title: State of the Art: Novel Applications for Cortical Stimulation.
abstract: OBJECTIVE
  Electrical stimulation via implanted electrodes that overlie the cortex of the brain is an upcoming neurosurgical technique that was hindered for a long time by insufficient knowledge of how the brain functions in a dynamic, physiological, and pathological way, as well as by technological limitations of the implantable stimulation devices.
  
  
  METHODS
  This paper provides an overview of cortex stimulation via implantable devices and introduces future possibilities to improve cortex stimulation.
  
  
  RESULTS
  Cortex stimulation was initially used preoperatively as a technique to localize functions in the brain and only later evolved into a treatment technique. It was first used for pain, but more recently a multitude of pathologies are being targeted by cortex stimulation. These disorders are being treated by stimulating different cortical areas of the brain. Risks and complications are essentially similar to those related to deep brain stimulation and predominantly include haemorrhage, seizures, infection, and hardware failures. For cortex stimulation to fully mature, further technological development is required to predict its outcomes and improve stimulation designs. This includes the development of network science-based functional connectivity approaches, genetic analyses, development of navigated high definition transcranial alternating current stimulation, and development of pseudorandom stimulation designs for preventing habituation.
  
  
  CONCLUSIONS
  In conclusion, cortex stimulation is a nascent but very promising approach to treating a variety of diseases, but requires further technological development for predicting outcomes, such as network science based functional connectivity approaches, genetic analyses, development of navigated transcranial electrical stimulation, and development of pseudorandom stimulation designs for preventing habituation.
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.affiliation: Auckland City Hospital, New Zealand.
authors.forename: Sanjaya
authors.initials: S
authors.lastname: Perera
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand.|The University of Texas at Dallas, Richardson, TX, USA.
authors.forename: Sven
authors.initials: S
authors.lastname: Vanneste
mesh_terms: D000818:Animals; D001927:Brain Diseases / Q000628:therapy*; D002540:Cerebral Cortex / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods*; D003863:Depression / Q000628:therapy; D006801:Humans; D010146:Pain; D059408:Pain Management; D014012:Tinnitus / Q000628:therapy
keywords: Addiction; cortex; depression; movement disorder; obsessive compulsive disorder; pain; stimulation; tinnitus