Stereo-Electroencephalography-Guided Network Neuromodulation for Psychiatric Disorders: The Neurophysiology Monitoring Unit

Overview

Journal Oper Neurosurg (Hagerstown)

Specialty Neurosurgery

Date 2024 Aug 15

PMID 39145663

Authors

Anusha B Allawala

Kelly R Bijanki

Joshua Adkinson

Denise Oswalt

Evangelia Tsolaki

Sanjay Mathew

Raissa K Mathura

Eleonora Bartoli

Nicole Provenza

Andrew J Watrous

Jiayang Xiao

Victoria Pirtle

Madaline M Mocchi

Sameer Rajesh

Nabeel Diab

Jeffrey F Cohn

David A Borton

Wayne K Goodman

Nader Pouratian

Sameer A Sheth

Affiliations

Soon will be listed here.

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.

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