Deep brain stimulation (DBS) has become an important tool in the management of a wide spectrum of diseases in neurology and psychiatry. Target selection is a vital aspect of DBS so that only the desired areas are stimulated. Segmented leads and current steering have been shown to be promising additions to DBS technology enabling better control of the stimulating electric field. Recently introduced orientation selective DBS (OS-DBS) is a related development permitting sensitization of the stimulus to axonal pathways with different orientations by freely controlling the primary direction of the electric field using multiple contacts. Here, we used OS-DBS to stimulate the subthalamic nucleus (STN) in healthy rats while simultaneously monitoring the induced brain activity with fMRI. Maximal activation of the sensorimotor and basal ganglia-thalamocortical networks was observed when the electric field was aligned mediolaterally in the STN pointing in the lateral direction, while no cortical activation was observed with the electric field pointing medially to the opposite direction. Such findings are consistent with mediolateral main direction of the STN fibers, as seen with high resolution diffusion imaging and histology. The asymmetry of the OS-DBS dipolar field distribution using three contacts along with the potential stimulation of the internal capsule, are also discussed. We conclude that OS-DBS offers an additional degree of flexibility for optimization of DBS of the STN which may enable a better treatment response.

A 1 Virtanen Institute for Molecular Sciences University of Eastern Finland Kuopio Finland

Center for Magnetic Resonance Research University of Minnesota Minneapolis MN USA

Center for Magnetic Resonance Research University of Minnesota Minneapolis MN USA; 1st Department of Neurology Faculty of Medicine Masaryk University and University Hospital of St Anne Brno Czech Republic

Center for Magnetic Resonance Research University of Minnesota Minneapolis MN USA; A 1 Virtanen Institute for Molecular Sciences University of Eastern Finland Kuopio Finland

Center for Magnetic Resonance Research University of Minnesota Minneapolis MN USA; Department of Medicine Surgery and Dentistry Scuola Medica Salernitana University of Salerno Salerno Italy

Department of Biomedical Engineering University of Minnesota Minneapolis USA

Department of Neurosurgery University of Minnesota Minneapolis USA

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