Electrical impedance of cat brain with cold-induced edema

The electrical impedance of cat brain tissue was measured with a sharp-pointed electrode, inserted into the brain hemispheres, one of which had been made edematous by a cold injury on the cortex. In the normal hemisphere the impedance profile reflected the structural characteristics of the brain. In the edematous areas a lower impedance was measured, and there was a significant negative correlation between tissue impedance and tissue water content. A rise of cortical impedance was observed during asphyxiation. A postmortally induced cold lesion (to prevent exudation) did not result in a change of impedance.     

Noninvasive measurement of cerebral bioimpedance for detection of cerebral edema in the neonatal piglet

The association of sustained cerebral edema with poor neurological outcome following hypoxia-ischaemia in the neonate suggests that measurement of cerebral edema may allow early prediction of outcome in these infants. Direct measurements of cerebral impedance have been widely used in animal studies to monitor cerebral edema, but such invasive measurements are not possible in the human neonate. This study investigated the ability of noninvasive cerebral impedance measurements to detect cerebral edema following hypoxia-ischaemia. One-day-old piglets were anaesthetized, intubated and ventilated. Hypoxia was induced by reducing the inspired oxygen concentration to 4-6% O(2). Noninvasive cerebral bioimpedance was measured using gel electrodes attached to the scalp. Cerebral bioimpedance was also measured directly by insertion of two silver-silver chloride electrodes subdurally. Noninvasive and invasive measurements were made before, during and after hypoxia. Whole body impedance was measured to assess overall fluid movements. Intracranial pressure was measured continuously via a catheter inserted subdurally, as an index of cerebral edema. There was good agreement between noninvasive and invasive measurements of cerebral impedance although externally obtained responses were attenuated. Noninvasive measurements were also well correlated with intracranial pressure. Whole body impedance changes did not account for increases in noninvasively measured cerebral impedance. Results suggest that noninvasive cerebral impedance measurements do reflect intracranial events, and are able to detect cerebral edema following hypoxia-ischaemia in the neonate.     

Calf impedance plethysmographic evaluation of peripheral sympathetic nerve activity--comparison with microneurographic analysis

Although the method of impedance plethysmography made it possible to evaluate the vascular resistance of lower extremities, the actual correlation to the sympathetic nerve activity is not known. We performed examinations of microneurography and impedance plethysmography of the lower extremities, in six healthy volunteers, placed on a tilting table. Blood pressure, heart rate, muscle nerve sympathetic activity to calf muscles (microneurography), calf vascular resistance (impedance plethysmography) were simultaneously recorded with increasing angles of the head-up tilting (0, 30, 60 degrees). With the increase of tilting angles, sympathetic nerve activity and the calf vascular resistance significantly increased and these values were statistically correlated to the increase of tilting angles (expressed as sine function). Moreover, a statistically significant positive correlation was observed between the sympathetic nerve activity and vascular resistance. We concluded that the impedance plethysmographic method for measurement of calf vascular resistance is a good indicator for evaluating the peripheral sympathetic nerve activity.     

Cerebral impedance and neurological outcome following a mild or severe hypoxic/ischemic episode in neonatal piglets

Multi-frequency bio-impedance has the potential to identify infants at risk of poor neurodevelopmental outcome following hypoxia by detecting cerebral edema. This study investigated the relationship between the severity of an hypoxic/ischemic episode, neurological outcome following the hypoxia and non-invasively measured cerebral bioelectrical impedance in piglets. One-day-old piglets were anaesthetised and ventilated. Hypoxia was induced by reducing the inspired oxygen concentration to 3-5%. Severe hypoxia was defined as hypoxia resulting in at least 30 min of low amplitude EEG (<5 microV) as well as hypotension and acidosis. Cerebral bio-impedance was measured before, during and for up to 6 h post-hypoxia. Neurological outcome was determined by a neurology score at 24 and 48 h after hypoxia, and by histological examination of the brain at 72 h. There was no increase in cerebral impedance in control animals. Following mild hypoxia cerebral impedance increased transiently. Following severe hypoxia, cerebral impedance increased and remained elevated. Cerebral impedance following severe hypoxia was significantly higher than after mild hypoxia at 10 min and from 2 to 6 h after resuscitation. Cerebral impedance measurements made up to 1 h and between 3 and 6 h after resuscitation were significantly correlated with neurological outcome. Results indicate that non-invasive cerebral impedance measurements are able to discriminate early between those individuals who have suffered a mild, acute hypoxic episode, and those who have suffered a severe hypoxic episode. The technique has the potential to predict which individuals will have a poor neurological outcome.     

Impedance study of brain tissue changes after penetrating injury

Different aspects of tissue reaction to injury after probe insertions in the cat and rabbit brain have been elucidated by means of the impedographic technique. The fine track of a semimicroprobe (0.1 mm in diameter) in the living brain was clearly represented in the impedograph as a fine black strip of low impedance, but no pattern of changes in the tissue immediately surrounding or far from the track were seen in serial observation of 1 or 2 weeks. Similar results were also observed on tracks made with a medium-size probe (gauge 26-22). There is a series of reactions that develop in a typical pattern and these obtain only when using a large probe (gauge 19-15) or a narrow scalpel with a sharp tip. A sharp black image with low impedance usually appeared in the tissue of gray or white matter along the probe track at 24 hr after probe insertion. On the other hand, another reaction with an associated impedance rise or fall in isolated areas far from the probe track was observed occasionally. These reactions recovered completely within 1 week leaving no permanent damage except for a probe scar. The transient black image in the tissue surrounding the track was caused by a traumatic (vasogenic) extracellular edema which was confirmed by Evans blue dye administration. The impedance drop probably resulted from the increased edema fluid in the extracellular space.     

Measurement of tissue electrical impedance confirms stereotactically localized internal segment of the globus pallidus during surgery

Lesions surgically made in the internal segment of the posteroventral globus pallidus (Gpi) reduce many medically intractable symptoms in patients with Parkinson's disease. The Gpi is localized for pallidotomy by stereotactic procedures. We sought to confirm the stereotactically localized Gpi segment by measuring impedance between the tip of an active electrode that was advanced toward the target and a remote reference electrode. A stereotactic instrument was used to place an active electrode in 53 conscious patients undergoing pallidotomy. The electrode was manually advanced slowly toward the Gpi segment by a microdrive. Impedance was measured every 10 mm initially and every 1 mm in the final 10 mm of the electrode's advancement, using an impedance monitor interconnected with a lesion generator. Measurements were continued for several millimeters after each patient's target was reached. Impedance values ranged from 250 to 350 ohms throughout of the electrode passage. Impedance increased by 25-35 ohms at 1-3 mm before the center of the target and then dropped abruptly when the electrode passed the target. Impedance values depended strongly on the electrode's configuration. The impedance measurement confirmed the location of each surgical target identified by stereotactic navigation. The accuracy of the impedance measurement is acceptable, and the procedure can be recommended as an aid to confirm the stereotactically localized Gpi during neurological surgery.     

Characterization of intraluminal impedance patterns associated with gas reflux in healthy volunteers

Abstract  Multichannel intraluminal impedance (MII) recording allows assessment of flow through the oesophagus and differentiation between liquid and gas contents. Existing MII criteria for recognition of gas gastro-oesophageal reflux (GOR) have not been validated during known gas GOR in humans. Aims: (i) Characterize MII patterns of known gas GOR and optimize criteria. (ii) Clarify interrelationships between magnitude of maximal impedance change, luminal diameter and electrode-mucosa contact. Ten healthy volunteers (six male, 21–37 years) were studied using an oesophageal MII-manometry catheter. After catheter placement, subjects were asked to drink 600 mL of carbonated soft drink. Recordings were made for 20 min and the protocol repeated. Reported belches confirmed manometrically (triggered by transient lower oesophageal sphincter relaxations) were included for analysis. Those episodes were compared against commonly used criteria. Another five subjects (three male, 26–52 years) underwent simultaneous MII and videofluoroscopy using the same protocol. Videofluoroscopic images were analyzed for luminal diameter and the presence of electrode–mucosa contact. All analyzed gas GOR episodes ( n  = 88) were associated with a pattern of impedance rise which was either retrograde (62.5%), synchronous (19.3%) or antegrade (18.2%). Depending on the exact criteria used, sensitivity ranged from 33% to 75%. A multivariate regression model including luminal diameter and the presence of electrode-mucosa contact as independent factors accounted for 53% of all variation in impedance changes. In conclusion, a significant number of gas GOR episodes does not meet criteria for their recognition. New criteria are proposed to include specific antegrade patterns of impedance rise. Luminal diameter and the extent of contact between the oesophageal mucosa and MII-electrodes influence the magnitude and patterning of impedance change.     

Complex impedance spectroscopy for monitoring tissue responses to inserted neural implants

A series of animal experiments was conducted to characterize changes in the complex impedance of chronically implanted electrodes in neural tissue. Consistent trends in impedance changes were observed across all animals, characterized as a general increase in the measured impedance magnitude at 1 kHz. Impedance changes reach a peak approximately 7 days post-implant. Reactive responses around individual electrodes were described using immuno- and histo-chemistry and confocal microscopy. These observations were compared to measured impedance changes. Several features of impedance changes were able to differentiate between confined and extensive histological reactions. In general, impedance magnitude at 1 kHz was significantly increased in extensive reactions, starting about 4 days post-implant. Electrodes with extensive reactions also displayed impedance spectra with a characteristic change at high frequencies. This change was manifested in the formation of a semi-circular arc in the Nyquist space, suggestive of increased cellular density in close proximity to the electrode site. These results suggest that changes in impedance spectra are directly influenced by cellular distributions around implanted electrodes over time and that impedance measurements may provide an online assessment of cellular reactions to implanted devices.     

An in vitro model for investigating impedance changes with cell growth and electrical stimulation: implications for cochlear implants

The impedance of stimulating electrodes used in cochlear implants and other neural prostheses often increases post-implantation, and is thought to be due to fibrous tissue encapsulation of the electrode array. Increased impedance results in higher power requirements to stimulate target neurons at set charge densities. We developed an in vitro model to investigate the electrode-tissue interface in a highly controlled environment. This model was tested using three cell types, with and without charge-balanced biphasic electrical stimulation. Under standard tissue culture conditions, a monolayer of cells was grown over the electrode surface. Electrode impedance increased in proportion to the extent of cell coverage of the electrode. Cell type was a significant factor in the amount of impedance increase, with kidney epithelial cells (MDCK) creating the greatest impedance, followed by dissociated rat skin fibroblasts and then macrophages (J774). The application of electrical stimulation to cell-covered electrodes caused impedance fluctuations similar to that seen in vivo, with a lowering of impedance immediately following stimulation, and a recovery to pre-stimulation levels during inactive periods. Examination of these electrodes suggests that the stimulation-induced impedance changes were due to the amount of cell cover over the electrodes. This in vitro technique accurately models the changes in impedance observed with neural prostheses in vivo, and shows the close relationship between impedance and tissue coverage adjacent to the electrode surface. We believe that this in vitro approach holds great promise to further our knowledge of the mechanisms contributing to electrode impedance.     

生物电阻抗测量电极的阻抗特性

生物电阻抗测量是一种利用生物组织与器官的电特性及其变化规律提取与人体生理、病理状况相关信息的检测技术,具有无创、无害,廉价、操作简单和功能信息丰富等特点。生物电阻抗测量电极以生物组织的阻抗或阻抗变化为目标,并承受长时间交流信号激励,其交、直流阻抗及其稳定性至关重要,特别是交流阻抗值及其变化十分重要。文章对不同生产厂家的4种一次性银/氯化银心电图电极的交、直流阻抗性能及其变化情况进行观察分析,发现不同电极的交、直流阻抗值及其稳定性相差很大。电极在长时间交流激励后,其正、反向直流电阻值相差很大,提示在交流阻抗测量期间,被测电极的直流电阻性质发生了很大的变化。     

Time dependence of whole blood aggregation in response to platelet activating factor (PAF)

The aggregation/adhesion response to platelet activating factor (PAF) was studied in diluted whole blood by impedance aggregometry. The extent of aggregation varied directly with the interval between blood sampling and aggregation measurement over the first 30 minutes from sampling, then remained stable for the next 60 minutes of observation. This is an effect opposite to that described for aggregation to PAF in platelet rich plasma which, however, cannot be studied soon after sampling. Time dependence of aggregation is important and comparative measurements should be made during the period of stable aggregability.     

Mechanisms of gastric and supragastric belching: a study using concurrent high‐resolution manometry and impedance monitoring

Background Esophageal impedance monitoring has made it possible to distinguish two types of belches, designated gastric and supragastric. We aimed to compare the esophageal pressure characteristics during supragastric belches and gastric belches using combined high‐resolution manometry and impedance monitoring. Methods We included 10 patients with severe and frequent belching. Combined high‐resolution manometry and impedance monitoring was performed. Key Results Whereas gastric belching was relatively rare in all patients (median incidence 2 per 90‐min period), nine of the 10 patients exhibited excessive supragastric belching (36 in 90 min). Supragastric belches were characterized by: (i) movement of the diaphragm in aboral direction and increased esophagogastric junction (EGJ) pressure, (ii) decrease in esophageal pressure, (iii) upper esophageal sphincter (UES) relaxation, (iv) antegrade airflow into the esophagus, and (v) increase in esophageal and gastric pressure leading to expulsion of air out of the esophagus in retrograde direction. In contrast, gastric belches were characterized by: (i) decreased or unchanged EGJ pressure, which was significantly lower than during supragastric belches, (ii) absence of decreased esophageal pressure preceding entrance of air into the esophagus (iii) retrograde airflow into the esophagus, (iv) common cavity phenomenon, and (v) upper esophageal sphincter relaxation after the onset of the retrograde airflow. Conclusions & Inferences In gastric belching UES relaxation is a late event, allowing efflux of air that entered the esophagus from the stomach. In most patients with supragastric belching air is brought into the esophagus by movement of the diaphragm in aboral direction, creation of negative esophageal pressure, and UES relaxation.     

Current density distributions, field distributions and impedance analysis of segmented deep brain stimulation electrodes

Deep brain stimulation (DBS) electrodes are designed to stimulate specific areas of the brain. The most widely used DBS electrode has a linear array of 4 cylindrical contacts that can be selectively turned on depending on the placement of the electrode and the specific area of the brain to be stimulated. The efficacy of DBS therapy can be improved by localizing the current delivery into specific populations of neurons and by increasing the power efficiency through a suitable choice of electrode geometrical characteristics. We investigated segmented electrode designs created by sectioning each cylindrical contact into multiple rings. Prototypes of these designs, made with different materials and larger dimensions than those of clinical DBS electrodes, were evaluated in vitro and in simulation. A finite element model was developed to study the effects of varying the electrode characteristics on the current density and field distributions in an idealized electrolytic medium and in vitro experiments were conducted to measure the electrode impedance. The current density over the electrode surface increased towards the edges of the electrode, and multiple edges increased the non-uniformity of the current density profile. The edge effects were more pronounced over the end segments than over the central segments. Segmented electrodes generated larger magnitudes of the second spatial difference of the extracellular potentials, and thus required lower stimulation intensities to achieve the same level of neuronal activation as solid electrodes. For a fixed electrode conductive area, increasing the number of segments (edges) decreased the impedance compared to a single solid electrode, because the average current density over the segments increased. Edge effects played a critical role in determining the current density distributions, neuronal excitation patterns, and impedance of cylindrical electrodes, and segmented electrodes provide a means to increase the efficiency of DBS.     

Adaptation of the Reitboeck method of multiple microelectrode recording to the neocortex of the waking monkey

We adapted to the neocortex of waking monkeys a method for multiple microelectrode recording devised by Reitboeck. A sliding platform allows micropositioning of 7 electrodes independently, in 2 microns steps. Microelectrodes are quartz glass filaments (80 microns o.d.) with central metal cores (30 microns) of tungsten-platinum alloy. Filaments are drawn in a high temperature chamber, and ground to the desired form and tip size. The microdrive is held over the region to be explored, and the microelectrodes passed through 300 microns o.d. guide tubes fixed in implant thimbles of chosen size an and x - y arrangement of tubes, sealed by an O-ring into a small craniotomy opening. A microprocessor controlled recording system provides gain, noise and wave-shape filtering, impedance testing, and differential amplitude discrimination for each channel. Electrode movement is obtained via the microprocessor which displays and updates on the console terminal the electrode depth, impedance, and the channel assignment of each electrode. A second microprocessor based system is used to collect, buffer, and encode in real time all event data, which are transferred whenever convenient to a minicomputer that controls the experiment. Exploratory recordings were made in the posterior parietal, somatic sensory, and motor cortical areas. The system has now been used successfully in a number of investigations.     

A new computerized impedance plethysmograph: accuracy in the detection of proximal deep-vein thrombosis in symptomatic outpatients

Because of the lack of specificity of the clinical diagnosis it is appropriate in patients with clinically suspected deep-vein thrombosis to apply an objective test before starting anticoagulant treatment. Impedance plethysmography is a highly accurate technique for the detection of proximal-vein thrombosis with a reported sensitivity and specificity of 93 and 97%, respectively. In all previous reported evaluations of impedance plethysmography an apparatus which was developed in 1971 was used. A new computerized impedance plethysmography, using a novel device to measure impedance, was blindly compared against venography in 443 consecutive outpatients with clinically suspected deep-vein thrombosis. In the first phase of the study the computerized impedance plethysmography test results of 242 symptomatic patients were used to develop a discriminant line. Subsequently, this discriminant line was validated in the second phase of the study in another 201 symptomatic patients. The combined sensitivity and specificity of these two phases for proximal-vein thrombosis was 91% [95% confidence interval (CI), 86 to 94%] and 94% and (95% CI, 90 to 96%), respectively, which compares favourably with impedance plethysmography. It is concluded that computerized impedance plethysmography is a simple, portable, non-invasive technique with a high accuracy for the detection of proximal vein thrombosis. However, before computerized impedance plethysmography can be used as the only test in the diagnosis of deep-vein thrombosis, the safety of withholding anticoagulant treatment to patients with repeated normal computerized test results should be assessed during long-term follow-up studies.     

Optimal criteria for detecting bolus passage across the pharyngo-oesophageal segment during the normal swallow using intraluminal impedance recording

Abstract  The impedance criteria for the detection of the arrival of bolus head and clearance of bolus tail in the pharynx have not been defined, and may differ from accepted criteria used in the oesophagus. Our aim was to define the optimal impedance criteria that most accurately defined passage of the swallowed bolus moving through the pharyngo-oesophageal segment. In eight healthy volunteers, an assembly incorporating seven impedance-measuring segments was positioned across the pharyngo-oesophageal segment, and subjects swallowed liquid and semisolid radio-opaque boluses (2–20 mL) while impedance was simultaneously recorded with videofluoroscopic images. To derive the optimal criteria, in an iterative process we correlated impedance defined bolus presence with fluoroscopy (Cohen's Kappa) for a range of impedance cut-off values from 100% to 0% for both the initial fall, and recovery of impedance. Bolus presence in the pharynx, as determined by the 'standard' criteria (50% drop and recovery to 50% of baseline), correlated very modestly with videofluoroscopy (κ≈0.35). The criteria that most accurately defined bolus passage varied between pharyngeal regions. Threshold (% of baseline) for bolus head entry into the region ranged from 71% to 80%. Threshold for bolus tail clearance varied from nadir to 19%. Correlation of impedance with videofluoroscopy improved to κ≈0.6 with the above criteria. The impedance criteria defining bolus presence across the pharyngo-oesophageal segment differ from those adopted in the oesophagus. Pharyngeal impedance provides an accurate, non-radiological indicator of bolus transit through the pharynx.     

Longitudinal Impedance Variability in Patients with Chronically Implanted DBS Devices

BackgroundDeep brain stimulation (DBS) is an effective therapy for advanced movement disorders, but its optimal use is still controversial. One factor that could play a role in the proper delivery of therapeutic stimulation by current DBS devices is the variability of the impedance at the interface between the electrode surface and surrounding tissue.ObjectiveTo analyze variability and trends in the impedance of chronically-implanted DBS electrodes in subjects with movement disorders.MethodsWe reviewed impedance values from medical records of DBS patients at an academic tertiary-care movement disorders center. The standard deviation of data recorded within individual subjects and single contacts were used as measures of longitudinal impedance variability. A generalized linear mixed model (GLMM) determined if a number of effects had significant influences on impedance.ResultsWe analyzed 2863 impedance measurements from 94 subjects. Median variability, for subjects with follow-up from 6 months to 5 years (n = 77), was 194 Ω for individual subjects and 141 Ω for individual contacts, with a range spanning from 18 to over 600 Ω. The GLMM, incorporating all subjects (n = 94), identified time, electrical activity, implanted target, contact position on the electrode and side of implantation as significant predictors of impedance. Age and disease duration at surgery, gender or ethnicity were not significant predictors.ConclusionsOur analysis suggests that a significant amount of impedance variability can be expected in chronically implanted DBS electrodes and indicates a number of factors with possible predictive value. Further studies are needed to link impedance characteristics to clinical outcomes.     

Verification of the intraluminal multiple electrical impedance measurement for the recording of gastrointestinal motility

A new intraluminal electrical impedance procedure for high-resolution measurements and the quantitative assessment of gastrointestinal motility is examined in healthy volunteers by cineradiography and manometry. The peristalsis in the oesophagus, stomach and small bowel is recorded with a combined impedance-pressure catheter. Additionally, investigations with a flexible 16-channel impedance catheter with a closed surface and a diameter of 3 mm are carried out in the oesophagus and small intestine. The 16 measuring segments with a length of 2 cm each record the contractile patterns from a 32-cm-long organ section without a gap. The correctness of the physical approach is validated by concurrent impedance and cineradiography recordings of the oesophageal peristalsis. The comparative studies confirm a close relation between the pressure and the impedance changes in the oesophagus and small intestine. The time analysis of the impedance tracings offers information about the bolus transit and the change of the wall compliance along the organ. Regions of high or low compliance of the muscular wall can be recognized. From the impedance tracings the direction of the contraction waves as well as their velocities, lengths, beginnings and ends can be determined. Moreover, the beginning and end of the bolus, and from them the momentary bolus length, can be characterized for any instant during the bolus transit.     

Factors Affecting Impedance of Percutaneous Leads in Spinal Cord Stimulation

Objectives. Although the load impedance of a pulse generator has a significant effect on battery life, the electrical impedance of contact arrays in spinal cord stimulation (SCS) has not been extensively studied. We sought to characterize the typical impedance values measured from common quadripolar percutaneous SCS contact arrays. Methods. In 36 patients undergoing percutaneous trial stimulation for various chronic pain conditions, bipolar impedance between adjacent contacts of 64 leads with 9 mm center‐to‐center spacing was measured in two different vertebral level regions, cervical (C3–C7) and lower‐thoracic (T7–T12). Multiple linear regression was applied to analyze the contribution of six variables to the biological tissue portion of the impedance (excluding the resistance of the lead wires). Results. The median impedance in the cervical region (351 ± 90 Ω) was significantly lower (36%, p < 0.001) than in the lower‐thoracic region (547 ± 151 Ω). In addition, time since implant had a weaker but still significant effect on tissue impedance. Conclusions. Results from finite‐difference mathematical modeling of SCS suggest that the difference in tissue impedance related to vertebral level may be due to the dorsoventral position of the lead in the epidural space. The presence of a larger space between the triangularly shaped dorsal part of the vertebral arch and the round shape of the dural sac in the lower‐thoracic region increases the likelihood that the stimulating lead will not make dural contact, and thus “see” an increased impedance from the surrounding epidural fat. This implies that the energy requirements for stimulation in the thoracic region will be higher than in the cervical region, at least during the acute phase of implant.     

Sources and effects of electrode impedance during deep brain stimulation.

OBJECTIVE: Clinical impedance measurements for deep brain stimulation (DBS) electrodes in human patients are normally in the range 500-1500 Omega. DBS devices utilize voltage-controlled stimulation; therefore, the current delivered to the tissue is inversely proportional to the impedance. The goals of this study were to evaluate the effects of various electrical properties of the tissue medium and electrode-tissue interface on the impedance and to determine the impact of clinically relevant impedance variability on the volume of tissue activated (VTA) during DBS. METHODS: Axisymmetric finite-element models (FEM) of the DBS system were constructed with explicit representation of encapsulation layers around the electrode and implanted pulse generator. Impedance was calculated by dividing the stimulation voltage by the integrated current density along the active electrode contact. The models utilized a Fourier FEM solver that accounted for the capacitive components of the electrode-tissue interface during voltage-controlled stimulation. The resulting time- and space-dependent voltage waveforms generated in the tissue medium were superimposed onto cable model axons to calculate the VTA. RESULTS: The primary determinants of electrode impedance were the thickness and conductivity of the encapsulation layer around the electrode contact and the conductivity of the bulk tissue medium. The difference in the VTA between our low (790 Omega) and high (1244 Omega) impedance models with typical DBS settings (-3 V, 90 mus, 130 Hz pulse train) was 121 mm3, representing a 52% volume reduction. CONCLUSIONS: Electrode impedance has a substantial effect on the VTA and accurate representation of electrode impedance should be an explicit component of computational models of voltage-controlled DBS. SIGNIFICANCE: Impedance is often used to identify broken leads (for values > 2000 Omega) or short circuits in the hardware (for values < 50 Omega); however, clinical impedance values also represent an important parameter in defining the spread of stimulation during DBS.