Over the past century, advances in neuroimaging and cognitive neuroscience reshaped how we understand psychiatric disorders, expanding the portfolio of evidence-based treatments while routine clinical practice has mostly relied on trial and error. Precision medicine has steadily extended to psychiatry, and today we can target specific cortical or subcortical brain regions within defined pathological circuits to individualize treatments to particular symptoms. Neuromodulation sits at the frontier of this shift in psychiatry, with extensive ongoing research to identify optimal treatment targets and protocols personalized to individuals’ neural circuitry.

Neuromodulation using neuronavigation achieves precise clinical target identification through computer-assisted integration of multimodal brain imaging. Neuron avigated approaches have been central to deep brain stimulation (DBS) for decades. More recent advances in functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) extended this framework from isolated gray matter nuclei toward pathological neural circuits through resting-state functional connectivity analysis and tractography, which enabled the identification of connectomic fingerprints associated with specific symptom clusters, or circuitopathies, a concept particularly relevant to psychiatric disorders, such as obsessive-compulsive disorder and depression.