title: Analyzing the tradeoff between electrical complexity and accuracy in patient-specific computational models of deep brain stimulation.
abstract: Deep brain stimulation (DBS) is an adjunctive therapy that is effective in treating movement disorders and shows promise for treating psychiatric disorders. Computational models of DBS have begun to be utilized as tools to optimize the therapy. Despite advancements in the anatomical accuracy of these models, there is still uncertainty as to what level of electrical complexity is adequate for modeling the electric field in the brain and the subsequent neural response to the stimulation.
  
  
  
  We used magnetic resonance images to create an image-based computational model of subthalamic DBS. The complexity of the volume conductor model was increased by incrementally including heterogeneity, anisotropy, and dielectric dispersion in the electrical properties of the brain. We quantified changes in the load of the electrode, the electric potential distribution, and stimulation thresholds of descending corticofugal (DCF) axon models.
  
  
  
  Incorporation of heterogeneity altered the electric potentials and subsequent stimulation thresholds, but to a lesser degree than incorporation of anisotropy. Additionally, the results were sensitive to the choice of method for defining anisotropy, with stimulation thresholds of DCF axons changing by as much as 190%. Typical approaches for defining anisotropy underestimate the expected load of the stimulation electrode, which led to underestimation of the extent of stimulation. More accurate predictions of the electrode load were achieved with alternative approaches for defining anisotropy. The effects of dielectric dispersion were small compared to the effects of heterogeneity and anisotropy.
  
  
  
  The results of this study help delineate the level of detail that is required to accurately model electric fields generated by DBS electrodes.
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Howell
authors.forename: Cameron C
authors.initials: CC
authors.lastname: McIntyre
mesh_terms: D016880:Anisotropy; D001369:Axons / Q000502:physiology; D001921:Brain / Q000033:anatomy & histology; D003198:Computer Simulation; D046690:Deep Brain Stimulation / Q000379:methods* / Q000706:statistics & numerical data; D056324:Diffusion Tensor Imaging; D004566:Electrodes; D004581:Electronics; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D015203:Reproducibility of Results; D020531:Subthalamic Nucleus / Q000033:anatomy & histology