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Book ; Online ; E-Book: Stereotactic and Functional Neurosurgery

Pouratian, Nader / Sheth, Sameer A.

Principles and Applications

2020

Abstract: This text presents a comprehensive and state-of the-art approach to stereotactic and functional neurosurgery. Overarching sections include achieving stereotactic precision, defining trajectories and targets, the biophysics of stereotactic therapies, ... ...

Author's details	edited by Nader Pouratian, Sameer A. Sheth
Abstract	This text presents a comprehensive and state-of the-art approach to stereotactic and functional neurosurgery. Overarching sections include achieving stereotactic precision, defining trajectories and targets, the biophysics of stereotactic therapies, diseases and targets, and the future of functional neurosurgery. Each section is designed to be inclusive of all relevant topics, serving as an unbiased resource to new clinicians in this field or established clinicians that are aiming to better understand complementary methods. Importantly, each section and the associated chapters can be used by basic and translational scientists as well as engineers and industry to better understand and deliver innovation to the field. Chapters within each section methodically analyze traditional and recently emerging concepts and techniques; address underlying principles with examples drawn from specific diseases and applications; and cover patient selection, target selection, available stereotactic methods, nuanced surgical methods, and clinical evidence across treatment options. Written by experts in each area, Stereotactic and Functional Neurosurgery is a definitive guide to the latest developments in stereotactic targeting, electrode implantation, surgical treatment of neurological and psychiatric disorders, the renaissance of stereotactic lesions, and the frontier of restorative neurosurgery for a variety of disorders that have no other therapeutic options.
Keywords	Neurosurgery ; Neurology ; Pain medicine ; Neurology ; Pain Medicine
Subject code	617.48
Language	English
Size	1 online resource (XVIII, 561 p. 111 illus., 75 illus. in color.)
Edition	1st ed. 2020.
Publisher	Springer International Publishing ; Imprint: Springer
Publishing place	Cham
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
ISBN	3-030-34906-3 ; 3-030-34905-5 ; 978-3-030-34906-6 ; 978-3-030-34905-9
DOI	10.1007/978-3-030-34906-6
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Evaluating Deep Learning Performance for P300 Neural Signal Classification.

Ravipati, Yashwanth / Pouratian, Nader / Arnold, Corey / Speier, William

AMIA ... Annual Symposium proceedings. AMIA Symposium

2024 Volume 2023, Page(s) 1218–1225

Abstract: P300 event-related potential (ERP) signals are useful neurological biomarkers, and their accurate classification is important when studying the cognitive functions in patients with neurological disorders. While many studies have proposed models for ... ...

Abstract	P300 event-related potential (ERP) signals are useful neurological biomarkers, and their accurate classification is important when studying the cognitive functions in patients with neurological disorders. While many studies have proposed models for classifying these signals, results have been inconsistent. As a result, a consensus has not yet been reached on the optimal model for this classification. In this study, we evaluated the performance of classic machine learning and novel deep learning methods for P300 signal classification in both within and across subject training scenarios across a dataset of 75 subjects. Although the deep learning models attained high attended event classification F1 scores, they did not outperform Stepwise Linear Discriminant Analysis (SWLDA) in the within-subject paradigm. In the across-subject paradigm, however, EEG-Inception was able to significantly outperform SWLDA. These results suggest that deep learning models may provide a general model that do not require subject-specific training and calibration in clinical settings.
MeSH term(s)	Humans ; Deep Learning ; Electroencephalography/methods ; Brain-Computer Interfaces ; Event-Related Potentials, P300 ; Machine Learning ; Algorithms
Language	English
Publishing date	2024-01-11
Publishing country	United States
Document type	Journal Article
ISSN	1942-597X
ISSN (online)	1942-597X
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Article ; Online: Connectivity-based segmentation of the thalamic motor region for deep brain stimulation in essential tremor: A comparison of deterministic and probabilistic tractography.

Tsolaki, Evangelia / Kashanian, Alon / Chiu, Kevin / Bari, Ausaf / Pouratian, Nader

NeuroImage. Clinical

2024 Volume 41, Page(s) 103587

Abstract: Objective: Deep brain stimulation (DBS) studies have shown that stimulation of the motor segment of the thalamus based on probabilistic tractography is predictive of improvement in essential tremor (ET). However, probabilistic methods are ... ...

Abstract	Objective: Deep brain stimulation (DBS) studies have shown that stimulation of the motor segment of the thalamus based on probabilistic tractography is predictive of improvement in essential tremor (ET). However, probabilistic methods are computationally demanding, requiring the need for alternative tractography methods for use in the clinical setting. The purpose of this study was to compare probabilistic vs deterministic tractography methods for connectivity-based targeting in patients with ET. Methods: Probabilistic and deterministic tractography methods were retrospectively applied to diffusion-weighted data sets in 36 patients with refractory ET. The thalamus and precentral gyrus were selected as regions of interest and fiber tracking was performed between these regions to produce connectivity-based thalamic segmentations, per prior methods. The resultant deterministic target maps were compared with those of thresholded probabilistic maps. The center of gravity (CG) of each connectivity map was determined and the differences in spatial distribution between the tractography methods were characterized. Furthermore, the intersection between the connectivity maps and CGs with the therapeutic volume of tissue activated (VTA) was calculated. A mixed linear model was then used to assess clinical improvement in tremor with volume of overlap. Results: Both tractography methods delineated the region of the thalamus with connectivity to the precentral gyrus to be within the posterolateral aspect of the thalamus. The average CG of deterministic maps was more medial-posterior in both the left (3.7 ± 1.3 mm Conclusions: Deterministic tractography can reconstruct DBS thalamic target maps in approximately 5 min comparable to those produced by probabilistic methods that require > 12 h to generate. Despite differences in CG between the methods, both deterministic-based and probabilistic targeting were predictive of clinical improvement in ET.
MeSH term(s)	Humans ; Essential Tremor/diagnostic imaging ; Essential Tremor/therapy ; Deep Brain Stimulation/methods ; Retrospective Studies ; Thalamus/diagnostic imaging ; Tremor
Language	English
Publishing date	2024-02-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2701571-3
ISSN	2213-1582 ; 2213-1582
ISSN (online)	2213-1582
ISSN	2213-1582
DOI	10.1016/j.nicl.2024.103587
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Article: Computational mechanism underlying switching of motor actions.

Zhong, Shan / Pouratian, Nader / Christopoulos, Vassilios

bioRxiv : the preprint server for biology

2023

Abstract: Surviving in a constantly changing environment requires not only the ability to select actions, but also the flexibility to stop and switch actions when necessary. Extensive research has been devoted to understanding how the brain switches actions, yet ... ...

Abstract	Surviving in a constantly changing environment requires not only the ability to select actions, but also the flexibility to stop and switch actions when necessary. Extensive research has been devoted to understanding how the brain switches actions, yet the computations underlying switching and how it relates to selecting and stopping processes remain elusive. A central question is whether switching is an extension of the stopping process or involves different mechanisms. To address this question, we modeled action regulation tasks with a neurocomputational theory and evaluated its predictions on individuals performing reaches in a dynamic environment. Our findings suggest that, unlike stopping, switching does not necessitate a proactive pause mechanism to delay movement onset. However, switching engages a pause mechanism after movement onset, if the new target location is unknown prior to switch signal. These findings offer a new understanding of the action-switching computations, opening new avenues for future neurophysiological investigations.
Language	English
Publishing date	2023-11-06
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.10.27.564490
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Article ; Online: Two Practices to Improve Informed Consent for Intraoperative Brain Research.

Peabody Smith, Ally / Pouratian, Nader / Feinsinger, Ashley

Neurosurgery

2023 Volume 92, Issue 5, Page(s) e97–e101

Abstract: As the clinical applications of neurologically implanted devices increase, so do opportunities for intracranial investigations in human patients. In some of these studies, patients participate in research during their awake brain surgery, performing ... ...

Abstract	As the clinical applications of neurologically implanted devices increase, so do opportunities for intracranial investigations in human patients. In some of these studies, patients participate in research during their awake brain surgery, performing additional tasks without the prospect of personal therapeutic benefit. These intraoperative studies raise persistent ethical challenges because they are conducted during a clinical intervention, in a clinical space, and often by the treating clinician. Whether intraoperative research necessitates innovative informed consent methods has become a pressing conversation. Familiar worries about inadequate participant understanding and undue influence dominate these discussions, as do calls for increasing information retention (e.g., using methods such as "teach-back") and minimizing enrollment pressures (e.g., preventing surgeons from consenting their own patients). However, efforts have yet to inspire widespread consent practices that mirror the scope of ethical concern. Focusing on awake, intraoperative intracranial research, we identify 2 underappreciated problems in approaches to informed consent. The first is epistemic: Many practices do not fully consider when and under which conditions participants are adequately informed. The second is relational: Many practices do not fully consider the effects of trust between patient-participants and surgeon-researchers. In exploring these concerns, we also raise questions about whether additional steps beyond preoperative consent may improve the process because decisions at this time are decoupled from both the experiences and vulnerability of awake brain surgery. Motivated by these considerations, we propose 2 practices: first, requiring a third-party patient advocate in initial consent and second, requiring verbal intraoperative reconsent before initiating research.
MeSH term(s)	Humans ; Informed Consent ; Brain
Language	English
Publishing date	2023-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002336
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Article ; Online: Irregularity of instantaneous gamma frequency in the motor control network characterize visuomotor and proprioceptive information processing.

Ryu, Jihye / Choi, Jeong Woo / Niketeghad, Soroush / Torres, Elizabeth B / Pouratian, Nader

Journal of neural engineering

2024 Volume 21, Issue 2

Abstract: Objective. ...

Abstract	Objective.
MeSH term(s)	Humans ; Parietal Lobe ; Fingers/physiology ; Proprioception/physiology ; Movement/physiology ; Electrocorticography
Language	English
Publishing date	2024-03-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2170901-4
ISSN	1741-2552 ; 1741-2560
ISSN (online)	1741-2552
ISSN	1741-2560
DOI	10.1088/1741-2552/ad2e1d
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Article: Engagement, Exploitation, and Human Intracranial Electrophysiology Research.

Pham, Michelle T / Pouratian, Nader / Feinsinger, Ashley

Neuroethics

2022 Volume 15, Issue 3

Abstract: Motivated by exploitation concerns, we argue for the importance of participant engagement in basic human intracranial electrophysiology research. This research takes advantage of unique neurosurgical opportunities to better understand complex systems of ... ...

Abstract	Motivated by exploitation concerns, we argue for the importance of participant engagement in basic human intracranial electrophysiology research. This research takes advantage of unique neurosurgical opportunities to better understand complex systems of the human brain, but it also exposes participants to additional risks without immediate therapeutic intent. We argue that understanding participant values and incorporating their perspectives into the research process may (i) help determine whether and to what extent research practices and the resulting distributions of risks and benefits constitute exploitation and (ii) contribute to building a brain research paradigm that is genuinely responsive to participant values. More broadly, we highlight the importance of paying attention to participant interests in non-therapeutic brain research.
Language	English
Publishing date	2022-08-13
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2421622-7
ISSN	1874-5504 ; 1874-5490
ISSN (online)	1874-5504
ISSN	1874-5490
DOI	10.1007/s12152-022-09502-1
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Article ; Online: Diffusion tensor imaging correlates of depressive symptoms in Parkinson disease.

Uhr, Lauren / Tsolaki, Evangelia / Pouratian, Nader

The Journal of comparative neurology

2022 Volume 530, Issue 10, Page(s) 1729–1738

Abstract: Depression is a heterogeneous clinical syndrome prevalent in patients with Parkinson disease (PD) that remains incompletely understood. Further, the differences in biomarkers of depression in PD and in non-PD patients are unclear. The subcallosal ... ...

Abstract	Depression is a heterogeneous clinical syndrome prevalent in patients with Parkinson disease (PD) that remains incompletely understood. Further, the differences in biomarkers of depression in PD and in non-PD patients are unclear. The subcallosal cingulate cortex (SCC) and its connections have been implicated in the pathophysiology of major depressive disorder (MDD). Diffusion tensor imaging (DTI) provides a tool to quantify MDD-related structural abnormalities underlying depressive symptoms in PD. Diffusion-weighted magnetic resonance imaging data were collected from 31 patients with PD. Depression symptom severity was measured using the Beck Depression Inventory (BDI-II), and assessed using three subscales: dysphoric mood, loss of interest/pleasure, and somatic symptoms. Probabilistic tractography methods were used to quantify the SCC connectivity to target regions in cortico-limbic-striatal network (ventral striatum, medial prefrontal cortex [mPFC], dorsal anterior cingulate cortex, and uncinate fasciculus), while fractional anisotropy (FA) was calculated in predefined white matter regions of interest. DTI data were correlated with severity of depression across three domains. SCC-mPFC connectivity in the left hemisphere was positively correlated with severity of dysphoric mood (Benjamini-Hochberg adjusted p = .02). Region of interest-based analyses demonstrated a significant and distinct topographic association between FA and dysphoric mood, loss of interest/pleasure, and somatic symptom severity, although these findings did not maintain significance after applying the false discovery rate correction. Abnormal SCC connectivity underlies depressive symptoms in both PD and MDD, suggesting that interventions used for MDD should be explored in treating depressive symptoms in PD, particularly depression dominated by dysphoric mood.
MeSH term(s)	Depression/diagnostic imaging ; Depression/etiology ; Depressive Disorder, Major/diagnostic imaging ; Diffusion Magnetic Resonance Imaging ; Diffusion Tensor Imaging/methods ; Humans ; Parkinson Disease/complications ; Parkinson Disease/diagnostic imaging ; Parkinson Disease/pathology ; White Matter/pathology
Language	English
Publishing date	2022-02-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	3086-7
ISSN	1096-9861 ; 0021-9967 ; 0092-7317
ISSN (online)	1096-9861
ISSN	0021-9967 ; 0092-7317
DOI	10.1002/cne.25310
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Article ; Online: The Value of Heterogeneity in Practices to Promote Ethical Research.

Feinsinger, Ashley / Pham, Michelle / Pouratian, Nader

AJOB neuroscience

2021 Volume 12, Issue 1, Page(s) 80–82

MeSH term(s)	Electrophysiology ; Ethics, Research ; Humans ; Informed Consent ; Research Design
Language	English
Publishing date	2021-02-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	2576262-X
ISSN	2150-7759 ; 2150-7740
ISSN (online)	2150-7759
ISSN	2150-7740
DOI	10.1080/21507740.2020.1866116
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Article ; Online: Longitudinal prognosis of Parkinson's outcomes using causal connectivity.

Mellema, Cooper J / Nguyen, Kevin P / Treacher, Alex / Andrade, Aixa X / Pouratian, Nader / Sharma, Vibhash D / O'Suileabhain, Padraig / Montillo, Albert A

NeuroImage. Clinical

2024 Volume 42, Page(s) 103571

Abstract: Despite the prevalence of Parkinson's disease (PD), there are no clinically-accepted neuroimaging biomarkers to predict the trajectory of motor or cognitive decline or differentiate Parkinson's disease from atypical progressive parkinsonian diseases. ... ...

Abstract	Despite the prevalence of Parkinson's disease (PD), there are no clinically-accepted neuroimaging biomarkers to predict the trajectory of motor or cognitive decline or differentiate Parkinson's disease from atypical progressive parkinsonian diseases. Since abnormal connectivity in the motor circuit and basal ganglia have been previously shown as early markers of neurodegeneration, we hypothesize that patterns of interregional connectivity could be useful to form patient-specific predictive models of disease state and of PD progression. We use fMRI data from subjects with Multiple System Atrophy (MSA), Progressive Supranuclear Palsy (PSP), idiopathic PD, and healthy controls to construct predictive models for motor and cognitive decline and differentiate between the four subgroups. Further, we identify the specific connections most informative for progression and diagnosis. When predicting the one-year progression in the MDS-UPDRS-III
Language	English
Publishing date	2024-02-06
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2701571-3
ISSN	2213-1582 ; 2213-1582
ISSN (online)	2213-1582
ISSN	2213-1582
DOI	10.1016/j.nicl.2024.103571
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