Modeling and simulation of electric fields generated by brain stimulation electrodes: the effect of cystic cavities in the basal ganglia

Deep brain stimulation (DBS) is an effective method for managing movement disorders. A small electrode is implanted in the basal ganglia and an electric potential is applied to one or more active elements of the electrode in order to simulate the neurons in the surrounding tissue. The fundamental understanding of the mechanisms responsible for the therapeutic DBS effects is unknown. A method to increase the knowledge is to use computer simulations. In this study the finite element method has been used for investigation of relative changes of the electrical field extension surrounding a monopolar DBS-electrode positioned in gray matter. Due to the frequently appearing cystic cavities in globus pallidus and putamen a nucleus of gray matter with and without a cerebrospinal fluid filled cystic cavity was modeled. The simulations demonstrated an electrical field around the active element with decreasing values in the radial direction. A stepwise change was present at the edge between gray and white matter. The cyst increased the radial extension and changed the shape of the field. This may result in closely related unexpected structures being stimulated and could be one of the reasons of reported postoperative complications