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New Advances in Functional Neurosurgery—2nd Edition

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Special Issue Editor

Special Issue Information

Dear Colleagues,

Functional neurosurgery has witnessed remarkable advancements in recent years, significantly improving patient outcomes in various neurological disorders. This Special Issue aims to bring together researchers and clinicians to explore innovative surgical techniques, neuromodulation strategies, and intraoperative monitoring advancements that are shaping the field.

The focus of this Special Issue is on research on the advancement of surgical techniques for the treatment of neuropathic pain, new indications for neuromodulation, such as spasticity and movement disorders, and advances in the management of neurovascular conflict syndromes, alongside the use of artificial intelligence for optimizing patient selection and outcome prediction. Furthermore, key topics are the expanding role of MR-guided focused ultrasound (MRgFUS), the role of deep brain stimulation (DBS) beyond movement disorders, and innovative therapeutic options for drug-resistant epilepsy, such as laser interstitial thermal therapy (LiTT). Additionally, the advancement of intraoperative neurophysiological monitoring in all fields of neurosurgery is of great interest for the purpose of this Special Issue.

We invite original research articles, reviews, and case reports that contribute to these themes and provide new insights into the fundamental mechanisms and clinical applications of functional neurosurgery.

We believe that this Special Issue will serve as a valuable resource for researchers and clinicians to share their latest findings, and advance the field.

Dr. Nicola Montano
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

functional neurosurgery
trigeminal neuralgia
microvascular decompression
deep brain stimulation
neuromodulation
spinal cord stimulation
epilepsy surgery
neurophysiological intraoperative monitoring
artificial intelligence in neurosurgery
MR-guided focused ultrasound (MRgFUS)
laser interstitial thermal therapy (LiTT)

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10 pages, 237 KB

Open AccessArticle

High-Frequency Spinal Cord Stimulation for the Treatment of Spasticity: A Preliminary Case Series

by Alessandro Izzo, Benedetta Burattini, Renata Martinelli, Quintino Giorgio D’Alessandris, Manuela D'Ercole, Maria Filomena Fuggetta and Nicola Montano

Brain Sci. 2026, 16(1), 118; https://doi.org/10.3390/brainsci16010118 - 22 Jan 2026

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Abstract

Background: Spasticity is a complex and multifactorial condition resulting from upper motor neuron injury. It manifests through muscle contractions, pain, limited range of motion, and clonus, which significantly impair daily activities and quality of life. High-frequency spinal cord stimulation (HF SCS) has shown optimal results in treating chronic neuropathic pain, but its potential role in spasticity remains underexplored. This study aimed to evaluate the efficacy of HF SCS in patients with spasticity. Methods: From April 2021 to July 2024, six patients with spasticity from various etiologies underwent SCS implantation at our institution. Clinical evaluations including the use of the Visual Analog Scale (VAS), Douleur Neuropathique 4 (DN4), and the Ashworth score, as well as ambulation ability and clonus episodes, were performed preoperatively and at a minimum of six months post-surgery. Subjective assessments of motor function, including coordination, movement efficiency, and postural transitions, were also recorded. Results: The mean age of patients was 50.12 ± 9.41 years, with follow-up averaging 24.32 ± 10.83 months. Statistically significant improvements were observed in VAS (p = 0.0412) and DN4 (p = 0.0422) scores, alongside a reduction in clonus episodes. All patients reported subjective improvements in coordination, movement efficiency, and postural transitions. Ambulation remained stable or improved in all cases. No perioperative complications or sensory/motor side effects were noted. Conclusions: HF SCS offers a promising approach to managing spasticity, with improvements in motor function, ambulation, and postural transitions. These findings support further investigation into HF SCS for spasticity, with multicenter trials needed to optimize treatment protocols and identify the most responsive patient populations. Full article

(This article belongs to the Special Issue New Advances in Functional Neurosurgery—2nd Edition)

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