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Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models
Published on: August 12, 2018
9.3K
Comparing Current Steering Technologies for Directional Deep Brain Stimulation Using a Computational Model That
Simeng Zhang1, Peter Silburn2, Nader Pouratian3
1Neuromodulation Division, Abbott, Plano, TX, USA.
Summary
Current steering technologies for deep brain stimulation (DBS) show limitations. Computational modeling reveals that while multiple independent current control (MICC) and multi-stim set (MSS) offer steering, concurrent activation (co-activation) is more accurate and power-efficient.
Area of Science:
- Computational neuroscience
- Biomedical engineering
- Neurosurgery
Background:
- Deep brain stimulation (DBS) is a therapeutic intervention for neurological disorders.
- Current steering technologies aim to precisely modulate neural targets.
- Heterogeneous tissue properties can influence the effectiveness of DBS.
Purpose of the Study:
- To compare the performance of multiple independent current control (MICC), multi-stim set (MSS), and concurrent activation (co-activation) current steering technologies in DBS.
- To evaluate these technologies based on volume of tissue activated (VTA) and power consumption.
- To assess the impact of heterogeneous tissue properties on current steering accuracy and VTA characteristics.
Main Methods:
- A computational model using Sim4Life v4.0 with a multimodal image-based detailed anatomical (MIDA) model was employed.
- A segmented DBS lead was simulated in the subthalamic nucleus (STN).
- Three milliamperes of current with a 90 μs pseudo-biphasic waveform was distributed across electrodes, with VTA laterality, directional accuracy, volume, shape, and power consumption computed for MICC, MSS, and co-activation.
Main Results:
- MICC, MSS, and co-activation demonstrated reduced laterality compared to single-segment activation.
- MICC and MSS exhibited directional inaccuracy during radial steering, more so with MSS.
- Co-activation provided superior directional accuracy at the centerline between electrodes.
- MSS resulted in smaller, more compact VTAs with less current spread than MICC.
- Electrode co-activation consistently consumed less power than MICC or MSS.
Conclusions:
- Current fractionalization technologies (MICC, MSS) can achieve steering between segmented electrodes but have limitations.
- Accounting for tissue heterogeneity reveals significant constraints in the accuracy and focus of VTA.
- Co-activation emerges as a more accurate and power-efficient current steering strategy in heterogeneous tissues.
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