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Stereoelectroencephalography Electrode Implantation for Inpatient Workup of Treatment-Resistant Depression.
Starkweather, Clara Kwon; Sugrue, Leo P; Cajigas, Iahn; Speidel, Benjamin; Krystal, Andrew D; Scangos, Katherine; Chang, Edward F.
Afiliación
  • Starkweather CK; Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Sugrue LP; Current affiliation: Department of Neurological Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Cajigas I; Department of Radiology, University of California San Francisco, San Francisco, California, USA.
  • Speidel B; Department of Psychiatry, University of California San Francisco, San Francisco, California, USA.
  • Krystal AD; Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Scangos K; Current affiliation: Department of Neurological Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Chang EF; Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
Neurosurgery ; 95(4): 941-948, 2024 Oct 01.
Article en En | MEDLINE | ID: mdl-39283114
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Treatment-resistant depression is a leading cause of disability. Our center's trial for neurosurgical intervention for treatment-resistant depression involves a staged workup for implantation of a personalized, closed-loop neuromodulation device for refractory depression. The first stage ("stage 1") of workup involves implantation of 10 stereoelectroencephalography (SEEG) electrodes bilaterally into 5 anatomically defined brain regions and involves a specialized preoperative imaging and planning workup and a frame-based operating protocol.

METHODS:

We rely on diffusion tractography when planning stereotactic targets for 3 of 5 anatomic areas. We outline the rationale and fiber tracts that we focus on for targeting amygdala, ventral striatum and ventral capsule, and subgenual cingulate. We also outline frame-based stereotactic considerations for implantation of SEEG electrodes. EXPECTED

OUTCOMES:

Our method has allowed us to safely target all 5 brain areas in 3 of 3 trial participants in this ongoing study, with adequate fiber bundle contact in each of the 3 areas targeted using tractography. Furthermore, we ultimately used tractography data from our stage 1 workup to guide targeting near relevant fiber bundles for stage 2 (implantation of a responsive neuromodulation device). On completion of our data set, we will determine the overlap between volume of tissue activated for all electrodes and areas of interest defined by anatomy and tractography.

DISCUSSION:

Our protocol outlined for SEEG electrode implantation incorporates tractography and frame-based stereotaxy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Técnicas Estereotáxicas / Electrodos Implantados / Electroencefalografía / Trastorno Depresivo Resistente al Tratamiento Límite: Humans Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Técnicas Estereotáxicas / Electrodos Implantados / Electroencefalografía / Trastorno Depresivo Resistente al Tratamiento Límite: Humans Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos