Neural Mechanisms of Spatial Representations Beyond the Self

This research study is based upon a unique opportunity to work with neurosurgical patients, who already have electrodes implanted in deep brain structures for clinical reasons (i.e., for the monitoring and treatment of pharmaco-resistant epilepsy). Research procedures will only be performed with patients who already have such electrodes implanted for clinical reasons; no electrodes will be implanted for research purposes, and the researchers will not have any influence on the implantation procedures of these electrodes. Two groups of participants will be asked to participate in the research study: 1. Hospitalized patients who have electrodes implanted temporarily (typically for up to two weeks) for epilepsy monitoring in the epilepsy monitoring unit (EMU participants). 2. Patients who have chronically/permanently implanted electrodes as part of the NeuroPace RNS System for the treatment of epilepsy (RNS participants). Independent from and prior to the research study, the patient's clinical care team (neurologists, neurosurgeons, etc.) decide whether electrodes or the RNS System will be implanted based solely on clinical criteria. If electrodes or the RNS System are implanted, patients will then be offered to participate in the research study; however, the decision whether or not to participate in the research study will not have any effect on the patient's treatment or clinical care.

Screening, recruitment, and consent procedures for EMU participants:

If the clinical care team decides - independent from the research study - that a patient's clinical condition merits implantation of temporary electrodes and hospitalization in the epilepsy monitoring unit (EMU), the patient's neurologists or neurosurgeons will invite the patient to participate in the research study. The neurosurgeons and neurologists make it clear to the patient that the decision to participate in the research is entirely voluntary and that the patient's medical needs will not be affected in any way by this decision. For patients who are interested in participating in the research study, the principal investigators meet with the patient to discuss the consent form. Subsequently the principal investigator also ensures that the patient fully understands the consent form and emphasizes again to the patient that participation is entirely voluntary and that the patient's decision whether to participate or not will have no effect on their medical care. If the patients are local, the research team meets with the patient at UCLA before or after pre-surgical tests. This is commonly done a 1-3 weeks before the surgery. For patients traveling long distance, the discussion may take place the day before the surgery. After discussion the patient signs the consent form to participate in the research study and it is countersigned by the principal investigator.

Screening, recruitment, and consent procedures for RNS participants:

For the proposed study, the investigators have already identified a number of patients for other ongoing studies that received NeuroPace RNS System at the UCLA medical center with RNS devices implanted in medial temporal lobe regions. These patients have been identified through their neurosurgeon or neurologist, who are part of the study team. These neurosurgeons and neurologists will inform their patients about the opportunity to participate in this research study. The neurosurgeons and neurologists make it clear to the patient that the decision to participate in the research is entirely voluntary and that the patient's medical needs will not be affected in any way by this decision. Potential subjects external to the UCLA medical center may have preliminary contact from their treating physician from a referring institution. If patients indicate interest in the study, the principal investigator, faculty sponsor, or the study coordinator will make initial direct contact via phone in a private secure location to introduce and describe the study after which further information and copy of consent form can be sent for review via secure encrypted e-mail and/or mail, if necessary. The principal investigators also ensure that the patient fully understands the consent form and emphasize again that participation is entirely voluntary and that the patient's decision whether to participate will have no effect on their medical care. Potential participants will be approached no earlier than 3 months after their RNS system placement to see if the patient would be interested in volunteering for the study. Consent may be obtained over the phone or internet for participants necessitating extended travel arrangements and accommodations. Participants, particularly those consented over the phone or via the internet, will be provided with a physical copy of the consent form and asked to sign it before performing any research procedures.