also acknowledges the support of the Minnesota Partnership for Biotechnology & Medical Genomics

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA

    Ghazaleh Soleimani, Kelvin O. Lim & Hamed Ekhtiari

  2. Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA

    Ghazaleh Soleimani & Alexander Opitz

  3. Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany

    Michael A. Nitsche

  4. Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, Bielefeld, Germany

    Michael A. Nitsche

  5. Germany Center for Mental Health (DZPG) Center Bochum, Bochum, Germany

    Michael A. Nitsche

  6. Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Colleen A. Hanlon

  7. BrainsWay, Burlington, MA, 01803, USA

    Colleen A. Hanlon

  8. Laureate Institute for Brain Researches (LIBR), Tulsa, OK, USA

    Hamed Ekhtiari

Authors
  1. Ghazaleh Soleimani
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  2. Michael A. Nitsche
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  3. Colleen A. Hanlon
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  4. Kelvin O. Lim
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  5. Alexander Opitz
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  6. Hamed Ekhtiari
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Contributions

GS developed the idea under the supervision of HE. GS wrote the main manuscript based on inputs from HE, MAN, CH, AO, and KOL. GS developed Figure.

Corresponding authors

Correspondence to Ghazaleh Soleimani or Hamed Ekhtiari.

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Competing interests

MAN is in the scientific advisory boards of Neuroelectrics, and Precisis. CH is a member of BrainsWay’s senior leadership (Nov. 2022) and has a financial interest in BrainsWay. She has previously served on an advisory board for Welcony-Magstim and as a consultant for BrainsWay and Roswell Park Cancer Center. AO is an inventor on patents and patent applications describing methods and devices for non-invasive Brain Stimulation. Research reported in this publication was supported by the University of Minnesota’s MnDRIVE (Minnesota’s Discovery, Research and Innovation Economy) initiative awarded to GS and the University of Minnesota’s Medical Discovery Team on Addiction (MDTA). AO also acknowledges the support of the Minnesota Partnership for Biotechnology & Medical Genomics. The remaining authors have nothing to disclose

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Soleimani, G., Nitsche, M.A., Hanlon, C.A. et al. Four dimensions of individualization in brain stimulation for psychiatric disorders: context, target, dose, and timing. Neuropsychopharmacol. 50, 857–870 (2025). https://doi.org/10.1038/s41386-025-02094-3

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