A double burden: depression and early pain recurrence following surgical management of trigeminal neuralgia.

Objective: Trigeminal neuralgia (TN) is characterized by recurrent, unilateral episodes of electric shock-like facial pain, frequently triggered by routine activities, that can significantly impair quality of life. Although interventions such as microvascular decompression, stereotactic radiosurgery, and minimally invasive percutaneous procedures often provide rapid pain relief, recurrence remains a clinical challenge. Psychological comorbidities, particularly depressive disorder, may play a role in predicting outcomes after surgical intervention.

Frontotemporal bursting supports human working memory.

Cortical neural activity varies dynamically during memory periods, when relevant information is not present in the environment. But how those dynamics are related to a code defining working memory (WM) performance is not known. Recent data shows brief bursts of activity in the high gamma (70-140 Hz) and beta (12-30 Hz) band within non-human primate lateral prefrontal cortex (PFC) is associated with WM processing.

A human brain network linked to restoration of consciousness after deep brain stimulation.

Disorders of consciousness are characterized by severe impairments in arousal and awareness. Deep brain stimulation is a potential treatment, but outcomes vary-possibly due to differences in patient characteristics, electrode placement, or the specific brain network engaged. We describe 40 patients with disorders of consciousness undergoing deep brain stimulation targeting the thalamic centromedian-parafascicular complex.

Deep Brain Stimulation for Epilepsy: Optimal Targeting and Clinical Outcomes.

Background: Deep brain stimulation (DBS) has been investigated for patients with drug-resistant epilepsy who are not candidates for resective surgery. Because different types of epilepsy involve different brain networks, numerous DBS targets have been explored.

Methods: To provide a comprehensive overview of this expanding literature, we conducted a systematic review of studies for DBS in epilepsy, collecting data on surgical targets, individual disease characteristics, outcomes, and precise electrode placements.

Cell-type-specific responses to single-pulse electrical stimulation of the human brain.

Background: Currently approved human brain stimulation therapies, ranging from deep brain stimulation to responsive neuromodulation, use macro electrodes to deliver current to the brain. Despite daily clinical use, it remains fundamentally unknown how human neurons respond to intracranial stimulation.

Objective: We address this knowledge gap by characterizing cell-type-specific firing rate (FR) responses to broadly distributed single pulses of electrical stimulation as part of a common clinical procedure for epilepsy patients.

Direct electrical stimulation of the human amygdala enhances recognition memory for objects but not scenes.

Research from neuroscience studies using invasive neuroanatomy-inspired direct manipulations suggests the basolateral amygdala (BLA) mediates a generalized modulation of many different types of memory. In contrast, noninvasive, psychology-inspired indirect correlations suggest that specificity exists in how the BLA prioritizes experiences in memory. We used direct electrical stimulation of the BLA to investigate the specificity of the memory enhancement in the human brain.

Optimal focused ultrasound lesion location in essential tremor.

Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is an effective treatment for medically refractory essential tremor. We investigate ablation sites and potential tracts associated with optimal tremor control and side effects based on the analysis of 351 cases from three international hospitals. Lesions were segmented on day 1 thin-cut T2 axial images, mapped to standard Montreal Neurological Institute space, and used to derive probabilistic maps and tracts associated with tremor improvement and side effects.

Macroscale Traveling Waves Evoked by Single-Pulse Stimulation of the Human Brain.

Understanding the spatiotemporal dynamics of neural signal propagation is fundamental to unraveling the complexities of brain function. Emerging evidence suggests that corticocortical-evoked potentials (CCEPs) resulting from single-pulse electrical stimulation (SPES) may be used to characterize the patterns of information flow between and within brain networks. At present, the basic spatiotemporal dynamics of CCEP propagation cortically and subcortically are incompletely understood.

Stereoelectroencephalography versus subdural electrodes for invasive monitoring of drug-resistant epilepsy patients: a systematic review and meta-analysis.

Introduction: Invasive monitoring for epilepsy surgery is critical for localizing epileptogenic zones. Stereoelectroencephalography (SEEG) and subdural electrodes (SDE) are two primary techniques used for this purpose. This meta-analysis aims to compare the effectiveness and safety of SEEG and SDE regarding various clinical outcomes in patients undergoing invasive epilepsy monitoring.

Natural language processing models reveal neural dynamics of human conversation.

Through conversation, humans engage in a complex process of alternating speech production and comprehension to communicate. The neural mechanisms that underlie these complementary processes through which information is precisely conveyed by language, however, remain poorly understood. Here, we used pre-trained deep learning natural language processing models in combination with intracranial neuronal recordings to discover neural signals that reliably reflected speech production, comprehension, and their transitions during natural conversation between individuals.

A generalized epilepsy network derived from brain abnormalities and deep brain stimulation.

Idiopathic generalized epilepsy (IGE) is a brain network disease, but the location of this network and its relevance for treatment remain unclear. We combine the locations of brain abnormalities in IGE (131 coordinates from 21 studies) with the human connectome to identify an IGE network. We validate this network by showing alignment with structural brain abnormalities previously identified in IGE and brain areas activated by generalized epileptiform discharges in simultaneous electroencephalogram-functional magnetic resonance imaging.

A Posterior Approach for Combined Targeting of the Centromedian Nucleus and Pulvinar for Responsive Neurostimulation.

Background And Objectives: Neuromodulation for the treatment of epilepsy is a growing field, and several thalamic nuclei (including the anterior nucleus, centromedian nucleus [CM], and pulvinar) have been implicated and targeted. Although an anterior trajectory approach to the CM is conventionally used, we report on a novel posterior trajectory which can be useful when the conventional anterior approach is surgically challenging, or where dual CM and pulvinar coverage is desired.

Methods: Clinical and imaging data were retrospectively collected from 7 patients with at least 1 posterior trajectory CM lead and 4 patients with at least 1 anterior trajectory CM lead.

Protocol for detecting and analyzing non-oscillatory traveling waves from high-spatiotemporal-resolution human electrophysiological recordings.

Innovations in electrophysiological recordings and computational analytic techniques enable high-resolution analysis of neural traveling waves. Here, we present a protocol for the detection and analysis of traveling waves from multi-day microelectrode array human electrophysiological recordings through a multi-linear regression statistical approach using point estimator data. We describe steps for traveling wave detection, feature characterization, and propagation pattern analysis.

Association of Chronic Pain with Motor Symptom Severity in Parkinson's Disease: An Exploratory Cross-Sectional Analysis.

Background: Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor symptoms like bradykinesia, tremor, rigidity, and postural instability. Additionally, PD severely impacts physical abilities and independence. Chronic pain, affecting 67.

Decoding semantics from natural speech using human intracranial EEG.

Brain-computer interfaces (BCIs) hold promise for restoring natural language production capabilities in patients with speech impairments, potentially enabling smooth conversation that conveys meaningful information via synthesized words. While considerable progress has been made in decoding phonetic features of speech, our ability to extract lexical semantic information (i.e.

Towards accredited clinical training in brain stimulation: Proceedings from the brain stimulation subspecialty summits.

The rapid development and clinical use of brain stimulation has renewed debates about whether to define and accredit a pathway for clinical subspecialty training. To address this, the Brain Stimulation Subspecialty Summits (BraSSS) were convened in 2023 and 2024, featuring international leaders in brain stimulation across psychiatry, neurology, neurosurgery, psychology, and neuroscience. Both meetings included two days of lectures and debates focused on clinical content, emerging science, and educational standards.

and electrochemical impedance spectroscopy of acute and chronic intracranial electrodes.

Unlabelled: Invasive intracranial electrodes are used in both clinical and research applications for recording and stimulation of brain tissue, providing essential data in acute and chronic contexts. The impedance characteristics of the electrode-tissue interface (ETI) evolve over time and can change dramatically relative to pre-implantation baseline. Understanding how ETI properties contribute to the recording and stimulation characteristics of an electrode can provide valuable insights for users who often don't have access to complex impedance characterizations of their devices.

Cortical Response to Acute Implantation of the Utah Optrode Array in Macaque Cortex.

Optogenetics has transformed the study of neural circuit function, but limitations in its application to species with large brains, such as non-human primates (NHPs), remain. A major challenge in NHP optogenetics is delivering light to sufficiently large volumes of deep neural tissue with high spatiotemporal precision, without simultaneously affecting superficial tissue. To overcome these limitations, we recently developed and tested in NHP cortex, the Utah Optrode Array (UOA).

The effects of deep brain stimulation on sleep: a systematic review and meta-analysis.

Background: Deep brain stimulation (DBS) is a standard treatment for movement disorders, epilepsy, and others, yet its influence on postprocedural sleep quality remains an under-researched topic.

Study Objectives: We performed a systematic review and meta-analysis of all DBS effects on sleep.

Methods: The use of preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) was utilized.

Beyond seizure freedom: Reduction in anti-seizure medication after epilepsy surgery.

Introduction: Patients considering therapeutic epilepsy surgery often seek to decrease the number of anti-seizure medications (ASMs) they need. Predicting such reductions remains challenging. Although predictors of seizure freedom after epilepsy surgery are well-established, long-term outcomes remain modest and factors associated with ASM reduction, even in the absence of seizure freedom, may improve surgical planning to align with patient goals.