An electric bike for the brain

Using an electrode cap and an animated film, neuroscientist and psychologist Lilian Konicar and her team are investigating whether electrical brain stimulation can help children and adolescents with mental health conditions to better regulate their emotions.

Biology and Medicine

by Anna Stockhammer

November 2, 2026

Sadness, anxiety, anger: we humans constantly regulate our emotions – for instance by redirecting our attention or trying to assess a situation from a different angle. People with mental health conditions, however, find this even more difficult than it is in any case.

This can be observed in conditions such as depression, anxiety disorders, or social behavior disorders. Even though these conditions are very diverse, the common denominator is the challenge for those affected to manage their emotions. It is precisely this commonality that is of interest to Lilian Konicar of the ABC BRAIN Lab at the Medical University of Vienna. She does not want to focus solely on individual diagnoses. In her FWF-funded “eBrain” project she is pursuing a so-called transdiagnostic approach. “Mental health issues are a major concern in childhood and adolescence. If we can improve emotional regulation, children and adolescents with a whole range of mental health conditions could benefit from it.”

Where emotions are regulated

For this purpose, one first needs to look inside the brain. One of the areas that play an important role in the regulation of emotions is the ventromedial prefrontal cortex, which is located at the front of the brain. This is exactly the site addressed by Konicar’s study. The technique she uses is called transcranial direct current stimulation, or tDCS for short. The children and adolescents put on a cap equipped with electrodes that touch the scalp and deliver a weak electrical current.

Can Brain Stimulation Help?

Lilian Konicar conducts research at the ABC BRAIN Lab at the Medical University of Vienna on neurotherapies and their impact on emotions, thoughts, and behavior. In her FWF-funded project “eBrain,” she is investigating how electrical brain stimulation can alleviate emotionally distressing feelings in young people. The upcoming “INSPIRE” project, will be researching neurofeedback in patients with ME/CFS.

Konicar uses an analogy to explain what happens in this setup: “You can think of the brain as a bicycle.” It’s already working – but the electrical stimulation is designed to give it an extra boost. “We’re not a regular bike; we’re modern – we’re an e-bike,” smiles Konicar. In a way, the stimulation shifts the brain into an extra gear.

Konicar hopes that by supporting the areas involved in emotion regulation, children and adolescents might find it easier to control their feelings. And if emotion regulation improves, symptoms such as deep sadness, anxiety, or anger could subsequently become less intense.

Already tested in adults

Electrical brain stimulation is not a completely new thing, as it has been studied in adults for years. But the situation is different when it comes to children and adolescents. According to Konicar, this is a fundamental problem in medical and psychological research. “There’s still a focus on the 50-year-old white male and not on adolescents or women.”

Hence there needs to be a specific study to see whether the treatment works just as well in adolescents, and the research team has adapted the neurotherapy for this young target group. During brain stimulation, adults sometimes sit in front of a white wall for 20 minutes. “We’re making it a little cooler,” notes Konicar, explaining that during the stimulation adolescents between the ages of 13 and 18 watch excerpts from the animated film Inside Out, in which emotions themselves become characters in the action. This film is used by educational institutions such as the Harvard Graduate School of Education to illustrate and explain research on emotions and the human brain. In addition, the children and adolescents complete a computer-based training program where they practice emotion regulation, with the tasks automatically adapting to their performance. The better someone gets, the more difficult the tasks become – similar to reaching higher levels in a video game.

Two intensive weeks

Detailed measurements are taken before and after the two-week treatment and the adolescents and their parents complete questionnaires. Using the computer, the researchers examine how well the respondents recognize emotions in facial expressions. This is supplemented by eye-tracking as well as measurements using EEG and magnetic resonance imaging.

It is not just about brain processes, but Konicar and her team assess three different aspects: what do the adolescents themselves report? Does their behavior change during experiments? And can changes be detected in the brain or in physiological measurements?

One month and three months later, the adolescents are interviewed again and invited to participate in experiments. The team does this because it would be particularly interesting to see whether, in case the brain stimulation is effective, any potential effects persist beyond the two-week treatment period.

A strictly controlled study design is intended to show whether the stimulation makes a difference. Some of the adolescents receive the actual brain stimulation, while others do not. Otherwise, there are no differences: they all wear the same cap, feel the same initial tingling sensation during the electrode check, watch the same movie, and complete the same training. This is a triple-blind study, meaning that neither the adolescents nor Konicar and her team know who is in which group during the study. And even those who subsequently analyze the data do not initially know the group assignments. More than 90 adolescents have already completed the study, and data collection will continue for just a few more weeks. The ultimate goal is clear: “We want the adolescents to feel better,” avows Konicar. In the long term, evidence-based neurotherapies could become an additional treatment option.

Controlling the brain itself

While the “eBrain” project is about to conclude soon, Konicar is already launching another FWF-funded study. In this case it is not about providing external electrical stimulation to the brain, but about the patients learning to influence their own brain activity.

The new “INSPIRE” project is aimed at adolescents and adults with myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS for short. The condition can include symptoms such as severe fatigue and cognitive impairments. This time around, Konicar is focusing on neurofeedback.

The key difference from brain stimulation is that neurofeedback is active. “People have to do something and learn something for themselves,” notes Konicar. Measured by means of an EEG, their brain activity is displayed to participants on a screen in real time.

In simple terms, the process works like a game: first, a symbol on a screen indicates whether brain activity should be increased or decreased. Then, the participant’s own activity is displayed as an image – for example as a bird flying higher or lower. Participants must experiment to find out which thoughts or mental images allow them to move the bird in the desired direction.

There is no silver bullet strategy. From her previous work with neurofeedback, Konicar is familiar with a wide variety of approaches: some people imagine snowboarding or a tennis serve, others a roller coaster ride; some think of a color or do mental arithmetic. The key is for them to figure out for themselves what works.

Training based on individual resilience

Konicar and her team aim to tailor the training to the individual resilience of ME/CFS patients. The plan is for two to three sessions per week, but depending on the shape the patient is in , these may be spread out over several weeks. The study foresees participation by a total of 60 adolescents and adults.

Measurements will include quality of life, fatigue, sleep, pain, and depressive symptoms. In addition the patients will undergo a grip strength test, an EEG at rest, and an experiment. It remains to be seen, whether the training actually helps with ME/CFS, as the project is still in its early stages. But it builds on the question that has long been at the heart of Konicar’s research: how can the brain, emotions, and behavior be influenced together?

In “eBrain,” the brain receives a small external electrical nudge. In “INSPIRE,” patients are expected to learn to adjust the controls themselves.

About the researcher

Lilian Konicar is a trained clinical psychologist and psychotherapist who conducts research at the ABC BRAIN Lab at the Medical University of Vienna. Her work focuses on neurotherapies and the question of how changes in brain activity relate to emotions, thoughts, and behavior. Funded by the Austrian Science Fund FWF, her “eBrain” project (2021–2026) investigates electrical brain stimulation to improve emotional regulation in adolescents with mental health conditions. With the “INSPIRE” project, likewise funded by the FWF, Konicar will investigate neurofeedback in adolescents and adults with ME/CFS.