Structural and Functional Connectivity Predict the Effects of Direct Brain Stimulation on Memory

Memory enhancement through direct brain stimulation holds substantial clinical promise, yet inconsistent outcomes have limited its therapeutic translation. This study shows that the effectiveness of closed-loop brain stimulation for memory improvement is determined by the structural network architecture of the stimulation target. Sites more deeply embedded within white-matter pathways connecting a distributed verbal encoding network yield the greatest mnemonic benefits when stimulation is delivered adaptively during poor encoding states. These findings establish a principled, network-based rationale for precision-guided neuromodulation: optimizing both the target's structural embedding and the timing of stimulation delivery are necessary and complementary conditions for reliable, individualized memory enhancement.