MRI-guided focused ultrasound thalamotomy reduced hand tremor in patients with essential tremor. Side effects included sensory and gait disturbances. (Funded by InSightec and others; ClinicalTrials.gov number, NCT01827904.).

MR CBV maps provided diagnostic information not available with conventional MR imaging in six cases and offers a functional parameter for assessing glioma grade and regions of focal activity.

The extent of microglial heterogeneity in humans remains a central yet poorly explored question in light of the development of therapies targeting this cell type. Here, we investigate the population structure of live microglia purified from human cerebral cortex samples obtained at autopsy and during neurosurgical procedures. Using single cell RNA sequencing, we find that some subsets are enriched for disease-related genes and RNA signatures. We confirm the presence of four of these microglial subpopulations histologically and illustrate the utility of our data by characterizing further microglial cluster 7, enriched for genes depleted in the cortex of individuals with Alzheimer’s disease (AD). Histologically, these cluster 7 microglia are reduced in frequency in AD tissue, and we validate this observation in an independent set of single nucleus data. Thus, our live human microglia identify a range of subtypes, and we prioritize one of these as being altered in AD.

After GTR without postoperative radiation, AMs have a high recurrence rate. Most recurrences occurred within 5 years after resection. Recurrences caused numerous reoperations per patient and shortened survival. Our finding suggesting lower recurrence rates in patients undergoing immediate postoperative radiation should be investigated in larger, prospective series.

The human dorsal anterior cingulate cortex (dACC) has been implicated in cognitive processes that have been proposed to play a role in integrating contextual information needed to select or modify appropriate motor responses. In humans, however, there has been little direct evidence tying the dACC to the integration of contextual information and behavioral response. We used single-neuron recordings from human subjects to evaluate the role of the dACC in reward-based decision making. Subjects undergoing planned surgical cingulotomy performed a task where they were instructed to make specific movements in response to changing monetary rewards. In many neurons, activity increased in response to a diminished reward, and was also predictive of the movement ultimately made. After dACC ablation, subjects made selectively more errors when they were required to change movement based on reward reduction. These findings suggest that the dACC in humans plays an important role in linking reward-related information with alternative actions.

This fMRI method shows potential for evaluating language dominance in patients with a variety of brain lesions.

Thirty-two percent to 45% of patients previously unresponsive to medication and behavioral treatments for OCD were at least partly improved after cingulotomy. Cingulotomy remains a viable treatment option for patients with severe treatment-refractory OCD.

We perform a review of the literature in the field of white matter tractography for neurosurgical planning, focusing on those works where tractography was correlated with clinical information such as patient outcome, clinical functional testing, or electro-cortical stimulation. We organize the review by anatomical location in the brain and by surgical procedure, including both supratentorial and infratentorial pathologies, and excluding spinal cord applications. Where possible, we discuss implications of tractography for clinical care, as well as clinically relevant technical considerations regarding the tractography methods.We find that tractography is a valuable tool in variable situations in modern neurosurgery. Our survey of recent reports demonstrates multiple potentially successful applications of white matter tractography in neurosurgery, with progress towards overcoming clinical challenges of standardization and interpretation.