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Comprehensive map of axonal pathway activation as a function of subthalamic deep brain stimulation location and
Anneke M Frankemolle-Gilbert1, Angela M Noecker2, Tjitske Heida3
1Department of Biomedical Engineering, Duke University, Durham, NC, USA; TechMed Centre, University of Twente, Enschede, the Netherlands.
Brain Stimulation
|November 23, 2025
Summary
This study maps deep brain stimulation (DBS) pathway activation in Parkinson's disease (PD) patients. Advanced modeling shows electrode location significantly impacts which brain pathways are stimulated, aiding personalized treatment.
Area of Science:
- Neuroscience
- Computational modeling
- Biophysics
Background:
- Deep brain stimulation (DBS) is a key therapy for Parkinson's disease (PD).
- Current computational models for subthalamic DBS often use simplified methods.
- Advanced modeling is needed to refine understanding of DBS effects.
Purpose of the Study:
- To map axonal pathway activation in the subthalamic region for DBS.
- To explore effects of varied stimulation settings (polarity, pulse width, amplitude) and electrode locations.
- To provide detailed insights into DBS mechanisms for PD.
Main Methods:
- Utilized a detailed computational model of subthalamic DBS.
- Calculated responses for 9 axonal pathways across 256 DBS locations.
- Investigated ring, directional, and bipolar stimulation modes.
Main Results:
- Electrode location is critical in determining activated axonal pathways.
- Developed a pathway selectivity index to guide stimulation parameters.
- Achieving complete pathway selectivity is challenging due to co-activation.
Conclusions:
- Specific pathway activation may correlate with PD symptom control.
- This study predicts conditions for pathway-selective DBS.
- An interactive software tool quantifies DBS pathway activation in the subthalamic region.
