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Kai J. Miller, Casey H. Halpern, Mark F. Sedrak, John A. Duncan III, and Gerald A. Grant

fiber-optic probes are used for laser ablation of the hippocampus and adjacent structures under MRI guidance (Visualase/Medtronic or Monteris). C: Recording/stimulating electrodes are placed stereotactically for responsive neurostimulation (Neuropace). Figure is available in color online only. Stereotactic targeting for these approaches is evolving, although it is currently prescribed for general anatomical structures rather than a landmark-based coordinate system. The present standard for directly targeting the amygdalohippocampal complex for SLAH is defined by

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Daniel J. DiLorenzo, Erwin Z. Mangubat, Marvin A. Rossi, and Richard W. Byrne

patient selection and in preoperative planning. 1 , 14 New chronically implanted neural monitoring technologies, such as those developed by NeuroPace 4 , 9 , 18 and separately by NeuroVista, 2 , 3 , 5 enable evaluation of an entirely new modality of pre-resective identification of the ictal circuit, that is, chronic unlimited recording electrocorticography (CURE)–guided resection. The NeuroPace Responsive Neurostimulation (RNS) System delivers contingent electrical stimulation to a seizure focus and has recently been assessed in a multicenter pivotal clinical trial

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Daniel Yoshor, William H. Bosking, Bradley C. Lega, Ping Sun, and John H. R. Maunsell

integration in superior parietal lobule revealed by human intracranial recordings . J Neurophysiol 96 : 721 – 729 , 2006 19 Morrell M : Brain stimulation for epilepsy: can scheduled or responsive neurostimulation stop seizures? . Curr Opin Neurol 19 : 164 – 168 , 2006 20 Ohara S , Crone NE , Weiss N , Treede RD , Lenz FA : Cutaneous painful laser stimuli evoke responses recorded directly from primary somatosensory cortex in awake humans . J Neurophysiol 91 : 2734 – 2746 , 2004 21 Ojemann JG , Ojemann GA , Lettich E : Cortical

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Samuel S. Shin, C. Edward Dixon, David O. Okonkwo, and R. Mark Richardson

performing real-time seizure detection and delivering responsive stimulation, and the stimulation target depends on each patient's seizure focus or foci. The responsive neurostimulation system (RNS) (NeuroPace, Inc.) was recently approved by the FDA for use in the US and employs separate electrodes for seizure detection and stimulation delivery. 105 Alternating current systems that allow detection and stimulation on the same electrode lead are currently under investigation. 138 As electrophysiological biomarkers of other TBI comorbidities are discovered, closed

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Panagiotis Kerezoudis, Sanjeet S. Grewal, Matthew Stead, Brian Nils Lundstrom, Jeffrey W. Britton, Cheolsu Shin, Gregory D. Cascino, Benjamin H. Brinkmann, Gregory A. Worrell, and Jamie J. Van Gompel

cortical and subcortical brain regions, including the thalamus, the cerebellum, and the hippocampus, have been selected as neurostimulation targets utilizing either duty cycle 14 or responsive stimulation paradigms. 3 Despite their demonstrated efficacy in randomized controlled trials, currently approved stimulation approaches do not often result in seizure-free outcomes. 3 , 14 Chronic subthreshold cortical stimulation (CSCS) might represent a more effective option. Currently available responsive neurostimulation device detection algorithms 3 use a low spectral

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Nicole C. Swann, Coralie de Hemptinne, Svjetlana Miocinovic, Salman Qasim, Jill L. Ostrem, Nicholas B. Galifianakis, Marta San Luciano, Sarah S. Wang, Nathan Ziman, Robin Taylor, and Philip A. Starr

(Neuropace Inc.), 23 , 38 the first fully implanted responsive neurostimulation device approved for use in humans for epilepsy treatment, and the BrainGate device (BrainGate Co.), a brain-machine interface designed for patients with paralysis. 14 , 41 While all 3 of these devices allow invasive electrophysiological recording, there are important differences, advantages, and limitations to each. Both the RNS and Activa PC+S devices are fully internalized devices, whereas the BrainGate device has an externalized component. The internalized devices have the significant

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Rene Molina, Michael S. Okun, Jonathan B. Shute, Enrico Opri, P. Justin Rossi, Daniel Martinez-Ramirez, Kelly D. Foote, and Aysegul Gunduz

the FDA as a responsive neurostimulation device. 11 Our research group used the RNS-300 system to study the electrophysiological underpinnings of tic generation and to develop a responsive stimulation system for tic suppression through FDA investigational device exemption approval. These neurostimulators were programmed on a scheduled duty cycle paradigm as part of the initial NIH trial, with the hypothesis that patients with TS would not need continuous stimulation for symptom relief due to the paroxysmal nature of the symptoms ( Fig. 2A ; third row). 12 As part

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Charles B. Mikell, Saurabh Sinha, and Sameer A. Sheth

characterized by phasically active units, although tonically active neurons are also observed, with functions likely distinct from phasically active, burst-type neurons. 37 There are reports of DBS of the dorsal striatum for the treatment of tinnitus, suggesting that stimulation of this area may carry no more risk than what is standard to DBS in the basal ganglia. 15 , 64 Open-Loop Versus Closed-Loop Stimulation The availability of new DBS generators has made it possible to consider whether responsive neurostimulation could be beneficial in schizophrenia. 97 , 112

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Kerry A. Vaughan, Christian Lopez Ramos, Vivek P. Buch, Rania A. Mekary, Julia R. Amundson, Meghal Shah, Abbas Rattani, Michael C. Dewan, and Kee B. Park

lead to bias in our estimates. The accuracy and applicability of our estimates will be greatly enhanced by further study of regional epilepsy surgical treatment trends and availability of newer technology such as laser ablation and responsive neurostimulation. Regional variations in epilepsy etiology and access to care would also significantly inform our initial volume estimates, such as patterns in temporal lobe epilepsy and medically intractable cases that may be more amenable to surgery. Given the relatively long range selected for article inclusion (from 1990 to