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Papers of the Week

Papers: 3 Feb 2024 - 9 Feb 2024

2024 Feb 16





A pilot study on a patient with refractory headache: Personalized deep brain stimulation through stereoelectroencephalography.


Zhao H, Zhang S, Wang Y, Zhang C, Gong Z, Zhang M, Dai W, Ran Y, Shi W, Dang Y, Liu A, Zhang Z, Yeh CH, Dong Z, Yu S


The integration of stereoelectroencephalography with therapeutic deep brain stimulation (DBS) holds immense promise as a viable approach for precise treatment of refractory disorders, yet it has not been explored in the domain of headache or pain management. Here, we implanted 14 electrodes in a patient with refractory migraine and integrated clinical assessment and electrophysiological data to investigate personalized targets for refractory headache treatment. Using statistical analyses and cross-validated machine-learning models, we identified high-frequency oscillations in the right nucleus accumbens as a critical headache-related biomarker. Through a systematic bipolar stimulation approach and blinded sham-controlled survey, combined with real-time electrophysiological data, we successfully identified the left dorsal anterior cingulate cortex as the optimal target for the best potential treatment. In this pilot study, the concept of the herein-proposed data-driven approach to optimizing precise and personalized treatment strategies for DBS may create a new frontier in the field of refractory headache and even pain disorders.