• Caio M Matias, Raja Mehanna, Scott E Cooper, Amit Amit, Scott F Lempka, Danilo Silva, Carlos G Carlotti, Robert S Butler, and Andre G Machado.
• *Center for Neurological Restoration, Cleveland Clinic Neurological Institute, Cleveland, Ohio; ‡Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; §University of Texas Health Science Center, Houston, Texas; ¶Department of Neurology, Cleveland Clinic Neurological Institute, Cleveland, Ohio; ‖Department of Neurosurgery, Cleveland Clinic Neurological Institute, Cleveland, Ohio; #Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
• Neurosurgery. 2015 Mar 1;11 Suppl 2:99-108; discussion 108-9.

BackgroundClinical benefits of deep brain stimulation can be limited by the presence of side effects produced by current spread to adjacent structures.ObjectiveTo identify a correlation between coordinates for each individual contact, neighboring structures, and pattern of side effects.MethodsCoordinates of the electrodes and anatomic landmarks were obtained with a stereotactic surgical planning software and were correlated with stimulation-related side effects by using univariate and multivariable analyses.ResultsMonopolar stimulation elicited capsular side effects (CSEs) in 208 of 316 contacts (65.8%) and noncapsular side effects (NCSEs) in 223 of 316 contacts (70.6%). The occurrence of CSEs was correlated with contact number (P = .009) and with the "Z" (P = .03), whereas voltage threshold to CSEs exhibited correlation with the internal capsule angle (P = .035). The occurrence of NCSEs was correlated with contact number (P = .005), "X" (P = .03), "Y" (P = .004), and the distance to the red nucleus (P = .001 and P = .003). There was correlation between voltage threshold to NCSEs and the internal capsule angle (P = .006), electrode's coronal angle (P = .02), "X" (P = .001), "Y" (P < .001), "Z" (P < .001), and the distances to the internal capsule (P = .02) and to the red nucleus (P = .004 and P < .001).ConclusionA better understanding how patient anatomy, stimulation parameters, and lead location in relation to neighboring structures influence the occurrence of side effects can be useful to inform targeting strategies.

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