Defining a therapeutic target for pallidal deep brain stimulation for dystonia

Abstract

Our results provide a map of the region of influence of therapeutic DBS for dystonia and represent a potential target to refine current methods of surgical planning and stimulation parameters selection. Based on their role in alleviating symptoms, these regions may also provide anatomical and physiological information relevant to disease models of dystonia. Further experimental and clinical studies will be needed to validate their importance.

Brain Stimulation for Torsion Dystonia

“…Algorithms that allow one to identify the ideal contact and stimulation parameters based on neuroimaging, brain connectivity, and modeling of the stimulation field could represent a major advance for programming DBS in dystonia in the near future (e.g. Figure 2) 17 .…”

Modeling sequence and quasi-uniform assumption in computational neurostimulation

“…In principle, the process involves exploring various montages (dose) with the goal of identifying a current flow pattern that best supports the presumed mechanism of action or experimental hypothesis (Wongsarnpigoon and Grill, 2012). However, how to select a "best" target and consider collateral brain current flow (side effects) is an open question (Cheung et al, 2014;Fytagoridis et al, 2013) because the relationship between brain current flow patterns and cognition is complex. One solution, which is implicitly adopted in many reports though not made explicit, is the quasi-uniform assumption.…”

Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor

“…In addition to patient-specific DBS data, decision support systems for DBS tuning may also make use of historical population-specific data. Historical population-specific data has been used in a number of studies to create and visualize probabilistic stimulation maps (PSMs) related to therapeutic as well as side effects of stimulation [19-26]. It has been shown that model-based approaches, with and without PSMs, can assist selection of the clinically best electrode contacts and increase the efficiency of programming [27-29].…”