Spatial steering of deep brain stimulation volumes using a novel lead design.
OBJECTIVE
To investigate steering the volume of activated tissue (VTA) with deep brain stimulation (DBS) using a novel high spatial-resolution lead design.


METHODS
We examined the effect of asymmetric current-injection across the DBS-array on the VTA. These predictions were then evaluated acutely in a non-human primate implanted with the DBS-array, using motor side-effect thresholds as the metric for estimating VTA asymmetries.


RESULTS
Simulations show the DBS-array, with electrodes arranged together in a cylindrical configuration, can generate field distributions equivalent to commercial DBS leads, and these field distributions can be modulated using field-steering methods. Stimulation with implanted DBS-arrays showed directionally-selective muscle activation, presumably through spread of stimulation fields into portions of the corticospinal tract lying in the internal capsule.


CONCLUSIONS
Our computational and experimental studies demonstrate that the DBS-array is capable of spatially selective stimulation. Displacing VTAs away from the lead's axis can be achieved using a single simple and intuitive control parameter.


CONCLUSIONS
Optimal DBS likely requires non-uniform VTAs that may differentially affect a nucleus or fiber pathway. The DBS-array allows positioning VTAs with sub-millimeter precision, which is especially relevant for those patients with DBS leads placed in sub-optimal locations. This may present clinicians with an additional degree of freedom to optimize the DBS therapy.
Martens
H C F
HCF
Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands. Electronic address: hubert.martens@philips.com.
Toader
E
E
Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands.
Decré
M M J
MMJ
Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands.
Anderson
D J
DJ
Neuronexus Technologies, 3985 Research Park Dr. Suite 100, Ann Arbor, MI 48108, USA.
Vetter
R
R
Neuronexus Technologies, 3985 Research Park Dr. Suite 100, Ann Arbor, MI 48108, USA.
Kipke
D R
DR
Neuronexus Technologies, 3985 Research Park Dr. Suite 100, Ann Arbor, MI 48108, USA.
Baker
Kenneth B
KB
Cleveland Clinic, Department of Neurosciences, NC30, 8900 Euclid Ave., Cleveland, OH 44195, USA; University of Minnesota, Department of Neurology, 516 Delaware Street SE, Minneapolis, MN 55455, USA.
Johnson
Matthew D
MD
Cleveland Clinic, Department of Neurosciences, NC30, 8900 Euclid Ave., Cleveland, OH 44195, USA; University of Minnesota, Department of Biomedical Engineering, 7-105 NHH, 312 Church Street SE, Minneapolis, MN 55455, USA.
Vitek
Jerrold L
JL
Cleveland Clinic, Department of Neurosciences, NC30, 8900 Euclid Ave., Cleveland, OH 44195, USA; University of Minnesota, Department of Neurology, 516 Delaware Street SE, Minneapolis, MN 55455, USA.
D000465:Algorithms; D000818:Animals; D003198:Computer Simulation; D046690:Deep Brain Stimulation / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D004574:Electromagnetic Fields; D007839:Functional Laterality / Q000502:physiology; D008253:Macaca mulatta; D008839:Microelectrodes; D008953:Models, Anatomic; D019919:Prosthesis Implantation / Q000379:methods*; D011712:Pyramidal Tracts / Q000502:physiology