Computational investigation of the impact of deep brain stimulation contact size and shape on neural selectivity.

Background.Understanding 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 investigate a simple, but important question from a generalized perspective: how do the size and shape of the contact influence neural selectivity?Methods.We 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.Results.We found that changes in contact size are predicted to induce substantial changes in orientation-based selectivity in the context of a cylindrical lead, and changes in contact width or height can alter this selectivity. Smaller contact sizes were more effective in constraining neural activation to small, nearby axons. 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.Interpretations.Small-scale contacts may be 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, we predict that contacts sized similarly to or slightly smaller than segmented clinical leads may optimize energy efficiency while avoiding charge density limitations.