The Systems-Based Neurotechnology for Emerging Therapies (SUBNETS) program aims to improve the health of military service members by using neurotechnology as the basis for effective, informed and precise treatments of neuropsychiatric illnesses. The effects of such illnesses, brought on by war, traumatic injuries and other experiences, remain challenging to treat.
Current treatment approaches – surgery, medications and psychotherapy – can often help alleviate the worst effects of illnesses such as major depression and post-traumatic stress, but they are imprecise and not universally effective. Through SUBNETS, DARPA seeks to generate the knowledge and technology required to deliver relief to patients with an otherwise intractable neuropsychiatric illness.
The SUBNETS vision is distinct from current therapeutic approaches in that it seeks to create an implanted, closed-loop diagnostic and therapeutic system for treating, and possibly even curing, neuropsychiatric illness. That vision is premised on the understanding that brain function – and dysfunction, in the case of neuropsychiatric illness – plays out across distributed neural systems, as opposed to being strictly relegated to distinct anatomical regions of the brain.
The program also aims to take advantage of neural plasticity, a feature of the brain by which the organ’s anatomy and physiology alter over time to support normal brain function. Because of plasticity, researchers are optimistic that by using SUBNETS-developed technology the brain can be trained or treated to restore normal functionality following injury or the onset of neuropsychiatric illness.
By measuring pathways involved in complex systems-based brain disorders, including post-traumatic stress, major depression, borderline personality, general anxiety, traumatic brain injury, substance abuse and addiction and fibromyalgia/chronic pain, SUBNETS pursues the ability to record and model how these systems function in both normal and abnormal conditions among volunteers seeking treatment for unrelated neurologic disorders and impaired clinical research participants.
SUBNETS uses these models to determine safe and effective therapeutic stimulation methodologies. The models will be adapted onto next-generation, closed-loop neural stimulators that exceed currently developed capacities for simultaneous stimulation and recording, with the goal of providing investigators and clinicians the unprecedented ability to record, analyze and stimulate multiple brain regions for therapeutic purposes. DARPA intends for the SUBNETS program to culminate in technology demonstrations and the submission of devices for approval by the U.S. Food and Drug Administration.
SUBNETS is designed to advance neuropsychiatry beyond the realm of dialogue-driven observations and into the realm of therapy driven by quantifiable characteristics of the neural state. In doing so, the program would create one of the most comprehensive datasets of systems-based brain activity ever recorded. If successful, SUBNETS will lead to informed and precise neurotechnological therapy to produce major improvements in quality of life for service members and veterans with neuropsychological illness who have very few options with existing therapies.
SUBNETS is informed by independent Ethical, Legal, and Social Implications (ELSI) experts to help DARPA proactively identify potential issues related to the use of neurotechnology. Communications with ELSI experts supplement the standard oversight provided by institutional review boards that govern human clinical studies and animal use.