Motor cortex stimulation for Parkinson's disease: a modelling study

Daphne G. M. Zwartjes*, Tjitske Heida, Hans K. P. Feirabend, Marcus L. F. Janssen, Veerle Visser-Vandewalle, Hubert C. F. Martens, Peter H. Veltink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Chronic motor cortex stimulation (MCS) is currently being investigated as a treatment method for Parkinson's disease (PD). Unfortunately, the underlying mechanisms of this treatment are unclear and there are many uncertainties regarding the most effective stimulation parameters and electrode configuration. In this paper, we present a MCS model with a 3D representation of several axonal populations. The model predicts that the activation of either the basket cell or pyramidal tract (PT) type axons is involved in the clinical effect of MCS. We propose stimulation protocols selectively targeting one of these two axon types. To selectively target the basket cell axons, our simulations suggest using either cathodal or bipolar stimulation with the electrode strip placed perpendicular rather than parallel to the gyrus. Furthermore, selectivity can be increased by using multiple cathodes. PT type axons can be selectively targeted with anodal stimulation using electrodes with large contact sizes. Placing the electrode epidurally is advisable over subdural placement. These selective protocols, when practically implemented, can be used to further test which axon type should be activated for clinically effective MCS and can subsequently be applied to optimize treatment. In conclusion, this paper increases insight into the neuronal population involved in the clinical effect of MCS on PD and proposes strategies to improve this therapy.
Original languageEnglish
Pages (from-to)56005
JournalJournal of neural engineering
Issue number5
Publication statusPublished - Oct 2012

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