Determining the rotational orientation of directional deep brain stimulation electrodes using magnetoencephalography.

OBJECTIVE The aim of the present study was to evaluate the effect of different electrode configurations on the accuracy of determining the rotational orientation of the directional DBS electrode with our previously published MEG-based method. APPROACH A directional DBS electrode, along with its implantable pulse generator, was integrated into a head phantom and placed within the MEG sensor array. Predefined bipolar electrode configurations, based on activation of different directional and omnidirectional contacts of the electrode, were set to generate a defined magnetic field during stimulation. This magnetic field was then measured with MEG. Finite element modeling and model fitting approach were used to calculate electrode orientation. MAIN RESULTS The accuracy of electrode orientation detection depended on the electrode configuration: The vertical configuration (activation of two directional contacts arranged one above the other) achieved an average accuracy of only about 41°. The diagonal configuration (activation of the electrode tip and a single directional contact at the next higher level of the electrode) achieved an accuracy of 13°, while the horizontal electrode configuration (activation of two adjacent directional contacts at the same electrode level) achieved the best accuracy of 6°. The accuracy of orientation detection of the DBS electrode depends on the change in spatial distribution of the magnetic field with the rotation of the electrode along its own axis. In the vertical configuration, rotation of the electrode has a small effect on the magnetic field distribution, while in the diagonal or horizontal configuration, electrode rotation has a significant effect on the magnetic field distribution. SIGNIFICANCE Our work suggests that in order to determine rotational orientation of a DBS electrode using MEG, horizontal configuration should be used as it provides the most accurate results compared to other possible configurations.