19 Modelization: Overview

Hyoung-Ihl Kim, Donghyeon Kim, Hyeon Seo and Sung Chan Jun Textbook of Cortical Brain Sti | 발행연도 2014.12.01

Hyoung-Ihl Kim, Donghyeon Kim, Hyeon Seo, Sung Chan Jun19 Modelization: OverviewFollowing the implantation of an ICS system, clinicians must decide which electrode on a multi-electrode lead will deliver stimulation, which electrode will serve as the return electrode during bipolar stimulation, or whether to deliver monopolar stimulation (when available) and also program the stimulation parameters, including amplitude, frequency, polarity and pulse width. The large number of potential combinations of stimulation parameters results in excessively long programming sessions and suboptimal treatment. Only infrequently symptoms are alleviated immediately upon application of ICS with the appropriate parameters, e.g. pain and tremor; for parkinsonian akinesia, dystonia, stroke, depression, effects take days, weeks and even months to build up. Although amplitudes are typically set at a fixed percentage of the motor threshold, this is quite pointless for stimulations outside M1. That’s why efforts have been directed towards modelizing the effects of ICS in order to make the procedure speedier and more effective.