Investigating the Function of Deep Cortical and Subcortical Structures Using Stereotactic Electroencephalography: Lessons from the Anterior Cingulate Cortex

Summary

Stereotactic Electroencephalography (SEEG) is an operative technique used in epilepsy surgery to help localize seizure foci. It also affords a unique opportunity to investigate brain function. Here we describe how SEEG can be used to investigate cognitive processes in human subjects.

Abstract

Stereotactic Electroencephalography (SEEG) is a technique used to localize seizure foci in patients with medically intractable epilepsy. This procedure involves the chronic placement of multiple depth electrodes into regions of the brain typically inaccessible via subdural grid electrode placement. SEEG thus provides a unique opportunity to investigate brain function. In this paper we demonstrate how SEEG can be used to investigate the role of the dorsal anterior cingulate cortex (dACC) in cognitive control. We include a description of the SEEG procedure, demonstrating the surgical placement of the electrodes. We describe the components and process required to record local field potential (LFP) data from consenting subjects while they are engaged in a behavioral task. In the example provided, subjects play a cognitive interference task, and we demonstrate how signals are recorded and analyzed from electrodes in the dorsal anterior cingulate cortex, an area intimately involved in decision-making. We conclude with further suggestions of ways in which this method can be used for investigating human cognitive processes.

Introduction

Epilepsy, a common neurological disorder characterized by multiple recurrent seizures over time, accounts for 1% of the worldwide burden of diseases ¹. Anti-epileptic medications fail to control seizures in 20 - 30% of patients ^2,3. In these medically intractable patients, epilepsy surgery is often indicated ^4,5. The decision to proceed with surgery requires locating the seizure focus, a prerequisite to formulating a surgical plan. Initially, non-invasive techniques are used to lateralize and localize the seizure focus. Electroencephalography (EEG), for example, measures cortical electrical activity recorded from electrodes placed on t....

Protocol

Ensure that each patient is reviewed for suitability for the research study, and appropriate patients must be consented for participation in the study according to local IRB procedures.

1. Patient Selection for SEEG and Research

1. Patient Selection for SEEG
   Note: Epilepsy patients must be clinically assessed by a multidisciplinary team consisting of epileptologists, neuropsychologists and neurosurgeons.
   1. Ensure that the patient has medically refractory focal epilepsy, defined as failure to respond to at least 2 adequate trials of anti-epileptic medications.
   2. Ensure that non-invasive techniques have fail....

Results

Once a patient is selected for SEEG electrode placement, he/she undergoes a volumetric T2 and T1 contrast enhanced MRI. SEEG electrode trajectories are then planned using stereotactic navigation of the volumetric MRI sequences (Figure 1). This technique allows for the collection of local field potentials from structures deep within the cortex such as dorsal anterior cingulate cortex (light orange trajectory, Figure 1) that would not be possible with typical surface electrode placement. P.......

Discussion

In this paper SEEG was used to investigate the activity of local neuronal populations within the dACC during a decision-making task in humans. Previous work has investigated the activity of individual neurons in the dACC using intraoperative microelectode recordings ¹⁴ and demonstrated that dACC activity is modulated by previous activity. Microelectrode studies enable the investigation of the spiking activity of individual neurons. SEEG measures LFPs, which are related to the summated synaptic potentials acros.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Trigger I/O cable	Natus Medical Inc.	5029	PS2 to BNC cable
BNC cables for analog pulses			Can be ordered from most electronics stores.
Power strip with surge protection and battery backup	Tripp Lite	SMART500RT1U UPC	Power source and backup
National instruments multifunctional daq data acquisition box NI PCIe-6382 DAQ cards	National Instruments	PCIe-6382 w/ BNC 2090A	PCI cards for behavioral control interface
Custom made button box - human interface device			Any human interface device with three buttons may be used. Alternatively, 3 keyboard buttons may be used.
Xltek 128 channel clinical intracranial EEG monitoring system EMU128FS	Natus Medical Inc.	002047c	Clinical recording system
Subject monitor and associated cables for visual stimulus presentation	Dell	U2212HMc	Most Monitors are adequate here.
Personal comptuer running behavioral software with DAQ cards installed	Superlogics	SL-2U-PD-Q87SLQ-BA	Computer for recording neural data
Mains cable for monitor			Usually comes with the monitor, can be purchased at any electronics store.
Monkey Logic software which runs on Matlab 2010A			Free from MonkeyLogic website
MATLAB 2010a software with data acquisition toolbox	Mathworks		Matlab software
sEEG electrodes AD TECH or PMT	AD TECH	2102-##-101	Platinum tip, diameter (0.89 mm, 1 mm, 1.1 mm), uninsulated length 2.3 mm; The ## in the catalog number indicates the number of contacts on the electrode (08, 10, 12, or 16)
Cabrio connectors	PMT	2125-##-01	The ## in the catalog number indicates the number of contacts on the electrode (08, 10, 12, or 16)
Tucker Davis Technologies Amplifier	Tucker Davs Technologies	PZ5	preamplifier for neural data
Tucker Davis Technologies processor	Tucker Davs Technologies	RZ2	Neural signal processor for neural data
TuckerDavis Technologies data streamer	Tucker Davs Technologies	RS4	Data streamer and storage
Fiber optics cables to connect TDT systems	Tucker Davs Technologies	F05	Fiber optic cables for connecting Tucker Davis Technologies' prodcuts.
ribbon cable and snap serial connector for digital markers			Can be ordered from ost electronics stores.
personal computer fro running TDT RPvdsEx and OpenEx software	Superlogics	SL-2U-PD-Q87SLQ-BA	computer for behavioral control
middle atlantics server cabinet with casters	Middle Atlantic Products	PTRK-21	Server case to house all of the research items
Tucker Davis Technologies splitter box to split clinical and research recrodings	Tucker Davs Technologies		This splitter box is a semi-custom device. Researchers should consult the attending neurologists about splitting the research and clinical recordings in a way that doesn't interfere with clinical care.
Researcher monitor with requisite cables	Dell	U2212HMc	Most Monitors are adequate here.
button box power source - 5 volts, 2 amperes			Can be purchased at any electronics store.
TDT optical interface PCI card	Tucker Davs Technologies	P05