Patient-Specific Modeling and Network Perturbation to Enhance the Predictability of Direct Cortical Stimulation for Epilepsy

患者特异性建模和网络扰动可增强癫痫直接皮质刺激的可预测性

• 批准号: 10686306
• 负责人: JOHN D ROLSTON
• 金额: $ 19.23万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10686306
• 关键词: Acceleration; Affect; Area; Axon; Brain; Brain Mapping; Brain region; Characteristics; Clinical; Computer Models; Computer software; Computers; Data; Diffuse; Diffusion Magnetic Resonance Imaging; Distant; Doctor of Philosophy; Electric Stimulation; Electrical Stimulation of the Brain; Electrocorticogram; Electrodes; Elements; Epilepsy; Evoked Potentials; FDA approved; Freedom; Frequencies; Human; Image; Implant; Implanted Electrodes; Individual; Industry; Intractable Pain; Knowledge; Language; Lead; Link; Location; Maps; Mental Depression; Mental disorders; Mentors; Modeling; Monitor; Morbidity - disease rate; Motor; Network-based; Neurologic Deficit; Neurosurgeon; Operative Surgical Procedures; Outcome; Pathway interactions; Patient-Focused Outcomes; Patients; Physiologic pulse; Physiology; Postdoctoral Fellow; Research; Research Personnel; Residencies; Resolution; Rest; Safety; Scientist; Seizures; Site; Software Engineering; Stimulus; System; Technology; Testing; Tissues; Training; Universities; Utah; Work; career; density; design; experimental study; improved; insight; multi-electrode arrays; multimodality; neuroimaging; neuroregulation; neurosurgery; novel; patient population; post-doctoral training; predicting response; programs; prospective; response; sensory cortex; skill acquisition; skills; structural imaging; tool; tractography; white matter

PROJECT SUMMARY/ABSTRACT Direct cortical stimulation of the brain is used to treat epilepsy and map brain function during surgery. Yet few patients are free of seizures with this treatment, and morbidity occurs despite ostensibly adequate mapping. When cortical stimulation is used, it is assumed that the area nearby the electrode, within a few centimeters, is most affected. But our prior work shows that stimulation evokes widespread effects in distant regions of the brain. Understanding these network effects will be key in improving our use of brain stimulation. Using patients with electrodes implanted in the brain for epilepsy treatment, I will investigate cortical stimulation by 1) using resting-state functional connectivity to predict evoked potential characteristics, 2) using detailed computer models of patient brains to predict the responses of stimulation, and 3) correlating the networks activated by stimulation with patient outcomes following NeuroPace Responsive Neurostimulator placement. I am a practicing neurosurgeon and neuroscientist with a career devoted to understanding electrical stimulation of the brain. I was trained as a computer scientist and have relied heavily on this skillset during my PhD and post-doctoral training. For my PhD, I designed the hardware and software for a closed-loop neurostimulator, and applied this system to epilepsy research. During my post-doc and residency in neurosurgery, I studied the basis of electrical stimulation mapping using high-density electrocorticography. While in industry, I worked as lead software engineer for a company designing closed-loop stimulation/recording technology for multielectrode arrays. Now, as a functional neurosurgeon, I use multielectrode stimulation and recording daily in my patients. Network imaging and computer modeling of stimulation will provide new ways to understand and restore brain function. Such modeling goes beyond the empirical data that most researchers collect, and that most of my prior research has focused on. To develop these models, I will work with an expert in neuromodulation modeling, Dr. Christopher Butson, at the University of Utah. I will acquire these skills through hands-on training, didactic coursework, and intensive mentoring. At the end of my training, my hope is to create an independent research program to further link brain stimulation with an understanding of brain networks, and use these insights to improve the safety and efficacy of the direct cortical stimulation I use in my patients.

项目总结/文摘

项目成果

Asleep Deep Brain Stimulator Placement in the Intraoperative Magnetic Resonance Imaging System Hybrid Operating Suite: 2-Dimensional Operative Video.

术中磁共振成像系统混合手术套件中放置睡眠深部脑刺激器：二维手术视频。

• DOI: 10.1093/ons/opaa337
• 发表时间: 2021
• 期刊: Operative neurosurgery (Hagerstown, Md.)
• 作者: Brock,AndreaA;Kundu,Bornali;Rolston,JohnD
• 通讯作者: Rolston,JohnD

Therapies to Restore Consciousness in Patients with Severe Brain Injuries: A Gap Analysis and Future Directions.

• DOI: 10.1007/s12028-021-01227-y
• 发表时间: 2021-07
• 期刊: Neurocritical care
• 影响因子: 3.5
• 作者: Edlow BL;Sanz LRD;Polizzotto L;Pouratian N;Rolston JD;Snider SB;Thibaut A;Stevens RD;Gosseries O;Curing Coma Campaign and its contributing members
• 通讯作者: Curing Coma Campaign and its contributing members

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series.

与硬膜下网格相比，立体定向脑电图与减少疼痛和阿片类药物的使用有关：案例系列。

• DOI: 10.1093/ons/opab040
• 发表时间: 2021
• 期刊: Operative neurosurgery (Hagerstown, Md.)
• 作者: Scoville,JonathanP;Joyce,Evan;Hunsaker,Joshua;Reese,Jared;Wilde,Herschel;Arain,Amir;Bollo,RobertL;Rolston,JohnD
• 通讯作者: Rolston,JohnD

Using chronic recordings from a closed-loop neurostimulation system to capture seizures across multiple thalamic nuclei.

• DOI: 10.1002/acn3.51701
• 发表时间: 2023-01
• 期刊: ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY
• 影响因子: 5.3
• 作者: Kundu, Bornali;Arain, Amir;Davis, Tyler;Charlebois, Chantel M.;Rolston, John D.
• 通讯作者: Rolston, John D.

Spasm Freedom Following Microvascular Decompression for Hemifacial Spasm: Systematic Review and Meta-Analysis.

• DOI: 10.1016/j.wneu.2020.04.001
• 发表时间: 2020-07
• 期刊: World neurosurgery
• 影响因子: 2
• 作者: Holste K;Sahyouni R;Teton Z;Chan AY;Englot DJ;Rolston JD
• 通讯作者: Rolston JD