Abstract
Background
Deep brain stimulation (DBS) has revolutionized the treatment of neurological disorders,
yet the mechanisms of DBS are still under investigation. Computational models are
important in silico tools for elucidating these underlying principles and potentially
for personalizing DBS therapy to individual patients. The basic principles underlying
neurostimulation computational models, however, are not well known in the clinical
neuromodulation community.
Objective
In this study, we present a tutorial on the derivation of computational models of
DBS and outline the biophysical contributions of electrodes, stimulation parameters,
and tissue substrates to the effects of DBS.
Results
Given that many aspects of DBS are difficult to characterize experimentally, computational
models have played an important role in understanding how material, size, shape, and
contact segmentation influence device biocompatibility, energy efficiency, the spatial
spread of the electric field, and the specificity of neural activation. Neural activation
is dictated by stimulation parameters including frequency, current vs voltage control,
amplitude, pulse width, polarity configurations, and waveform. These parameters also
affect the potential for tissue damage, energy efficiency, the spatial spread of the
electric field, and the specificity of neural activation. Activation of the neural
substrate also is influenced by the encapsulation layer surrounding the electrode,
the conductivity of the surrounding tissue, and the size and orientation of white
matter fibers. These properties modulate the effects of the electric field and determine
the ultimate therapeutic response.
Conclusion
This article describes biophysical principles that are useful for understanding the
mechanisms of neurostimulation.
Keywords
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Article info
Publication history
Published online: May 19, 2023
Accepted:
April 24,
2023
Received in revised form:
April 2,
2023
Received:
September 28,
2022
Publication stage
In Press Corrected ProofFootnotes
Conflict of Interest: Cameron C. McIntyre is a paid consultant for Boston Scientific Neuromodulation, receives royalties from Hologram Consultants, Neuros Medical, and Qr8 Health, and is a shareholder in the following companies: Hologram Consultants, Surgical Information Sciences, BrainDynamics, CereGate, Autonomic Technologies, Cardionomic, and Enspire DBS. The remaining authors reported no conflict of interest.
Source(s) of financial support: The authors reported no funding sources.
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© 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.
