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ISSN: 2168-975X

Brain Disorders & Therapy
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Research Article

Influence on Deep Brain Stimulation from Lead Design, Operating Mode and Tissue Impedance Changes – A Simulation Study

Fabiola Alonso1, Simone Hemm-Ode1,2 and Karin Wårdell1*
1Department of Biomedical Engineering, Linköping University, Sweden
2University of Applied Sciences and Arts Northwestern Switzerland, School of Life Sciences, Institute for Medical and Analytical Technologies, Switzerland
Corresponding Author : Karin Wårdell
Department of Biomedical Engineering
Linköping University, 581 85 Linköping, Sweden
Tel: +46 10 1030000
E-mail: [email protected]
Received April 02, 2015; Accepted June 03, 2015; Published June 08, 2015
Citation: Alonso F, Hemm-Ode S, Wårdell K (2015) Influence on Deep Brain Stimulation from Lead Design, Operating Mode and Tissue Impedance Changes – A Simulation Study. Brain Disord Ther 4:169. doi:10.4172/2168-975X.1000169
Copyright: © 2015 Alonso F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Deep brain stimulation (DBS) systems in current mode and new lead designs are recently available. To switch between DBS-systems remains complicated as clinicians may lose their reference for programming. Simulations can help increase the understanding. Objective: To quantitatively investigate the electric field (EF) around two lead designs simulated to operate in voltage and current mode under two time points following implantation. Methods: The finite element method was used to model Lead 3389 (Medtronic) and 6148 (St Jude) with homogenous surrounding grey matter and a peri-electrode space (PES) of 250 μm. The PES-impedance mimicked the acute (extracellular fluid) and chronic (fibrous tissue) time-point. Simulations at different amplitudes of voltage and current (n=236) were performed using two different contacts. Equivalent current amplitudes were extracted by matching the shape and maximum EF of the 0.2 V/mm isolevel. Results: The maximum EF extension at 0.2 V/mm varied between 2-5 mm with a small difference between the leads. In voltage mode EF increased about 1 mm at acute compared to the chronic PES. Current mode presented the opposite relationship. Equivalent EFs for lead 3389 at 3 V were found for 7 mA (acute) and 2.2 mA (chronic). Conclusions: Simulations showed a major impact on the electric field extension between postoperative time points. This may explain the clinical decisions to reprogram the amplitude weeks after implantation. Neither the EF extension nor intensity is considerably influenced by the lead design. However, the EF distribution is affected by the larger contact of Lead 6148 generating an electric field below the tip.

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