Reshaping cortical circuits through stimulation represents an emerging therapy for
the restoration of cognitive function1–5, yet the biological mechanisms that underlie
its effects remain largely unexplored in humans. Here, to directly investigate the
mechanisms of neuromodulation elicited by human brain stimulation, we developed
an ex vivo platform that integrates microelectrode array stimulation with simultaneous
recording and single-nucleus genomics from resected temporal cortex obtained from
patients undergoing neurosurgery. We found that stimulation strengthens cell
assemblies and then linked this effect to cell-type-specific gene regulatory networks.
We further demonstrated the generalizability of these findings by identifying common
cell-type-specific gene expression signatures in the human cortex following in vivo
stimulation. Together, our results establish a foundation for identifying targetable
genetic signatures linked with physiology that may be harnessed for therapeutic
benefit via neuromodulation strategies.