Dataset Information

Stereo-EEG-guided network modulation for psychiatric disorders: Surgical considerations.

ABSTRACT:

Background

Deep brain stimulation (DBS) and other neuromodulatory techniques are being increasingly utilized to treat refractory neurologic and psychiatric disorders.

Objective

/Hypothesis: To better understand the circuit-level pathophysiology of treatment-resistant depression (TRD) and treat the network-level dysfunction inherent to this challenging disorder, we adopted an approach of inpatient intracranial monitoring borrowed from the epilepsy surgery field.

Methods

We implanted 3 patients with 4 DBS leads (bilateral pair in both the ventral capsule/ventral striatum and subcallosal cingulate) and 10 stereo-electroencephalography (sEEG) electrodes targeting depression-relevant network regions. For surgical planning, we used an interactive, holographic visualization platform to appreciate the 3D anatomy and connectivity. In the initial surgery, we placed the DBS leads and sEEG electrodes using robotic stereotaxy. Subjects were then admitted to an inpatient monitoring unit for depression-specific neurophysiological assessments. Following these investigations, subjects returned to the OR to remove the sEEG electrodes and internalize the DBS leads to implanted pulse generators.

Results

Intraoperative testing revealed positive valence responses in all 3 subjects that helped verify targeting. Given the importance of the network-based hypotheses we were testing, we required accurate adherence to the surgical plan (to engage DBS and sEEG targets) and stability of DBS lead rotational position (to ensure that stimulation field estimates of the directional leads used during inpatient monitoring were relevant chronically), both of which we confirmed (mean radial error 1.2±0.9 mm; mean rotation 3.6±2.6°).

Conclusion

This novel hybrid sEEG-DBS approach allows detailed study of the neurophysiological substrates of complex neuropsychiatric disorders.

SUBMITTER: Sheth SA

PROVIDER: S-EPMC10787578 | biostudies-literature | 2023 Nov-Dec

REPOSITORIES: biostudies-literature

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Publications

Stereo-EEG-guided network modulation for psychiatric disorders: Surgical considerations.

Sheth Sameer A SA Shofty Ben B Allawala Anusha A Xiao Jiayang J Adkinson Joshua A JA Mathura Raissa K RK Pirtle Victoria V Myers John J Oswalt Denise D Provenza Nicole R NR Giridharan Nisha N Noecker Angela M AM Banks Garrett P GP Gadot Ron R Najera Ricardo A RA Anand Adrish A Devara Ethan E Dang Huy H Bartoli Eleonora E Watrous Andrew A Cohn Jeffrey J Borton David D Mathew Sanjay J SJ McIntyre Cameron C CC Goodman Wayne W Bijanki Kelly K Pouratian Nader N

Brain stimulation 20231101 6

<h4>Background</h4>Deep brain stimulation (DBS) and other neuromodulatory techniques are being increasingly utilized to treat refractory neurologic and psychiatric disorders.<h4>Objective</h4>/Hypothesis: To better understand the circuit-level pathophysiology of treatment-resistant depression (TRD) and treat the network-level dysfunction inherent to this challenging disorder, we adopted an approach of inpatient intracranial monitoring borrowed from the epilepsy surgery field.<h4>Methods</h4>We i ...[more]

PMID: 38135358

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Dataset Information

Stereo-EEG-guided network modulation for psychiatric disorders: Surgical considerations.

Background

Objective

Methods

Results

Conclusion

Publications

Stereo-EEG-guided network modulation for psychiatric disorders: Surgical considerations.

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