A novel lead design enables selective deep brain stimulation of neural populations in the subthalamic region

Kees J. van Dijk, Rens Verhagen, Ashutosh Chaturvedi, Cameron C. McIntyre, Lo J. Bour, Tjitske Heida, Peter H. Veltink

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Abstract

Objective. The clinical effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) as a treatment for Parkinson's disease are sensitive to the location of the DBS lead within the STN. New high density (HD) lead designs have been created which are hypothesized to provide additional degrees of freedom in shaping the stimulating electric field. The objective of this study is to compare the performances of a new HD lead with a conventional cylindrical contact (CC) lead. Approach. A computational model, consisting of a finite element electric field model combined with multi-compartment neuron and axon models representing different neural populations in the subthalamic region, was used to evaluate the two leads. We compared ring-mode and steering-mode stimulation with the HD lead to single contact stimulation with the CC lead. These stimulation modes were tested for the lead: (1) positioned in the centroid of the STN, (2) shifted 1 mm towards the internal capsule (IC), and (3) shifted 2 mm towards the IC. Under these conditions, we quantified the number of STN neurons that were activated without activating IC fibers, which are known to cause side-effects. Main results. The modeling results show that the HD lead is able to mimic the stimulation effect of the CC lead. Additionally, in steering-mode stimulation there was a significant increase of activated STN neurons compared to the CC mode. Significance. From the model simulations we conclude that the HD lead in steering-mode with optimized stimulation parameter selection can stimulate more STN cells. Next, the clinical impact of the increased number of activated STN cells should be tested and balanced across the increased complexity of identifying the optimized stimulation parameter settings for the HD lead.
Original languageEnglish
Pages (from-to)046003
Number of pages9
JournalJournal of neural engineering
Volume12
Issue number4
DOIs
Publication statusPublished - 28 May 2015

Fingerprint

Deep Brain Stimulation
Brain
Lead
Internal Capsule
Population
Neurons
Electric fields
Subthalamic Nucleus
Parkinson Disease
Axons
Fibers

Keywords

  • steering-mode stimulation
  • EWI-26428
  • Computational modeling
  • IR-98200
  • Parkinson’s disease
  • novel lead design
  • METIS-315012
  • Deep Brain Stimulation

Cite this

van Dijk, Kees J. ; Verhagen, Rens ; Chaturvedi, Ashutosh ; McIntyre, Cameron C. ; Bour, Lo J. ; Heida, Tjitske ; Veltink, Peter H. / A novel lead design enables selective deep brain stimulation of neural populations in the subthalamic region. In: Journal of neural engineering. 2015 ; Vol. 12, No. 4. pp. 046003.
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A novel lead design enables selective deep brain stimulation of neural populations in the subthalamic region. / van Dijk, Kees J.; Verhagen, Rens; Chaturvedi, Ashutosh; McIntyre, Cameron C.; Bour, Lo J.; Heida, Tjitske ; Veltink, Peter H.

In: Journal of neural engineering, Vol. 12, No. 4, 28.05.2015, p. 046003.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - A novel lead design enables selective deep brain stimulation of neural populations in the subthalamic region

AU - van Dijk, Kees J.

AU - Verhagen, Rens

AU - Chaturvedi, Ashutosh

AU - McIntyre, Cameron C.

AU - Bour, Lo J.

AU - Heida, Tjitske

AU - Veltink, Peter H.

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N2 - Objective. The clinical effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) as a treatment for Parkinson's disease are sensitive to the location of the DBS lead within the STN. New high density (HD) lead designs have been created which are hypothesized to provide additional degrees of freedom in shaping the stimulating electric field. The objective of this study is to compare the performances of a new HD lead with a conventional cylindrical contact (CC) lead. Approach. A computational model, consisting of a finite element electric field model combined with multi-compartment neuron and axon models representing different neural populations in the subthalamic region, was used to evaluate the two leads. We compared ring-mode and steering-mode stimulation with the HD lead to single contact stimulation with the CC lead. These stimulation modes were tested for the lead: (1) positioned in the centroid of the STN, (2) shifted 1 mm towards the internal capsule (IC), and (3) shifted 2 mm towards the IC. Under these conditions, we quantified the number of STN neurons that were activated without activating IC fibers, which are known to cause side-effects. Main results. The modeling results show that the HD lead is able to mimic the stimulation effect of the CC lead. Additionally, in steering-mode stimulation there was a significant increase of activated STN neurons compared to the CC mode. Significance. From the model simulations we conclude that the HD lead in steering-mode with optimized stimulation parameter selection can stimulate more STN cells. Next, the clinical impact of the increased number of activated STN cells should be tested and balanced across the increased complexity of identifying the optimized stimulation parameter settings for the HD lead.

AB - Objective. The clinical effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) as a treatment for Parkinson's disease are sensitive to the location of the DBS lead within the STN. New high density (HD) lead designs have been created which are hypothesized to provide additional degrees of freedom in shaping the stimulating electric field. The objective of this study is to compare the performances of a new HD lead with a conventional cylindrical contact (CC) lead. Approach. A computational model, consisting of a finite element electric field model combined with multi-compartment neuron and axon models representing different neural populations in the subthalamic region, was used to evaluate the two leads. We compared ring-mode and steering-mode stimulation with the HD lead to single contact stimulation with the CC lead. These stimulation modes were tested for the lead: (1) positioned in the centroid of the STN, (2) shifted 1 mm towards the internal capsule (IC), and (3) shifted 2 mm towards the IC. Under these conditions, we quantified the number of STN neurons that were activated without activating IC fibers, which are known to cause side-effects. Main results. The modeling results show that the HD lead is able to mimic the stimulation effect of the CC lead. Additionally, in steering-mode stimulation there was a significant increase of activated STN neurons compared to the CC mode. Significance. From the model simulations we conclude that the HD lead in steering-mode with optimized stimulation parameter selection can stimulate more STN cells. Next, the clinical impact of the increased number of activated STN cells should be tested and balanced across the increased complexity of identifying the optimized stimulation parameter settings for the HD lead.

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KW - Computational modeling

KW - IR-98200

KW - Parkinson’s disease

KW - novel lead design

KW - METIS-315012

KW - Deep Brain Stimulation

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DO - 10.1088/1741-2560/12/4/046003

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SN - 1741-2560

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