Big debate around that, apparently — and one vs. more locations, etc. I should remember the exact area after having to draw so many version of the interaction g

Big debate around that, apparently — and one vs. more locations, etc. I should remember the exact area after having to draw so many version of the interaction graphs, but not on the top of my head — did check: Bed Nucleus of Stria Terminalis. I know one of her coauthor has doubt that the location matters that much (we are talking places that are less than a centimetre apart, at the very center of the brain for anyone who isn't up to date on their basal ganglia) and suspects that current works because it actually affects the whole area. Telling neurosurgeons that millimetres are not a matter of life-and-death apparently didn’t go too well at the latest conference… and honestly, it sounds a bit nerdy from the outside, but I’m really impressed by how much they care, and very happy that they do. There’s been progress on imaging, but given the image quality and resolution, the very small number of patients for whom it didn’t work to compare against, I’d be surprised if they can make non-obvious judgements like “it can work as long as one of those is electrified” vs. “it works because anywhere of that area has some current of at least that much” vs. “it works because everywhere in that area has current above a low threshold, but you need to put more if you use electrodes in only some location”. > crossover trial design Good idea, definitely my recommendation (I implemented a lot of tests with that for on-line AB-tests to account for novelty effects); I think it has been discussed and was used before, but I remember a story of patients who got very concerned over loosing the sanity they had finally gained, and begged to get the current back. The risk of regression might lead to worst outcomes. That’s the different with say, tremors from Parkinson’s: sure they are impossible to live with, but if you are confident they can be switched on and off, they become an annoying party trick. Same as a prosthetic leg: you need it to walk but if you have to take it off, you can. Mental health doesn't have the same tangibility: you are not yourself anymore without it? It’s hard to explain but it drives a lot of the trickier ethical questions in psychiatry. Check the literature because I could have made the patients up, or it could be a speculation from the ethics committee. But as the device gets more common, there will be better stats & methodology. I suspect that, to get from a research exception to a diagnostic recommendation, they will need to do investigate to recommend either switching it off in case of concern, how, how fast, which levels, when to stop lowering, etc.) or advise against any reduction, or recommend having the device removed… Crossover could be helpful in that context.