Neuromodulation最新文献

{"title":"Information for Readers","authors":"","doi":"10.1016/S1094-7159(25)00045-5","DOIUrl":"10.1016/S1094-7159(25)00045-5","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Page A5"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Long Does Deep Brain Stimulation Give Patients Benefit?","authors":"Esin Bulut MS ,&nbsp;P. Mitchell Johansen MD ,&nbsp;Alya Elbualy BS ,&nbsp;Cheyenne Kalman BS ,&nbsp;Ryan Mayer ,&nbsp;Nicholas Kato BS ,&nbsp;Rodrigo Salmeron de Toledo Aguiar MD ,&nbsp;Julie G. Pilitsis MD, PhD, MBA","doi":"10.1016/j.neurom.2024.05.007","DOIUrl":"10.1016/j.neurom.2024.05.007","url":null,"abstract":"<div><h3>Introduction</h3><div>One of the most common questions patients ask when they are contemplating deep brain stimulation (DBS) is how long it will last. To guide physicians in answering this query, we performed a scoping review to assess the current state of the literature and to identify the gaps that need to be addressed.</div></div><div><h3>Materials and Methods</h3><div>The authors performed a MEDLINE search inclusive of articles from January 1987 (advent of DBS literature) to June 2023 including human and modeling studies written in English. For longevity of therapy data, only studies with a mean follow-up of ≥three years were included. Using the Rayyan platform, two reviewers (JP and RM) performed a title screen. Of the 734 articles, 205 were selected by title screen and 109 from abstract review. Ultimately, a total of 122 articles were reviewed. The research questions we explored were 1) how long can the different components of the DBS system maintain functionality? and 2) how long can DBS remain efficacious in treating Parkinson’s disease (PD), essential tremor (ET), dystonia, and other disorders?</div></div><div><h3>Results</h3><div>We showed that patients with PD, ET, and dystonia maintain a considerable long-term benefit in motor scores seven to ten years after implant, although the percentage improvement decreases over time. Stimulation off scores in PD and ET show worsening, consistent with disease progression. Battery life varies by the disease treated and the programming settings used. There remains a paucity of literature after ten years, and the impact of new device technology has not been classified to date.</div></div><div><h3>Conclusion</h3><div>We reviewed existing data on DBS longevity. Overall, outcomes data after ten years of therapy are substantially limited in the current literature. We recommend that physicians who have data for patients with DBS exceeding this duration publish their results.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 472-483"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectangular Repetitive Transcranial Magnetic Monophasic vs Biphasic Stimulation for Major Depressive Disorder: A Randomized Controlled Pilot Trial","authors":"Michelle S. Goodman PhD ,&nbsp;Daniel M. Blumberger MD, MSc ,&nbsp;Mehran Talebinejad PhD ,&nbsp;Adrian D.C. Chan PhD ,&nbsp;Robert Chen MBBChir, MSc ,&nbsp;Tony T. Yang MD, PhD","doi":"10.1016/j.neurom.2024.11.010","DOIUrl":"10.1016/j.neurom.2024.11.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Biphasic sinusoidal repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation treatment that has been approved by the US Food and Drug Administration for treatment-resistant depression (TRD). Recent advances suggest that standard rTMS may be improved by altering the pulse shape; however, there is a paucity of research investigating pulse shape, owing primarily to the technologic limitations of currently available devices. This pilot study examined the feasibility, tolerability, and preliminary efficacy of biphasic and monophasic rectangular rTMS for TRD.</div></div><div><h3>Material and Methods</h3><div>Twenty adult participants with TRD received randomized biphasic and monophasic rectangular rTMS; 30 rectangular rTMS sessions (3000 pulses per session) were delivered as daily sessions over six weeks at 120% resting motor threshold. Neuropsychologic testing was conducted before and after the six-week treatment course, and at one, four, and 12 weeks after treatment.</div></div><div><h3>Results</h3><div>Two participants withdrew, leaving a final sample size of 18. Both monophasic and biphasic rTMS protocols significantly reduced depressive symptoms in patients with TRD without any significant side effects. In contrast to our hypothesis, there were no differences between the two treatment groups in terms of change in depressive scores, response rates, or remission rates.</div></div><div><h3>Conclusions</h3><div>Findings from this pilot study revealed that both biphasic and monophasic rectangular rTMS are safe and well-tolerated. Larger, double-blind sham-controlled trials are needed to confirm the response and remission rates observed in this study.</div></div><div><h3>Clinical Trial Registration</h3><div>The <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> registration number for the study is NCT02667041.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 511-519"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Economic Evaluation and Patient Perspectives on a Virtual Clinic: Advancing Digital Remote Care in Health Care.","authors":"Pedram Tabatabaei, Josef Salomonsson, Linda Bredemo, Johan Wänman","doi":"10.1016/j.neurom.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.007","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing adoption of digital health care solutions offers a transformative opportunity to improve patient access while addressing sustainability and cost-efficiency challenges. Our study evaluates a virtual remote care system (VRCS) that has been implemented at our clinic in northern Sweden. By combining patient-centered outcomes, environmental metrics, and health economic models, this study examines the impact of a VRCS on patient satisfaction, resource utilization, and environmental sustainability.</p><p><strong>Materials and methods: </strong>Eighty patients with chronic pain, treated with spinal cord or dorsal root ganglion stimulation, participated in this study. All accessed the NeuroSphere Virtual Clinic platform for remote consultations and troubleshooting. A patient satisfaction survey assessed usability, trust, and preference for digital vs in-person consultations. A health economic model analyzed travel costs, CO₂ emissions, and time burdens for in-clinic consultations vs a mixed care pathway across three scenarios of VRCS adoption (20%, 50%, and 100%).</p><p><strong>Results: </strong>The survey results indicated high levels of patient satisfaction, with an average score of 9.1 out of 10, and strong trust in the platform, reported by 98.75% of participants. The introduction of digital consultations led to substantial reductions in travel-related burdens, including a 75% decrease in costs, CO₂ emissions, and travel time during the first year, stabilizing at a 70% reduction in subsequent years. Patients traveling over 500 km experienced the greatest benefits, with annual savings of €525, a reduction of 231 kg in CO₂ emissions, and 19 fewer hours of travel time. The mixed care pathways enhanced accessibility, reducing cancellations and no-shows by up to 59%. Despite increased troubleshooting consultations, hospital resource utilization remained stable, with only marginal increases in workload and space utilization.</p><p><strong>Discussion: </strong>The VRCS aligns with key health care priorities, including improving access, enhancing patient experience, and promoting sustainability. It addresses regional challenges, such as long travel distances and harsh winters, while reducing the ecological footprint of health care delivery. The platform's ability to decrease travel burdens and CO₂ emissions aligns with global sustainability goals. However, barriers such as digital literacy and data privacy require further attention to ensure equitable access.</p><p><strong>Conclusions: </strong>The VRCS demonstrates significant benefits, including high patient satisfaction, reduced travel burdens, and improved resource utilization. By aligning with sustainability objectives, it offers a scalable model for digital transformation in health care, underscoring the importance of continued investment in remote care technologies.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Efficacy of Bilateral Globus Pallidus Stimulation in the Treatment of Meige Syndrome","authors":"Shiyu Fu MM,&nbsp;Zhiquan Yang MD,&nbsp;Xinghui He MD,&nbsp;Dingyang Liu MD,&nbsp;Zhuanyi Yang MD,&nbsp;Junmei Zhang MM,&nbsp;Liangchao Du BMed","doi":"10.1016/j.neurom.2024.02.002","DOIUrl":"10.1016/j.neurom.2024.02.002","url":null,"abstract":"<div><h3>Objective</h3><div><span><span>This study aimed to investigate the long-term efficacy and prognosis of bilateral globus pallidus internus (GPi) </span>deep brain stimulation (DBS) in patients with </span>benign essential blepharospasm<span> (BEB) and complete Meige syndrome, and to search for the best therapeutic subregion within the GPi.</span></div></div><div><h3>Materials and Methods</h3><div>Data were collected for 36 patients with Meige syndrome<span> who underwent bilateral GPi-DBS surgery at our hospital between March 2014 and February 2022. Using the Burk-Fahn-Marsden Dystonia Rating Scale (BFMDRS)-Movement (BFMDRS-M) and BFMDRS-Disability (BFMDRS-D), the severity of the symptoms of patients with complete Meige syndrome was evaluated before surgery and at specific time points after surgery. Patients with BEB were clinically evaluated for the severity of blepharospasm using BFMDRS-M, the Blepharospasm Disability Index (BDI), and Jankovic Rating Scale (JRS). Three-dimensional reconstruction of the GPi-electrode was performed in some patients using the lead-DBS software, and the correlation between GPi subregion volume of tissue activated (VTA) and symptom improvement was analyzed in patients six months after surgery. The follow-up duration ranged from six to 99 months.</span></div></div><div><h3>Results</h3><div>Compared with preoperative scores, the results of all patients at six months after surgery and final follow-up showed a significant decrease (<em>p</em> &lt; 0.05) in the mean BFMDRS-M score. Among them, the average BFMDRS-M improvement rates in patients with BEB at six months after surgery and final follow-up were 60.3% and 69.7%, respectively, whereas those in patients with complete Meige syndrome were 54.5% and 58.3%, respectively. The average JRS and BDI scores of patients with BEB also decreased significantly (<em>p</em><span> &lt; 0.05) at six months after surgery and at the final follow-up (JRS improvement: 38.6% and 49.1%, respectively; BDI improvement: 42.6% and 57.4%, respectively). We were unable to identify significantly correlated prognostic factors. There was a significant correlation between GPi occipital VTA and symptom improvement in patients at six months after surgery (</span><em>r</em> = 0.34, <em>p</em> = 0.025).</div></div><div><h3>Conclusions</h3><div>Our study suggests that bilateral GPi-DBS is an effective treatment for Meige syndrome, with no serious postoperative complications. The VTA in the GPi subregion may be related to the movement score improvement. In addition, further research is needed to predict patients with poor surgical outcomes.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 532-544"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Deep Brain Stimulation on Comorbid Self-injurious Behavior: A Systematic Review and Meta-analysis of Individual Patient Data","authors":"Karim Mithani MD, MEng ,&nbsp;Kristina Zhang BMSc ,&nbsp;Han Yan MD ,&nbsp;Lior Elkaim MD ,&nbsp;Peter J. Gariscsak BSc ,&nbsp;Hrishikesh Suresh MD ,&nbsp;Flavia Venetucci Gouveia PhD ,&nbsp;Alfonso Fasano MD, PhD ,&nbsp;Carolina Gorodetsky MD ,&nbsp;George M. Ibrahim MD, PhD","doi":"10.1016/j.neurom.2024.07.009","DOIUrl":"10.1016/j.neurom.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>Self-injurious behavior (SIB) can occur in the setting of many neurologic disorders that are amenable to deep brain stimulation (DBS). Although certain brain targets are believed to be particularly effective for SIB, improvements in the primary neurologic condition may also reduce co-occurring SIB. We performed a systematic review and meta-analysis of individual participant data to characterize the effects of DBS across various neurologic disorders and brain targets on comorbid SIB.</div></div><div><h3>Materials and Methods</h3><div>A systematic review of all available literature on DBS in treating disorders with co-occurring SIB was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Individual participant data were extracted and standardized mean differences (SMDs) in metrics of SIB severity and/or frequency were calculated for meta-analysis. Demographic variables and adverse events were also collated.</div></div><div><h3>Results</h3><div>Data from 59 patients, identified from 24 articles, with comorbid SIB who underwent DBS for various indications were extracted. The primary neurologic diagnoses included Tourette syndrome (<em>n</em> = 40), dystonia (<em>n</em> = 7), epilepsy (<em>n</em> = 5), acquired brain injury (<em>n</em> = 3), dyskinesia (<em>n</em> = 2), and obsessive-compulsive disorder (<em>n</em> = 2). Overall, DBS was highly effective in treating comorbid SIB (Mean SMD = −2.4, <em>p</em> &lt; 0.0001) across primary disorders and intracranial targets. Patients with dystonia and DBS targeting the posterior hypothalamus had relatively less success at mitigating comorbid SIB.</div></div><div><h3>Conclusions</h3><div>In patients with comorbid SIB, DBS to treat the primary neurologic condition may also mitigate SIB. Although several targets are emerging for the treatment of severe SIB, this work suggests that DBS targeting the primary neurologic condition should be first considered in comorbid SIB.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 373-379"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: The Neurostimulation Appropriateness Consensus Committee (NACC) ©: Recommendations for the Mitigation of Complications of Neurostimulation","authors":"Nick J. Koning MD, PhD ,&nbsp;Jan Willem Kallewaard MD, PhD","doi":"10.1016/j.neurom.2025.01.001","DOIUrl":"10.1016/j.neurom.2025.01.001","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 545-546"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Long-term Outcomes of Minimally Invasive Tubular Spinal Cord Stimulation Lead Placement.","authors":"Allyster B T Klassen, Christine D Potvin, Peggy A Flynn, Vibha Gaonkar, Murray Hong, Susan H Morris, Sean D Christie, Lutz M Weise","doi":"10.1016/j.neurom.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.006","url":null,"abstract":"<p><strong>Objectives: </strong>This study primarily addressed the feasibility of implanting a spinal cord stimulation (SCS) electrode in a minimally invasive tubular approach and the required frequency of escalating to a second tube or an open approach. It secondarily addressed the electrode placement in relation to the midline or to the side of the predominant pain, in addition to the long-term clinical outcomes.</p><p><strong>Materials and methods: </strong>A retrospective chart review was conducted in patients who underwent minimally invasive tubular surgery with paddle electrodes for neuropathic pain between January 2017 and December 2023 in Halifax, Canada. Midline placement was assessed anatomically and physiologically with intraoperative imaging and compound muscle action potentials, respectively. Clinical outcomes were described by pre- and postoperative visual analog scale scores, patient satisfaction, and adverse reactions.</p><p><strong>Results: </strong>In total, 25 participants were identified, and all surgeries proceeded without escalation. Anatomically, all but one electrode was placed fully or partially on the spinal midline. Physiologically, muscle activation favored the midline or the predominant pain side in 90% of cases. Four adverse reactions were reported within one year after surgery, one of which was classified as serious. Pre- and postoperative pain scores were significantly reduced from 7.2 ± 1.8 to 4.2 ± 2.5 (p < 0.001); 82.6% of the patients were very satisfied or somewhat satisfied and still using their device one year after surgery.</p><p><strong>Conclusions: </strong>Minimally invasive tubular placement of SCS electrodes is shown here to be feasible, achieving satisfactory alignment and clinical outcomes. The lack of surgical escalation supports the minimally invasive claim. Midline placement was indicated anatomically and physiologically in most cases, and clinical decisions for impactful pain coverage accounted for most nonmidline placements. Clinically, patient-reported outcomes were largely positive.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous Neuromodulation Promotes Functional Regeneration of the External Urethral Sphincter Neural Circuitry in Two Models of Nerve Lesion in Female Rats.","authors":"Ricardo Juárez, José Luis Palacios, Yolanda Cruz","doi":"10.1016/j.neurom.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.009","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effect of transcutaneous electrical stimulation of the dorsal nerve of the clitoris (DNC-TENS) on the functional recovery of the neural circuitry of the external urethral sphincter (EUS) neural circuitry in two models of childbirth trauma in rats: vaginal distension (VD) and injury of the motor branch of the pudendal nerve (MBPN).</p><p><strong>Materials and methods: </strong>In total, 42 Wistar adult female rats were used. Rats underwent sham VD (SH-VD), VD with sham DNC-TENS (VD SH-TENS) or VD with DNC-TENS, bilateral crush of MBPN crush injury (MBPNC) with sham DNC-TENS, or MBPNC with DNC-TENS. Stimulation was delivered to the dorsal region of the clitoral sheath, immediately and on days 2 and 4 after VD or MBPNC. The outcome parameters were EUS electromyograms (EMGs, amplitude and frequency) and cystometrograms (CMGs). Animals were evaluated at seven and 14 days after VD or SH-VD and at day 9 after the nerve crush.</p><p><strong>Results: </strong>In SH-VD animals, the EUS EMG activity increased concurrently with bladder contraction. Tonic and bursting responses also were observed. VD significantly impaired EUS and CMG characteristics in the first week postlesion; in the VD SH-TENS group, the bursting EMG response was abolished; the amplitude of tonic activity decreased (p < 0.0001), and the duration of bladder contraction decreased. DNC-TENS facilitated recovery of bursting and tonic EUS EMG activity after VD (p < 0.0001). As with VD, MBPNC abolished EUS bursting activity and decreased (∼80%) tonic activity. TENS significantly improved EMG and CMG parameters.</p><p><strong>Conclusions: </strong>VD and MBPNC significantly impair EUS EMG activity. DNC-TENS facilitates functional recovery of the EUS neural circuitry by promoting neuroregeneration and increases bladder compliance. Further studies are required to determine whether DNC-TENS is an effective noninvasive neuromodulation therapy to alleviate or prevent symptoms of stress urinary incontinence associated with childbirth trauma in women.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Healthy and Epileptic States in the Centromedian Nucleus Region.","authors":"David Satzer, Lesley C Kaye, Megan V Ryan, Steven G Ojemann, John A Thompson, Daniel R Kramer","doi":"10.1016/j.neurom.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>Neuromodulation of the centromedian nucleus (CM) has shown beneficial effects on seizure frequency. The effects of stimulation vary by location within the CM region, and during closed-loop stimulation, different contacts have been used for recording and stimulation. The spatial relationships between anatomy, stimulation efficacy, and recording utility remain unclear.</p><p><strong>Materials and methods: </strong>Local field potentials were recorded from participants undergoing responsive neurostimulation targeting the CM for the treatment of epilepsy. Spectral features, including periodic power and aperiodic offset, were derived from baseline recordings. Line length and bandpass detector metrics were calculated from device-detected epileptiform activity and compared with baseline. Spectral and detection features were mapped according to channel locations using coordinates in Montreal Neurological Institute space and spatial reconstruction of local field potential sources.</p><p><strong>Results: </strong>Ten adult participants were studied, including eight with genetic generalized epilepsy, one with Lennox-Gastaut syndrome, and one with multifocal epilepsy. Periodic spectra demonstrated a daytime beta peak and a nighttime alpha/low beta peak. Spatial variation was noted for all spectral and detection features. Daytime aperiodic exponent, daytime periodic beta power, and nighttime periodic alpha power were highest in the medial CM (p < 0.001), with an additional beta spatial maximum in the motor thalamus. Line length detection exhibited a maximum in the posterior CM and was lower near a previously described \"sweet spot\" for stimulation (p < 0.001). Maximal bandpass detection was observed in the lateral CM (p < 0.001), 3 mm away from the stimulation sweet spot.</p><p><strong>Conclusions: </strong>Maximal bandpass detection was observed in the lateral CM, near a previously described stimulation sweet spot. Other spectral and detection features were elevated in the medial/posterior CM, which has been described as a functionally distinct subregion. The lateral CM appears to be a favorable region for detection of epileptiform activity.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}