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Comparison between patient-specific deep brain stimulation simulations and commercial system SureTune3
Johannes D Johansson1,2, Peter Zsigmond3
1Department of Biomedical Engineering, Linköping University, 581 85 Linköping, Sweden.
Biomedical Physics & Engineering Express
|June 23, 2021
Summary
SureTune3 software accurately estimates volume of tissue activated (VTA) in deep brain stimulation using voltage control. However, current control and surrounding tissue characteristics, like cerebrospinal fluid, impact VTA accuracy, requiring consideration.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Computational Neuroscience
Background:
- Deep brain stimulation (DBS) relies on accurate visualization of the volume of tissue activated (VTA).
- Current clinical software, like SureTune3, often assumes homogeneous surrounding tissue.
- Patient-specific finite element method (FEM) simulations offer a more detailed approach.
Purpose of the Study:
- To compare VTA estimates from SureTune3 with homogeneous and heterogeneous patient-specific FEM simulations.
- To evaluate the impact of varying stimulation parameters and tissue properties on VTA.
- To determine the clinical applicability of SureTune3 versus FEM simulations.
Main Methods:
- FEM simulations of VTA were conducted using COMSOL Multiphysics.
- Comparisons were made with SureTune3 VTA estimates.
- Simulations varied voltage/current amplitude, pulse width, axon diameter, contact configuration, and surrounding tissue (grey/white matter, CSF).
Main Results:
- VTAs correlated well for voltage control in homogeneous tissue.
- FEM simulations showed larger VTAs in white matter and smaller VTAs in grey matter under current control.
- Patient-specific simulations agreed well, except in cases with near-contact cerebrospinal fluid (CSF) cysts.
Conclusions:
- SureTune3 provides good VTA estimates with voltage control in homogeneous tissue without CSF.
- Tissue conductivity and the presence of CSF significantly influence VTA accuracy, especially with current control.
- Patient-specific FEM simulations are crucial when tissue heterogeneity or CSF is present.
