Lateral hypothalamic area deep brain stimulation for refractory obesity: a pilot study with preliminary data on safety, body weight, and energy metabolism.

Object: Deep brain stimulation (DBS) of the lateral hypothalamic area (LHA) has been suggested as a potential treatment for intractable obesity. The authors present the 2-year safety results as well as early efficacy and metabolic effects in 3 patients undergoing bilateral LHA DBS in the first study of this approach in humans.

Methods: Three patients meeting strict criteria for intractable obesity, including failed bariatric surgery, underwent bilateral implantation of LHA DBS electrodes as part of an institutional review board- and FDA-approved pilot study.

Three-dimensional somatotopic organization and probabilistic mapping of motor responses from the human internal capsule.

Object: The somatotopic organization of the motor fibers within the posterior limb of the internal capsule (IC) in humans remains unclear. Several electrophysiological atlases created from stimulation during stereotactic neurosurgery have suggested that there is considerable overlap between representations of body parts. Overlap reported in these studies may have been due to linear scaling methods applied to the data that were unable to account for individual anatomical variability.

Comparison of different targeting methods for subthalamic nucleus deep brain stimulation.

The subthalamic nucleus (STN) has been adopted as a commonly used surgical target in deep brain stimulation (DBS) procedures for the treatment of Parkinson's disease. Many techniques have been developed to facilitate STN DBS targeting, and consequently to improve the surgical outcome. In this work, we conducted a retrospective study on 10 patients who were treated with bilateral STN DBS to assess the target localization accuracy and precision of six methods in STN DBS surgery.

Visualization and navigation system development and application for stereotactic deep-brain neurosurgeries.

We present the development of a visualization and navigation system and its application in pre-operative planning and intra-operative guidance of stereotactic deep-brain neurosurgical procedures for the treatment of Parkinson's disease, chronic pain, and essential tremor. This system incorporates a variety of standardized functional and anatomical information, and is capable of non-rigid registration, interactive manipulation, and processing of clinical image data. The integration of a digitized and segmented brain atlas, an electrophysiological database, and collections of final surgical targets from previous patients facilitates the delineation of surgical targets and surrounding structures, as well as functional borders.

Development and application of functional databases for planning deep-brain neurosurgical procedures.

This work presents the development and application of a visualization and navigation system for planning deep-brain neurosurgeries. This system, which incorporates a digitized and segmented brain atlas, an electrophysiological database, and collections of final surgical targets of previous patients, provides assistance for non-rigid registration, navigation, and reconstruction of clinical image data. The fusion of standardized anatomical and functional data, once registered to individual patient images, facilitates the delineation of surgical targets.

Three-dimensional database of subcortical electrophysiology for image-guided stereotactic functional neurosurgery.

We present a method of constructing a database of intraoperatively observed human subcortical electrophysiology. In this approach, patient electrophysiological data are standardized using a multiparameter coding system, annotated to their respective magnetic resonance images (MRIs), and nonlinearly registered to a high-resolution MRI reference brain. Once registered, we are able to demonstrate clustering of like interpatient physiologic responses within the thalamus, globus pallidus, subthalamic nucleus, and adjacent structures.