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ORIGINAL RESEARCH article

Front. Neurosci.

Sec. Translational Neuroscience

Volume 19 - 2025 | doi: 10.3389/fnins.2025.1661987

This article is part of the Research TopicDeep Brain Stimulation think tank: Updates in neurotechnology and neuromodulation, Volume VIView all articles

Patient-Specific and Interpretable Deep Brain Stimulation Optimisation Using MRI and Clinical Review Data

Provisionally accepted
Apostolos  V. MikroulisApostolos V. Mikroulis1*Andrej  LasicaAndrej Lasica2Pavel  FilipPavel Filip1,2Eduard  BaksteinEduard Bakstein1,3Daniel  NovakDaniel Novak1*
  • 1Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
  • 2Department of Neurology, First Faculty of Medicine, Charles University, Prague, Czechia
  • 3National Institute of Mental Health, Klecany, Czech Republic, Prague, Czechia

The final, formatted version of the article will be published soon.

Background Optimisation of Deep Brain Stimulation (DBS) settings is a key aspect in achieving clinical efficacy in movement disorders, such as the Parkinson's disease. Modern techniques attempt to solve the problem through data-intensive statistical and machine learning approaches, adding significant overhead to the existing clinical workflows. Here, we present a geometry-based optimisation approach for DBS electrode contact and current selection, grounded in routinely collected MRI data, well-established tools (Lead-DBS) and optionally, clinical review records. Methods The pipeline, packaged in a cross-platform tool, uses lead reconstruction data and simulation of Volume of Tissue Activated (VTA) to estimate the contacts in optimal position relative to the target structure, and suggests optimal stimulation current. The tool then allows further interactive user optimisation of the current settings. Existing electrode contact evaluations can be optionally included in the calculation process for further fine-tuning and adverse effect avoidance. Results Based on a sample of 174 implanted electrode reconstructions from 87 Parkinson's disease patients, we demonstrate that our algorithm's DBS parameter settings are more effective in covering the target structure (Wilcoxon p<5e-13, Hedges' g>0.94) and minimising electric field leakage to neighbouring regions (p<2e-10, g>0.46) compared to expert parameter settings. Retrospective analysis of a limited subset (n=50) predicts comparable improved motor outcomes with expert settings (g = 0.05–0.08, p = 0.09–1), suggesting potential for similar clinical efficacy, pending prospective validation. Conclusion The proposed automated method for optimisation of the DBS electrode contact and current selection shows promising results and is readily applicable to existing clinical workflows. We demonstrate that the algorithmically selected contacts perform better than manual selections according to electric field calculations, without the iterative optimisation procedure.

Keywords: Deep Brain Stimulation, optimisation, MRI, Parkinson's disease, Subthalamic Nucleus, Computational modelling

Received: 09 Jul 2025; Accepted: 07 Oct 2025.

Copyright: © 2025 Mikroulis, Lasica, Filip, Bakstein and Novak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Apostolos V. Mikroulis, apostolos.mikroulis@cvut.cz
Daniel Novak, xnovakd1@fel.cvut.cz

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