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. 2024 Jan 23;14(1):111–119. doi: 10.3233/JPD-225126

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© 2024 – The authors. Published by IOS Press

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig. 1 — Implementation of combined MoR and IGP in clinical practice saves time and assists clinical refinement. A) We observed 78% (50/64 directional leads) concordance of the electrode level identified by monopolar review and IGP software (A1). Among the 22 patients experiencing insufficient efficacy or mild side effects, 64% (14/22) saw clinical improvements by utilizing either directional stimulation or selecting the contact predicted by IGP. MoR, Monopolar review; IGP, Image Guided Programming. B) Representative VTA model in one patient with improvement using directional stimulation. 3D VTA visualization of the activated contacts are represented for ring mode stimulation (upper row) and directional stimulation (lower row). Basal ganglia nuclei near the STN are segmented on a T2-weighted MRI axial view. We observed a the VTA was more compressed in the case of directional mode (white arrows) than ring mode. Thal, Thalamus (turquoise); STN, Subthalamic Nucleus (green); RN, Red Nucleus (red); SN, Substantia Nigra (purple); A, anterior; P, posterior; R, right; L, left.