![]() Like many other games that appear on Steam and float in and out of the collective consciousness, this is a metaphysical journey that prioritizes discovery over solution, and it's a largely successful one, leading you through one gorgeous environment after another so that you might ogle the view and wonder about its meaning within Path to Thalamus' larger narrative. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.Mind: Path to Thalamus is easy to classify but difficult to parse, a first-person puzzle game that's not about the puzzles but instead about what they stand for. Neither of the other authors has any conflict of interest to disclose. consults for Medtronic and has stock or options from Avails Medical, Cerebral Therapeutics, Eysz, Irody, Smart Monitor, and Zeto. ![]() is a consultant for Neuralink, and serves on the medical advisory board of Enspire DBS. ![]() is a training and education employee of Medtronic. has waived contractual rights to royalties he is a principal investigator for the Medtronic Deep Brain Stimulation Therapy for Epilepsy Post-Approval Study (EPAS) and investigator for Mayo Clinic Medtronic NIH Public Private Partnership (UH3-NS95495) Mayo Clinic has received consulting fees on behalf of BNL from Medtronic and Philips. is a named inventor for intellectual property developed at Mayo Clinic and licensed to Cadence Neuroscience. has received honoraria from AbbVie, Abbott, Boston Scientific, Ceregate, Ipsen, Medtronic, and UCB and research support from AbbVie, Boston Scientific, and Medtronic. Controlled comparisons will be needed to choose the best approach.Ī.F. We present a flowchart for one protocol combining common practices. In conclusion, surveys of experts can provide Class IV evidence for the most prevalent practical use of ANT-DBS. Experienced users varied more from published parameters than did inexperienced users. Several physicians used DBS in conjunction with vagus nerve stimulation or responsive neurostimulation, although our study did not track efficacy for combined use. Off-label sites stimulated included centromedian thalamus, hippocampus, neocortex, and a few others. Mood or memory problems or paresthesias were the side effects most responsible for adjustments. ![]() Stimulation intensity was most often increased or reduced, respectively, for lack of efficacy or side effects, but changes in active contacts, cycle time, and pulse duration were also employed. ![]() Stimulation parameters mostly imitated the SANTE study parameters, except for initial stimulation amplitudes in the 2–3-V or -mA range, versus 5 V in the SANTE study. The majority used transventricular approaches. Targeting of leads mainly was by magnetic resonance imaging, sometimes with intraoperative imaging or microelectrode recording. Motivations for renewing therapy upon battery depletion were reduced convulsive, impaired awareness, and severe seizures and improved quality of life. The survey found that the best candidates for DBS were considered those with temporal or frontal seizures, refractory to at least two medicines. Multiple regions of the world were represented. In an attempt to fill this gap, a questionnaire with 37 questions was circulated to 578 clinicians who were either engaged in clinical trials of or known users of DBS for epilepsy, with responses from 141, of whom 58.2% were epileptologists and 28.4% neurosurgeons. Deep brain stimulation of the anterior nuclei of thalamus (ANT-DBS) is effective for reduction of seizures, but little evidence is available to guide practitioners in the practical use of this therapy. ![]()
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