School of Engineering, Brown University, Providence, Rhode Island, USA.
Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA.
Oper Neurosurg (Hagerstown). 2024 Sep 1;27(3):329-336. doi: 10.1227/ons.0000000000001122. Epub 2024 Apr 9.
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.
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.
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.
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.
立体定向和功能神经外科的最新进展带来了立体脑电图方法，该方法允许更深入地询问和描述深部结构对神经和情感功能的贡献。我们认为，这种方法可以而且应该用于解决定义难治性精神障碍的病理生理学和开发针对患者的优化刺激疗法这一棘手问题。
我们开发了一套方法，可最大程度地利用立体脑电图方法进行创新应用，以了解情感障碍，同时在更广泛的难治性神经精神疾病中具有较高的可转化性。
本文提供了确定所需电极覆盖范围的路线图，可在大量电极上跟踪高分辨率研究记录，将颅内信号与正在进行的研究任务和其他数据流进行同步，在记录过程中应用颅内刺激，并为患者的舒适度和安全性进行设计选择。
这些方法可以在需要进行强化电生理特征描述以定义生物标志物的其他神经精神疾病中实施，从而在严重和治疗抵抗性疾病的情况下更有效地指导治疗决策。
