Objective: To assess the ability of directional DBS leads and stimulation field shaping to provide more precisely targeted therapy.

Background: Deep brain stimulation (DBS) has traditionally been performed using single pulse waveforms delivered through four-contact cylindrical leads, which provide relatively uniform current spread in all directions. However, new technologies are now coming to market including directional electrode contacts and multiple stimulation programs on each lead. These technologies increase the range of possible options during DBS programming, but it is not clear what the tradeoffs might be in terms of programming time, complexity, clinical outcomes for the patient or power usage for the device.

Methods: A previously published computational model (Butson et al, 2011) was used to predict neural activation during DBS. We used these models to predict neural activation resulting from a range of stimulation settings to perform two contrasts. First, we assessed the effects of monopolar versus bipolar stimulation in directional leads. Second, we assessed the utility of multiple stimulation programs in time.

Results: Directional DBS electrode contacts brought about activation that was more focal compared to cylindrical leads, and the use of bipolar stimulation with directional contacts further enhanced this effect. The use of multiple stimulation programs provided additional customization by enabling focal targeting of multiple regions.

Conclusions: New technologies will provide practitioners with a wide range of new choices during DBS programming. Selective application of these technologies will enable more precise targeting of surrounding brain regions, which could bring about better clinical outcomes in some subjects.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/assessment-of-new-technology-in-deep-brain-stimulation-technology-what-are-the-anticipated-benefits/