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Related Concept Videos

Psychosurgery01:30

Psychosurgery

57
Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
57

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Related Experiment Video

Updated: Jul 7, 2025

Operative Technique and Nuances for the Stereoelectroencephalographic SEEG Methodology Utilizing a Robotic Stereotactic Guidance System
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Stereo-EEG-guided network modulation for psychiatric disorders: Surgical considerations.

Sameer A Sheth1, Ben Shofty1, Anusha Allawala2

  • 1Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA.

Brain Stimulation
|December 22, 2023
PubMed
Summary

This study combined deep brain stimulation (DBS) with stereo-EEG (sEEG) to investigate treatment-resistant depression (TRD). The hybrid approach successfully mapped brain circuits, offering new insights into TRD pathophysiology.

Keywords:
Deep brain stimulationDepressionNetworkNeuromodulationPsychiatric disorderStereo-electroencephalography

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Area of Science:

  • Neuroscience
  • Neurosurgery
  • Psychiatry

Background:

  • Refractory neurologic and psychiatric disorders are increasingly treated with neuromodulatory techniques like deep brain stimulation (DBS).
  • Treatment-resistant depression (TRD) presents a significant challenge due to its complex network-level dysfunction.

Purpose of the Study:

  • To understand the circuit-level pathophysiology of TRD.
  • To treat network-level dysfunction in TRD using an innovative intracranial monitoring approach.
  • To combine DBS with stereo-electroencephalography (sEEG) for enhanced neurophysiological assessment.

Main Methods:

  • Implanted 3 patients with DBS leads (ventral capsule/striatum and subcallosal cingulate) and sEEG electrodes targeting depression-relevant brain regions.
  • Utilized holographic visualization for surgical planning and robotic stereotaxy for electrode placement.
  • Conducted inpatient neurophysiological assessments followed by sEEG electrode removal and DBS lead internalization.

Main Results:

  • Intraoperative testing confirmed positive valence responses, validating the surgical targeting in all subjects.
  • Demonstrated accurate adherence to the surgical plan and stable DBS lead positioning, crucial for chronic stimulation and accurate field estimates.
  • Achieved mean radial error of 1.2±0.9 mm and mean rotation of 3.6±2.6° for DBS leads.

Conclusions:

  • The novel hybrid sEEG-DBS approach enables detailed investigation of neurophysiological substrates in complex neuropsychiatric disorders.
  • This method provides a powerful tool for studying and potentially treating conditions like TRD.