Defining the impact of deep brain stimulation contact size and shape on neural selectivity

Abstract

AbstractBackgroundUnderstanding neural selectivity is essential for optimizing medical applications of deep brain stimulation (DBS). We previously showed that modulation of the DBS waveform can induce changes in orientation-based selectivity, and that lengthening of DBS pulses or directional segmentation can reduce preferential selectivity for large axons. In this work, we sought to answer a simple, but important question: how do the size and shape of the contact influence neural selectivity?MethodsWe created multicompartment neuron models for several axon diameters and used finite element modeling with standard-sized cylindrical leads to determine the effects on changing contact size and shape on axon activation profiles and volumes of tissue activated. Contacts ranged in size from 0.04 to 16 mm2, compared with a standard size of 6 mm2.ResultsWe found that changes in contact size induce substantial changes in orientation-based selectivity in the context of a cylindrical lead, and rectangular shaping of the contact can alter this selectivity. Smaller contact sizes were more effective in constraining neural activation to small, nearby axons representative of grey matter. However, micro-scale contacts enable only limited spread of neural activation before exceeding standard charge density limitations; further, energetic efficiency is optimized by somewhat larger contacts.InterpretationsSmall-scale contacts are optimal for constraining stimulation in nearby grey matter and avoiding orientation-selective activation. However, given charge density limitations and energy inefficiency of micro-scale contacts, our results suggest that contacts about half the size of those on segmented clinical leads may optimize efficiency and charge density limitation avoidance.