Neural Circuit and Clinical Insights from Intraoperative Recordings During Deep Brain Stimulation Surgery

Abstract

Observations using invasive neural recordings from patient populations undergoing neurosurgical interventions have led to critical breakthroughs in our understanding of human neural circuit function and malfunction. The opportunity to interact with patients during neurophysiological mapping allowed for early insights in functional localization to improve surgical outcomes, but has since expanded into exploring fundamental aspects of human cognition including reward processing, language, the storage and retrieval of memory, decision-making, as well as sensory and motor processing. The increasing use of chronic neuromodulation, via deep brain stimulation, for a spectrum of neurological and psychiatric conditions has in tandem led to increased opportunity for linking theories of cognitive processing and neural circuit function. Our purpose here is to motivate the neuroscience and neurosurgical community to capitalize on the opportunities that this next decade will bring. To this end, we will highlight recent studies that have successfully leveraged invasive recordings during deep brain stimulation surgery to advance our understanding of human cognition with an emphasis on reward processing, improving clinical outcomes, and informing advances in neuromodulatory interventions.

Classification of Whisker Deflections From Evoked Responses in the Somatosensory Barrel Cortex With Spiking Neural Networks

“…Information carried by LFPs is debated and more challenging to relate to underlying neural activity owing to the lumped nature of the signal. However, it is recognized that they do carry information (Quiroga and Panzeri, 2009 ; Einevoll et al, 2013 ) such that, for this reason, they are also used in clinical practice for neuromodulation and neurosurgery purposes (Tekriwal et al, 2019 ). An additional important aspect is the reliability of the classification performance taking into account that the cortical evoked responses are deeply influenced by the underlying spontaneous brain activity (Panzeri et al, 2016 ).…”

“…In addition, extracellular spikes tend to fade away leading to signal loss in chronic implants, mainly because of gliosis that heavily affects single neuron-microelectrode interfacing (Szostak et al, 2017 ). LFPs are more robust over time in chronic conditions (Abosch et al, 2012 ) and may be preferable in clinic for long term implants (Jackson and Hall, 2017 ; Tekriwal et al, 2019 ). However, it is more difficult to relate them to the underlying neural activity and to devise decoding strategies (Buzsáki et al, 2012 ; Einevoll et al, 2013 ).…”

Deep learning based markerless motion tracking as a clinical tool for movement disorders: Utility, feasibility and early experience

“…5 Study 3: Use of deeplabcut for human motor neuroscience 5.1 Study 3: Background and related work MER during DBS surgery presents a rare opportunity to record from single neurons in wakeful humans (Engel et al, 2005;Cash and Hochberg, 2015;Lee et al, 2019;Tekriwal et al, 2019). This allows for basic neuroscience experiments to elucidate the neurophysiology of the targets of DBS, guiding the development of future treatments (Stein and Bar-Gad, 2013;Gonzalez-Escamilla et al, 2020).…”

Impulsivity Markers in Parkinsonian Subthalamic Single‐Unit Activity

“…11,12 However, a full understanding of the underlying activity at the single neuron level is still missing. Here, we investigate the possibility of identifying subjects displaying ICB with microelectrode recordings (MERs) 13 performed at rest for target identification during DBS implant surgery. We analyzed MERs acquired during STN-DBS implant surgery in 12 PD patients with diagnosed ICB (ICB+) and 12 PD patients without ICB (ICB−).…”