Single-neuron responses to neurostimulation: Insights for epilepsy

Invasive neurostimulation has been used in humans to treat and diagnose epilepsy for decades. Despite such ubiquitous probing and recording from the human brain, the efficacy of surgical outcomes has remained stable. One potential reason for the gradual improvement in outcome efficacy is the continued reliance on passive recordings of meso-scale field potentials for diagnosis. Yet, recordings from individual neurons have enriched our understanding of seizure physiology. Here, we review evidence that cellular recording, especially in response to stimulation, is a potentially valuable tool in diagnosing, treating, and advancing therapeutics for epilepsy. Building on recent evidence, we propose a shift toward expanded investigation in neuromodulation research and treatment, toward approaches that leverage the potential of single-neuron recordings as a therapeutic strategy to enhance diagnosis, surgical precision, and treatment efficacy.