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Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models
Published on: August 12, 2018
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Neural selectivity, efficiency, and dose equivalence in deep brain stimulation through pulse width tuning and
Collin J Anderson1, Daria Nesterovich Anderson2, Stefan M Pulst1
1University of Utah Department of Neurology, Salt Lake City, UT, USA.
Brain Stimulation
|April 13, 2020
Summary
Longer pulse widths in deep brain stimulation (DBS) can improve targeting of small nerve fibers and enhance battery life. Careful dose equivalence is crucial for accurate neural activation spread in future DBS studies.
Area of Science:
- Neuroscience
- Biomedical Engineering
- Computational Modeling
Background:
- Achieving dose equivalence in deep brain stimulation (DBS) is complex, particularly with pulse width adjustments and directional electrodes.
- The exact impact of pulse width modulation on neural selectivity remains unclear, with conflicting findings in recent literature compared to established biophysical models.
Purpose of the Study:
- To investigate the effects of pulse width tuning on neural activation and tissue volume in deep brain stimulation (DBS).
- To explore how directional leads and pulse width adjustments can optimize DBS therapy and potentially mitigate side effects.
Main Methods:
- Development of multicompartment neuron models for varying axon diameters.
- Application of finite element modeling to simulate extracellular electrical fields from standard and segmented electrodes.
- Analysis of axon activation patterns and calculation of the volume of tissue activated (VTA).
Main Results:
- Longer pulse widths were found to concentrate stimulation on smaller, adjacent nerve fibers, reducing activation in distant white matter tracts and improving power efficiency.
- Directional leads further enhanced these benefits, allowing for more focused stimulation.
- Patient-specific modeling demonstrated that longer pulse widths could expand the therapeutic window, using internal capsule avoidance during subthalamic stimulation as an example.
Conclusions:
- Findings align with classic studies, suggesting longer pulse widths can focus stimulation on small fibers and conserve power.
- Future research must prioritize dose equivalence in DBS studies, as energy/charge equivalence does not guarantee equivalent neural activation spread when altering pulse width.
