Universität zu Köln

Kramme, Johanna, Dembek, Till A., Treuer, Harald, Dafsari, Haidar S., Barbe, Michael T. ORCID: 0000-0003-1149-8054, Wirths, Jochen and Visser-Vandewalle, Veerle (2021). Potentials and Limitations of Directional Deep Brain Stimulation: A Simulation Approach. Stereotact. Funct. Neurosurg., 99 (1). S. 65 - 75. BASEL: KARGER. ISSN 1423-0372

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Abstract

Background: Directional leads are increasingly used in deep brain stimulation. They allow shaping the electrical field in the axial plane. These new possibilities increase the complexity of programming. Thus, optimized programming approaches are needed to assist clinical testing and to obtain full clinical benefit. Objectives: This simulation study investigates to what extent the electrical field can be shaped by directional steering to compensate for lead malposition. Method: Binary volumes of tissue activated (VTA) were simulated, by using a finite element method approach, for different amplitude distributions on the three directional electrodes. VTAs were shifted from 0 to 2 mm at different shift angles with respect to the lead orientation, to determine the best compensation of a target volume. Results: Malpositions of 1 mm can be compensated with the highest gain of overlap with directional leads. For larger shifts, an improvement of overlap of 10-30% is possible, depending on the stimulation amplitude and shift angle of the lead. Lead orientation and shift determine the amplitude distribution of the electrodes. Conclusion: To get full benefit from directional leads, both the shift angle as well as the shift to target volume are required to choose the correct amplitude distribution on the electrodes. Current directional leads have limitations when compensating malpositions >1 mm; however, they still outperform conventional leads in reducing overstimulation. Further, their main advantage probably lies in the reduction of side effects. Databases like the one from this simulation could serve for optimized lead programming algorithms in the future.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kramme, Johanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Dembek, Till A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Treuer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Dafsari, Haidar S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barbe, Michael T. UNSPECIFIED orcid.org/0000-0003-1149-8054 UNSPECIFIED Wirths, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-568196
DOI:	10.1159/000509781
Journal or Publication Title:	Stereotact. Funct. Neurosurg.
Volume:	99
Number:	1
Page Range:	S. 65 - 75
Date:	2021
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1423-0372
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Neurosciences; Neuroimaging; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56819