A Short History of Neurosurgical Localization

The future of neuromodulation: smart neuromodulation

Introduction: The International Neuromodulation Society defines neuromodulation as the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.Areas covered: In the near future (<5 years) increasingly complex implantable neuromodulation systems will enter the market. These devices are capable of closed-loop stimulation and the delivery of novel stimulation designs, pushing the need for upgradability. But what about the near-to-far future, meaning 5-10 years from now?Expert opinion: We propose that neuromodulation in the near to far future (5-10 years) will involve integration of adaptive network neuromodulation with predictive artificial intelligence, automatically adjusted by brain and external sensors, and controlled via cloud-based applications. The components will be introduced in a phased approach, culminating in a fully autonomous brain-stimulator-cloud interface. This may, in the long future (>10 years), lead to the brain of the future, a brain with integrated artificial intelligence.

Early craniometric tools as a predecessor to neurosurgical stereotaxis

In this paper the authors trace the history of early craniometry, referring to the technique of obtaining cranial measurements for the accurate correlation of external skull landmarks to specific brain regions. Largely drawing on methods from the newly emerging fields of physical anthropology and phrenology in the late 19th and early 20th centuries, basic mathematical concepts were combined with simplistic (yet at the time, innovative) mechanical tools, leading to the first known attempts at craniocerebral topography. It is important to acknowledge the pioneers of this pre-imaging epoch, who applied creativity and ingenuity to tackle the challenge of reproducibly and reliably accessing a specific target in the brain. In particular, with the emergence of Broca’s theory of cortical localization, in vivo craniometric tools, and the introduction of 3D coordinate systems, several innovative devices were conceived that subsequently paved the way for modern-day stereotactic techniques. In this context, the authors present a comprehensive and systematic review of the most popular craniometric tools developed during this time period (prior to the stereotactic era) for the purposes of craniocerebral measurement and target localization.