Safety of magnetic resonance imaging of deep brain stimulator systems: a serial imaging and clinical retrospective study

Chhabra, Vaninder; Sung, Edward; Mewes, Klaus; Bakay, Roy A.E.; Abosch, Aviva; Gross, Robert E.

doi:10.3171/2009.7.jns09572

Cited by 40 publications

(32 citation statements)

References 26 publications

(32 reference statements)

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“…Such safety considerations include the possibilities of thermal lesioning, electrode lead migration, and DBS hardware malfunction (Chhabra et al, 2010;Tagliati et al, 2009;Zekaj et al, 2013). In response to concerns about patient safety,…”

Section: Introductionmentioning

confidence: 99%

Neural Circuit Modulation During Deep Brain Stimulation at the Subthalamic Nucleus for Parkinson's Disease: What Have We Learned from Neuroimaging Studies?

Albaugh

Shih²

2013

Brain Connectivity

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Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) represents a powerful clinical tool for the alleviation of many motor symptoms that are associated with Parkinson's disease. Despite its extensive use, the underlying therapeutic mechanisms of STN-DBS remain poorly understood. In the present review, we integrate and discuss recent literature examining the network effects of STN-DBS for Parkinson's disease, placing emphasis on neuroimaging findings, including functional magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography. These techniques enable the noninvasive detection of brain regions that are modulated by DBS on a whole-brain scale, representing a key experimental strength given the diffuse and far-reaching effects of electrical field stimulation. By examining these data in the context of multiple hypotheses of DBS action, generally developed through clinical and physiological observations, we define a multitude of consistencies and inconsistencies in the developing literature of this rapidly moving field.

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Section: Introductionmentioning

confidence: 99%

Neural Circuit Modulation During Deep Brain Stimulation at the Subthalamic Nucleus for Parkinson's Disease: What Have We Learned from Neuroimaging Studies?

Albaugh

Shih²

2013

Brain Connectivity

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“…Postoperative magnetic resonance imaging (MRI) is used to determine the precise location of the implanted electrodes in a safe and effective manner. An alternate method proposed by Chhabra, et al postulates the inculcation of preoperative MRI with postoperative computer tomography [75]. Regions of stimulation within the brain may also be dictated by prior clinical experience which incorporates the limitations and advantages of DBS in a particular region for specific symptom alleviation.…”

Section: Pulse Generatorsmentioning

confidence: 99%

Neuroradiology, Anesthesia, Bioengineering, and Hardware Programming in the Clinical Applications of Deep Brain Stimulation

Jacob

Chakravarthy²

2014

Cureus

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“…All surgical tools needed to be MRI compatible, including an MRI-compatible drill. The risk of severe injury with the lead inserted into the brain when a 1.5-T MRI scan is performed has been already reported but has to be counterbalanced with the large number of patients in whom MRI scans, using head coils, have been performed also without any problems [4,6,16,25]. While some isolated MR complications occurred in implanted patients, with the need to modify safety rules [7,9,21], many teams reported accuracy, innocuousness, and advantages of its use.…”

Section: Feasibility and Technical Requirementmentioning

confidence: 99%

Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up

et al. 2015

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Background Improvement of surgical accuracy during DBSlead implantation has been described recently, leading to Bframeless^or BMRI-verifiedB techniques. However, combining a high-quality definition of the STN using intraoperative 1.5 MRI with the possibility to reduce errors due to coregistration and to monitor lead progression during surgical insertion while checking the absence of surgical complication is an appealing method. We report here surgical methodology, safety, application accuracy, and clinical benefit of STN-lead implantation under MRI guidance. Methods Two patients with a severe PD state were treated by bilateral STN-DBS. Leads were implanted under general anesthesia using intraoperative MRI guidance (ClearPoint system). Lead implantation accuracy was measured on T1 axial images at the level of the target. Clinical improvement was measured on the pre-and post-UPDRS 3 scale at 1-year follow-up. Results Surgery was safe and uneventful in both cases. Radial error was 0.36 (right) and 0.86 mm (left) in case 1, and 0.41 (right) and 0.14 mm (left) in case 2. No edema or hemorrhage were noticed. Conclusions Intraoperative MRI guidance allows DBS lead implantation with high accuracy and with great clinical efficacy. A larger cohort of patients is needed to confirm these initial results.

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Safety of magnetic resonance imaging of deep brain stimulator systems: a serial imaging and clinical retrospective study

Cited by 40 publications

References 26 publications

Neural Circuit Modulation During Deep Brain Stimulation at the Subthalamic Nucleus for Parkinson's Disease: What Have We Learned from Neuroimaging Studies?

Neural Circuit Modulation During Deep Brain Stimulation at the Subthalamic Nucleus for Parkinson's Disease: What Have We Learned from Neuroimaging Studies?

Neuroradiology, Anesthesia, Bioengineering, and Hardware Programming in the Clinical Applications of Deep Brain Stimulation

Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up

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