Outlook: Towards personalized connectomic deep brain stimulation

In light of heterogeneous phenotypes across pathologies and patients, the treatment of network disorders via neuromodulation techniques—among them deep brain stimulation (DBS)—is largely complicated. This emphasizes the need for more precisely tailoring these techniques to the individual patient. The approach of this chapter to the topic of personalized DBS is twofold: First, we review evidence that points to distinct—and potentially transdiagnostic—symptom profiles among patients mapping to different neuronal connectivity profiles, which mediate beneficial neuromodulatory outcome or side effects. Approaching neuromodulation targets as “sweet spots” within a therapeutic tract, while avoiding “sour spots” within detrimental connectivity not only allows for individualized treatment planning, but also for a better understanding of disease mechanisms. Second, we discuss in detail the applications of normative and patient-specific data in connectomic studies. This methods review is motivated by the scope of personalization strategies in the future of neuromodulation technology.