Deep brain stimulation (DBS) is a promising treatment for various brain disorders but the uncontrolled spread of stimulation outside target regions may induce side effects. With existing DBS leads, such side effects can be countered only by lowering the stimulus intensity, thus trading off the potential therapeutic benefit. New generations of leads are being developed that provide more and smaller electrodes. Using such DBS electrodes could allow the stimulation to be “steered” selectively to only target areas, which would prevent the occurrence of stimulation side effects while maintaining the optimal therapeutic benefit. We discuss various novel DBS lead designs that are currently in development stages. Using computational modeling, we theoretically address the expected improvements provided by these electrodes. To quantify the benefit of steering, we introduce two parameters: target coverage, i.e., the fraction of the target that receives stimulation, and target selectivity, i.e., the fraction of stimulation that does not leak outside the target, where it could induce side effects. We demonstrate that lead designs providing enhanced electrode resolution in both axial and circumferential directions may enable superior target coverage and target selectivity. Such high-resolution leads may provide clinicians with an additional degree of freedom to optimize neurostimulation therapy.
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