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Surgical Strategy for Directional Deep Brain Stimulation
Hiroshi Masuda1, Hiroshi Shirozu1, Yosuke Ito1
1Division of Functional Neurosurgery, Nishiniigata National Hospital.
Neurologia Medico-Chirurgica
|November 1, 2021
Summary
Directional leads in deep brain stimulation (DBS) offer improved outcomes but complex programming. New strategies are needed for effective directional DBS, potentially using imaging and future local field potential recordings.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Neurology
Background:
- Deep brain stimulation (DBS) effectively treats involuntary movements but conventional leads cause widespread electrical fields.
- Unintended effects arise from electrical field spread to adjacent brain structures with cylindrical leads.
- Novel directional leads (DS) aim to improve therapeutic outcomes and reduce side effects.
Purpose of the Study:
- To address the complexity of programming novel directional DBS leads.
- To propose new strategies for effective directional DBS programming.
- To optimize lead placement and stimulation parameters for improved patient outcomes.
Main Methods:
- Review of current directional DBS lead technology and programming challenges.
- Discussion of the importance of lead placement and orientation.
- Exploration of advanced imaging techniques for programming guidance.
Main Results:
- Directional leads offer a wider therapeutic window (TW) and reduced power consumption.
- Lead placement in a "sweet spot" and correct orientation are crucial for effective programming.
- Image-guided programming and future use of local field potentials can streamline the process.
Conclusions:
- Effective directional DBS requires systematic and efficient programming strategies.
- Advancements in imaging facilitate image-guided programming for directional leads.
- Future research should focus on utilizing local field potentials for optimal directional DBS programming.
