Next-Generation Electrodes for Steering Brain Stimulation

  • H. C. F. MartensEmail author
  • M. M. J. Decré
  • E. Toader


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.


Deep Brain Stimulation Essential Tremor Target Coverage Target Selectivity Electrode Design 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Benabid AL, Pollak P et al (1991) Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. The Lancet 337(8738):403–406CrossRefGoogle Scholar
  2. Benabid AL, Chabardes S et al (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8:67–81PubMedCrossRefGoogle Scholar
  3. Burdick AP, Fernandez HH et al (2010) Relationship between higher rates of adverse events in deep brain stimulation using standardized prospective recording and patient outcomes. Neurosurg Focus 29(2):E4PubMedCrossRefGoogle Scholar
  4. Butson CR, McIntyre CC (2006) Role of electrode design on the volume of tissue activated during deep brain stimulation. J Neural Eng 3:1–8Google Scholar
  5. Coffey R (2008) Deep brain stimulation devices: a brief technical history and review. Artif Organs 33(3):208–220PubMedCrossRefGoogle Scholar
  6. D’Haese PF, Pallavaram S et al (2010) Clinical accuracy of a customized stereotactic platform for deep brain stimulation after accounting for brain shift. Stereotact Funct Neurosurg 88(2):81–87PubMedCrossRefGoogle Scholar
  7. Diamond A, Jankovic J (2005) The effect of deep brain stimulation on quality of life in movement disorders. J Neurol Neurosurg Psychiatr 76(9):1188–1193PubMedCrossRefGoogle Scholar
  8. Edsberg L (2008) The finite element method. Introduction to computation and modeling for differential equations. Wiley-Interscience, Hoboken, pp 140–146Google Scholar
  9. Hegland M (2010) Implantable medical lead with multiple electrode configurations. Fridley, MedtronicGoogle Scholar
  10. Holsheimer J, Wesselink WA (1997) Optimum electrode geometry for spinal cord stimulation: the narrow bipole and tripole. Med Biol Eng Comput 35:493–497PubMedCrossRefGoogle Scholar
  11. Krauss JK, Pohle T et al (1999) Bilateral stimulation of globus pallidus internus for treatment of cervical dystonia. Lancet 354(9181):837–838PubMedCrossRefGoogle Scholar
  12. Kumar R, Lozano AM et al (1998) Pallidotomy and deep brain stimulation of the pallidum and subthalamic nucleus in advanced Parkinson’s disease. Mov Disord 13(S1):73–82Google Scholar
  13. Larson PS (2008) Deep brain stimulation for psychiatric disorders. Neurotherapeutics 5(1):50–58PubMedCrossRefGoogle Scholar
  14. Martens HCF, Toader E et al (2011) Spatial steering of deep brain stimulation volumes using a novel lead design. Clin Neurophysiol 211:558–566CrossRefGoogle Scholar
  15. Mayberg HS, Lozano AM et al (2005) Deep brain stimulation for treatment-resistant depression. Neuron 45(5):651–660PubMedCrossRefGoogle Scholar
  16. McIntyre CC, Mori S et al (2004) Electric field and stimulating influence generated by deep brain stimulation of the subthalamic nucleus. Clin Neurophysiol 115(3):589–595PubMedCrossRefGoogle Scholar
  17. Miocinovic S, Parent M et al (2006) Computational analysis of subthalamic nucleus and lenticular fasciculus activation during therapeutic deep brain stimulation. J Neurophysiol 96(3):1569–1580PubMedCrossRefGoogle Scholar
  18. Nuttin B, Gabriels LA et al (2003) Long-term electrical capsular stimulation in patients with obsessive–compulsive disorder. Neurosurgery 52:1263–1274PubMedCrossRefGoogle Scholar
  19. Rattay F (1999) The basic mechanism for the electrical stimulation of the nervous system. Neuroscience 89(2):335–346PubMedCrossRefGoogle Scholar
  20. Shih LC, Tarsy D (2011) Survey of U.S. neurologists’ attitudes towards deep brain stimulation for Parkinson’s disease. Neuromodulation Technol Neural Interface 14(3):208–213Google Scholar
  21. Zylka W, Sabczynski J et al (1999) A Gaussian approach for the calculation of the accuracy of stereotactic frame systems. Med Phys 26(3):381–391CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • H. C. F. Martens
    • 1
    Email author
  • M. M. J. Decré
    • 1
  • E. Toader
    • 2
  1. 1.Sapiens Steering Brain Stimulation B.V.EindhovenThe Netherlands
  2. 2.Philips Research LaboratoriesEindhovenThe Netherlands

Personalised recommendations