Critical review of the responsive neurostimulator system for epilepsy

George P Thomas, Barbara C Jobst Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA Abstract: Patients with medically refractory epilepsy have historically had few effective treatment options. Electrical brain stimulation for seizures has been studied for decades and ongoing technological refinements have made possible the development of an implantable electrical brain stimulator. The NeuroPace responsive neurostimulator was recently approved by the FDA for clinical use and the initial reports are encouraging. This device continually monitors brain activity and delivers an electric stimulus when abnormal activity is detected. Early reports of efficacy suggest that the device is well tolerated and offers a reduction in seizure frequency by approximately half at 2 years. Keywords: medically refractory epilepsy, seizures, brain surgery, brain stimulation, neurostimulatio

How the human brain represents perceived dangerousness or \u201cpredacity\u201d of animals

Common or folk knowledge about animals is dominated by three dimensions: (1) level of cognitive complexity or "animacy;" (2) dangerousness or "predacity;" and (3) size. We investigated the neural basis of the perceived dangerousness or aggressiveness of animals, which we refer to more generally as "perception of threat." Using functional magnetic resonance imaging (fMRI), we analyzed neural activity evoked by viewing images of animal categories that spanned the dissociable semantic dimensions of threat and taxonomic class. The results reveal a distributed network for perception of threat extending along the right superior temporal sulcus. We compared neural representational spaces with target representational spaces based on behavioral judgments and a computational model of early vision and found a processing pathway in which perceived threat emerges as a dominant dimension: whereas visual features predominate in early visual cortex and taxonomy in lateral occipital and ventral temporal cortices, these dimensions fall away progressively from posterior to anterior temporal cortices, leaving threat as the dominant explanatory variable. Our results suggest that the perception of threat in the human brain is associated with neural structures that underlie perception and cognition of social actions and intentions, suggesting a broader role for these regions than has been thought previously, one that includes the perception of potential threat from agents independent of their biological class