• Patrick R Ng, Alan Bush, Matteo Vissani, Cameron C McIntyre, and Robert Mark Richardson.
• Harvard Medical School, Boston, MA, USA. Electronic address: patrickrayng@gmail.com.
• Neuromodulation. 2024 Apr 1; 27 (3): 422439422-439.

BackgroundDeep brain stimulation (DBS) has revolutionized the treatment of neurological disorders, yet the mechanisms of DBS are still under investigation. Computational models are important in silico tools for elucidating these underlying principles and potentially for personalizing DBS therapy to individual patients. The basic principles underlying neurostimulation computational models, however, are not well known in the clinical neuromodulation community.ObjectiveIn this study, we present a tutorial on the derivation of computational models of DBS and outline the biophysical contributions of electrodes, stimulation parameters, and tissue substrates to the effects of DBS.ResultsGiven that many aspects of DBS are difficult to characterize experimentally, computational models have played an important role in understanding how material, size, shape, and contact segmentation influence device biocompatibility, energy efficiency, the spatial spread of the electric field, and the specificity of neural activation. Neural activation is dictated by stimulation parameters including frequency, current vs voltage control, amplitude, pulse width, polarity configurations, and waveform. These parameters also affect the potential for tissue damage, energy efficiency, the spatial spread of the electric field, and the specificity of neural activation. Activation of the neural substrate also is influenced by the encapsulation layer surrounding the electrode, the conductivity of the surrounding tissue, and the size and orientation of white matter fibers. These properties modulate the effects of the electric field and determine the ultimate therapeutic response.ConclusionThis article describes biophysical principles that are useful for understanding the mechanisms of neurostimulation.Copyright © 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.

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