Optimizing Deep Brain Stimulation Parameters to Enhance Treatment Efficacy in Obsessive Compulsive Disorder and Autism Spectrum Disorder
A Focus on Electrode Size, Current Steering, and Stimulation Directionality
DOI:
https://doi.org/10.58445/rars.1899Keywords:
Deep Brain Stimulation, Obsessive Compulsive Disorder, Autism Spectrum DisorderAbstract
Optimizing Deep Brain Stimulation (DBS) parameters is essential for enhancing treatment efficacy in developmental disorders such as Obsessive Compulsive Disorder (OCD) and Autism Spectrum Disorder (ASD). This study evaluates the impact of electrode size, current steering, and stimulation directionality on DBS outcomes, aiming to refine therapeutic strategies. A systematic review of high-impact journal studies with sample sizes of 30–50 participants was conducted to analyze the effects of these parameters on symptom reduction and side effect profiles. Results indicate that smaller electrodes provide greater precision, minimizing off-target effects by focusing on specific neural circuits, making them superior to larger electrodes. Current steering was found to be more effective than unipolar stimulation, as it allowed for precise modulation of targeted brain areas, which is particularly beneficial in conditions like OCD. Directional stimulation, by enabling focused activation of specific neural tissues, further improved treatment outcomes by fine-tuning the spatial distribution of electrical fields. These findings suggest that optimizing DBS with smaller electrodes, current steering, and directional stimulation enhances efficacy and safety, offering a more targeted approach to treating OCD and ASD. Future guidelines should prioritize these configurations to maximize therapeutic potential while minimizing adverse effects.
References
Alessandra Paffi, Francesca Camera, Filippo Carducci, Gianluigi Rubino, Paolo Tampieri, Micaela Liberti, Francesca Apollonio. "A Computational Model for Real‐Time Calculation of Electric Field due to Transcranial Magnetic Stimulation in Clinics." International Journal of Antennas and Propagation, 2015, doi:10.1155/2015/976854. https://onlinelibrary.wiley.com/doi/full/10.1155/2013/262739.
Appali, R., Sriperumbudur, K. K., & van Rienen, U. "Extracellular Stimulation of Neural Tissues: Activating Function and Sub-threshold Potential Perspective." Annual International Conference of IEEE Engineering in Medicine and Biology Society, 2019, 6273-6277, doi:10.1109/EMBC.2019.8857113. PMID: 31947276.
Arcot Desai, S., Gutekunst, C., Potter, S. M., & Gross, R. E. (2014). "Deep Brain Stimulation Macroelectrodes Compared to Multiple Microelectrodes in Rat Hippocampus." Frontiers in Neuroengineering, 7, 75909. https://doi.org/10.3389/fneng.2014.00016.
Bonham, B. H., & Litvak, L. M. "Current Focusing and Steering: Modeling, Physiology, and Psychophysics." Hearing Research, 242(1-2), 141-153, doi:10.1016/j.heares.2008.03.006. PMID: 18501539; PMCID: PMC2562351.
Chaturvedi, A., Foutz, T. J., & McIntyre, C. C. "Current Steering to Activate Targeted Neural Pathways During Deep Brain Stimulation of the Subthalamic Region." Brain Stimulation, 2012, 5(3):369-377, doi:10.1016/j.brs.2011.05.002. PMID: 22277548; PMCID: PMC3360111.
Frey, J., Cagle, J., Johnson, K. A., Wong, J. K., Hilliard, J. D., Butson, C. R., Okun, M. S., & De Hemptinne, C. (2022). "Past, Present, and Future of Deep Brain Stimulation: Hardware, Software, Imaging, Physiology, and Novel Approaches." Frontiers in Neurology, 13, 825178. https://doi.org/10.3389/fneur.2022.825178.
Haynes, W. I. A., & Mallet, L. (2010). "High-frequency Stimulation of Deep Brain Structures in Obsessive-Compulsive Disorder: The Search for a Valid Circuit." The European Journal of Neuroscience, 32(7), 1118-1127. https://doi.org/10.1111/j.1460-9568.2010.07418.x.
Lin, X., & Gorfe, A. A. "Transmembrane Potential of Physiologically Relevant Model Membranes: Effects of Membrane Asymmetry." Journal of Chemical Physics, 153(10), 105103, doi:10.1063/5.0018303. PMID: 32933265; PMCID: PMC7484991.
Maggio, F., Pasciuto, T., Paffi, A., Apollonio, F., Parazzini, M., Ravazzani, P., & d’Inzeo, G. (2010). "Micro vs Macro Electrode DBS Stimulation: A Dosimetric Study." Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2010, 2057-2060. https://doi.org/10.1109/IEMBS.2010.5626487.
Perlmutter, J. S., & Mink, J. W. (2006). "Deep Brain Stimulation." Annual Review of Neuroscience, 29, 229-257. https://doi.org/10.1146/annurev.neuro.29.051605.112824.
Ramasubbu, R., Lang, S., & Kiss, Z. H. (2018). "Dosing of Electrical Parameters in Deep Brain Stimulation (DBS) for Intractable Depression: A Review of Clinical Studies." Frontiers in Psychiatry, 9, 367058. https://doi.org/10.3389/fpsyt.2018.00302.
Schnitzler, A., Mir, P., Brodsky, M. A., Verhagen, L., Groppa, S., Alvarez, R., Evans, A., Blazquez, M., Nagel, S., Pilitsis, J. G., Pötter-Nerger, M., Tse, W., Almeida, L., Tomycz, N., Jimenez-Shahed, J., Libionka, W., Carrillo, F., Hartmann, C. J., Groiss, S. J., … Vesper, J. (2022). "Directional Deep Brain Stimulation for Parkinson’s Disease: Results of an International Crossover Study With Randomized, Double-Blind Primary Endpoint." Neuromodulation : Journal of the International Neuromodulation Society, 25(6), 817-828. https://doi.org/10.1111/ner.13407.
Xing, Y., Zan, C., & Liu, L. (2023). "Recent Advances in Understanding Neuronal Diversity and Neural Circuit Complexity Across Different Brain Regions Using Single-Cell Sequencing." Frontiers in Neural Circuits, 17, 1007755. https://doi.org/10.3389/fncir.2023.1007755.
Xu, T., Gao, Y., Li, B., Jiang, J., Guo, H., Liu, X., Huang, H., Cheng, Y., Yu, H., Hu, J., et al. (2022). "The Efficacy and Safety of Deep Brain Stimulation of Combined Anterior Limb of Internal Capsule and Nucleus Accumbens (ALIC/NAcc-DBS) for Treatment-Refractory Obsessive-Compulsive Disorder: Protocol of a Multicenter, Randomized, and Double-Blinded Study." Brain Sciences, 12(7), 933. https://doi.org/10.3390/brainsci12070933.
Zhang, C., Kim, S. G., Li, J., Zhang, Y., Lv, Q., Zeljic, K., Gong, H., Wei, H., Liu, W., Sun, B., Wang, Z., & Voon, V. (2021). "Anterior Limb of the Internal Capsule Tractography: Relationship With Capsulotomy Outcomes in Obsessive-Compulsive Disorder." Journal of Neurology, Neurosurgery & Psychiatry, 92(6), 637-644, doi:10.1136/jnnp-2020-323062.
Downloads
Posted
Categories
License
Copyright (c) 2024 Akshar Ammu
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.