By Hilgo Bruining (University Medical Center, Amsterdam, the Netherlands). November 7th, 2022.

New treatment developments for neurodevelopmental such as autism have failed to reach clinical implementation due to inter- and intraindividual variability across biological and clinical dimensions. To resolve this situation, we propose to use the framework of excitation/inhibition imbalances in resting-state EEG measurements to dissect an important element of the extant variability. To this end, we use a definition of E/I balance that is inspired by computational modeling of critical brain dynamics to measure a functional network-level E/I ratio (fEI). I will highlight how the application of the criticality framework and the fE/I measure can aid to understand variability in diagnostic and treatment responsivity in the context of autism spectrum disorder. It appears that both sub and supercritical regimes can contribute to developmental pathophysiology with different phenotypic consequences. In particular, I will show how the fE/I measure is sensitive to novel E/I balance shifting treatments across several of our EEG-assisted trial studies and how this application can be used for prediction of treatment effects in future patients.

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