Fig. 9: Methodological overview of the Cleartune algorithm.

In this example, a novel (hypothetical) patient is treated based on Cleartune, who appears to be tremor-dominant. Cleartune performs network blending (Fig. 2) taking into consideration the patient’s symptom profile, which directly leads to strong weights for tremor and rigidity tracts. After localization of DBS electrodes for the new patient, E-fields for various permutations and combinations of the contacts are simulated using a surrogate optimizer, and their impact on each symptom network is calculated. These impacts are weighted by the symptom profile, leading to an estimated improvement score for each solution. Finally, the solution leading to the best estimate is selected and reported to the clinician, who may consider programming the solution into the DBS pulse generator.