Modeling subcortical white matter stimulation

ObjectiveIntracranial electrical stimulation of subcortical axonal tracts is particularly useful during brain surgery, where mapping helps identify and excise dysfunctional tissue while avoiding damage to functional structures. Stimulation parameters are generally set empirically and consequences for the spatial recruitment of axons within subcortical tracts are not well identified. ApproachComputational modeling is employed to study the effects of stimulation parameters on the recruitment of axons: monophasic versus biphasic stimuli induced with monopolar versus bipolar electrodes, oriented orthogonal or parallel to the tract, for isotropic and anisotropic tracts. Main resultsThe area and depth of axonal activation strongly depend on tissue conductivity and electrode parameters. The largest activation area results from biphasic stimulation with bipolar electrodes oriented orthogonal to axonal fasciculi, for anisotropic and especially isotropic tracts. For anisotropic tracts, the maximal activation depth is similar regardless of whether a monopolar or bipolar electrode is employed. For isotropic tracts, bipolar parallel and monopolar stimulation activate axons deeper than orthogonal bipolar stimulation. Attention is warranted during monophasic stimulation: a blockade of action potentials immediately under cathodes and a propagation of action potentials under anodes are found. SignificanceConsidering the spatial patterns of blockade and activation present during monophasic stimulation with both monopolar and bipolar electrodes, biphasic stimulation is recommended to explore subcortical axon responses during intraoperative mapping. Finally, the precise effect of electrical stimulation depends on conductivity profiles of tracts, and as such, should be explicitly considered for each individual subject and tract undergoing intracranial mapping.