Language

English

Publication Date

9-1-2024

Journal

Operative Neurosurgery

DOI

10.1227/ons.0000000000001122

PMID

39145663

PMCID

PMC11315541

PubMedCentral® Posted Date

4-9-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background and objectives: Recent advances in stereotactic and functional neurosurgery have brought forth the stereo-electroencephalography approach which allows deeper interrogation and characterization of the contributions of deep structures to neural and affective functioning. We argue that this approach can and should be brought to bear on the notoriously intractable issue of defining the pathophysiology of refractory psychiatric disorders and developing patient-specific optimized stimulation therapies.

Methods: We have developed a suite of methods for maximally leveraging the stereo-electroencephalography approach for an innovative application to understand affective disorders, with high translatability across the broader range of refractory neuropsychiatric conditions.

Results: This article provides a roadmap for determining desired electrode coverage, tracking high-resolution research recordings across a large number of electrodes, synchronizing intracranial signals with ongoing research tasks and other data streams, applying intracranial stimulation during recording, and design choices for patient comfort and safety.

Conclusion: These methods can be implemented across other neuropsychiatric conditions needing intensive electrophysiological characterization to define biomarkers and more effectively guide therapeutic decision-making in cases of severe and treatment-refractory disease.

Keywords

Humans, Deep Brain Stimulation, Electroencephalography, Mental Disorders, Neurophysiological Monitoring, Stereotaxic Techniques, Deep brain stimulation, Intracranial EEG, Ventral capsule, Ventral striatum, Subcallosal cingulate, Subgenual cingulate, Depression

Published Open-Access

yes

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