In Silico Study for Optimizing Intensity and Focality Electrode Configurations for Directional DBS Under Uncertainty Using Metaheuristic L1L1 Method

Background and Objective: As Deep Brain Stimulation (DBS) advances toward directional leads and optimization-based current steering, selecting electrode contact configurations becomes complex. This study formulates configuration selection as an inverse mapping between target activation and electrode currents using metaheuristic L1-norm regularized L1-norm fitting (L1L1). L1L1 incorporates lead-field uncertainty arising from electrode placement, tissue properties, and forward modeling assumptions. Methods: The framework introduces lead-field perturbations and restricts the controllable domain through a sensitivity-based feasibility criterion within a finite element formulation derived using the Complete Electrode Model. Current distributions were optimized for 8- and 40-contact leads. Performance was evaluated using focused current density, nuisance current density, and their ratio under safety and sparsity constraints. Results: L1L1 was evaluated using noiseless and noisy lead fields, with noise selected to reflect attenuation within the volume of tissue activated. The method produced sparse, spatially selective stimulation patterns across perturbation levels. Hyperparameter optimization yielded bipolar or multipolar configurations. Compared with the Reciprocity Principle (RP), which produced strictly bipolar configurations, and Tikhonov-regularized least squares (TLS), which produced more distributed solutions, L1L1 enabled controlled transitions between sparse and multipolar patterns. It concentrated stimulation within the target while limiting unintended current spread, particularly under noisy conditions. Conclusions: L1L1 can assist specialists in optimizing DBS configurations. By incorporating uncertainty directly into optimization, it provides robust and interpretable current steering across lead configurations while accounting for forward-model variability.