Safety assessment of spine MRI in deep brain stimulation patients.

Safety assessment of spine MRI in deep brain stimulation patients. J Neurosurg Spine. 2020 Feb 14;:1-11 Authors: Boutet A, Elias GJB, Gramer R, Neudorfer C, Germann J, Naheed A, Bennett N, Li B, Gwun D, Chow CT, Maciel R, Valencia A, Fasano A, Munhoz RP, Foltz W, Mikulis D, Hancu I, Kalia SK, Hodaie M, Kucharczyk W, Lozano AM Abstract OBJECTIVE: Many centers are hesitant to perform clinically indicated MRI in patients who have undergone deep brain stimulation (DBS). Highly restrictive guidelines prohibit the use of most routine clinical MRI protocols in these patients. The authors' goals were to assess the safety of spine MRI in patients with implanted DBS devices, first through phantom model testing and subsequently through validation in a DBS patient cohort. METHODS: A phantom was used to assess DBS device heating during 1.5-T spine MRI. To establish a safe spine protocol, routinely used clinical sequences deemed unsafe (a rise in temperature> 2°C) were modified to decrease the rise in temperature. This safe phantom-based protocol was then used to prospectively run 67 spine MRI sequences in 9 DBS participants requiring clinical imaging. The primary outcome was acute adverse effects; secondary outcomes included long-term adverse clinical effects, acute findings on brain MRI, and device impedance stability. RESULTS: The increases in temperature were highest when scanning the cervical spine and lowest when scanning the lumbar spine. A tem...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research

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Abstract OBJECTIVE: The anterior thalamic nucleus (ATN) is a common target for deep brain stimulation (DBS) for the treatment of drug-refractory epilepsy. However, no atlas-based optimal DBS (active contacts) target within the ATN has been definitively identified. The object of this retrospective study was to analyze the relationship between the active contact location and seizure reduction to establish an atlas-based optimal target for ATN DBS. METHODS: From among 25 patients who had undergone ATN DBS surgery for drug-resistant epilepsy between 2016 and 2018, those who had follow-up evaluations for more than...
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
BackgroundDeep brain stimulation (DBS) is a well ‐accepted treatment of Parkinson's disease (PD). Motor phenotypes include tremor‐dominant (TD), akinesia‐rigidity (AR), and postural instability gait disorder (PIGD). The mechanism of action in how DBS modulates motor symptom relief remains unknown.ObjectiveBlood oxygen level ‐dependent (BOLD) functional magnetic resonance imaging (fMRI) was used to determine whether the functional activity varies in response to DBS depending on PD phenotypes.Materials and MethodsSubjects underwent an fMRI scan with DBS cycling ON and OFF. The effects of DBS cycling on BOLD activatio...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research
Abstract The goal of this study was to characterize the spectral characteristics and spatial topography of local field potential (LFP) activity in the internal segment of the globus pallidus (GPi) in patients with Parkinson's disease utilizing directional (segmented) deep brain stimulation (dDBS) leads. Data were collected from externalized dDBS leads of three patients with idiopathic Parkinson's disease after overnight withdrawal of parkinsonian medication at rest and during a cued reach-to-target task. Oscillatory activity across lead contacts/segments was examined in the context of lead locations and contact or...
Source: Neurobiology of Disease - Category: Neurology Authors: Tags: Neurobiol Dis Source Type: research
BACKGROUND AND PURPOSE: Deep brain stimulation electrodes induce massive artifacts on CT images, deteriorating the diagnostic value of examinations. We aimed to investigate the usefulness and potential limitations of a single-energy metal artifact reduction algorithm in head CT performed in patients with implanted deep brain stimulation devices. MATERIALS AND METHODS: Thirty-four patients with deep brain stimulation (bilateral, n = 28) who underwent head CT on a 320–detector row scanner and whose images were reconstructed with and without single-energy metal artifact reduction at the examinations were retrospectivel...
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: ADULT BRAIN Source Type: research
This study showed that bilateral STN DBS results in a very significant improvement in cervical dystonia with no mental worsening and suggests that STN DBS may be an alternative to GPi DBS for treating primary cervical dystonia.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
CONCLUSION: The differential impact of MFB DBS on the induced dopamine response, including different response patterns at given pulse widths, is suggestive of physiological and anatomical divergence in the MFB in the pathological and healthy state. Studying how varying stimulation parameters affect the physiological outcome will promote a better understanding of the biological substrate of the disease and the possible anti-depressant mechanisms at play in clinical MFB DBS. PMID: 32035070 [PubMed - as supplied by publisher]
Source: Experimental Neurology - Category: Neurology Authors: Tags: Exp Neurol Source Type: research
AbstractThe brainstem-based pedunculopontine nucleus (PPN) traditionally associates with motor function, but undergoes extensive degeneration during Parkinson ’s disease (PD), which correlates with axial motor deficits. PPN-deep brain stimulation (DBS) can alleviate certain symptoms, but its mechanism(s) of action remains unknown. We previously characterized rats hemi-intranigrally injected with the proteasomal inhibitor lactacystin, as an accurate prec linical model of PD. Here we used a combination of chemogenetics with positron emission tomography imaging forin vivo interrogation of discrete neural networks in thi...
Source: Neurotherapeutics - Category: Neurology Source Type: research
Medtronic obtained the European CE Mark for its Percept PC neurostimulator that uses smart feedback technology to deliver deep brain stimulation to treat Parkinson’s and other neurologic diseases. The so-called BrainSense technology powe...
Source: Medgadget - Category: Medical Devices Authors: Tags: Neurology Neurosurgery Source Type: blogs
The centromedian (CM) nucleus is an intralaminar thalamic nucleus that is considered as a potentially effective target of deep brain stimulation (DBS) and ablative surgeries for the treatment of multiple neurological and psychiatric disorders. However, the structure of CM is invisible on the standard T1- and T2-weighted (T1w and T2w) magnetic resonance images, which hamper it as a direct DBS target for clinical applications. The purpose of the current study is to demonstrate the use of quantitative susceptibility mapping (QSM) technique to image the CM within the thalamic region. Twelve patients with Parkinson’s dise...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
Publication date: Available online 31 December 2019Source: NeuroImageAuthor(s): Amar Awad, Patric Blomstedt, Göran Westling, Johan ErikssonAbstractEssential tremor is effectively treated with deep brain stimulation (DBS), but the neural mechanisms underlying the treatment effect are poorly understood. Essential tremor is driven by a dysfunctional cerebello-thalamo-cerebral circuit resulting in pathological tremor oscillations. DBS is hypothesised to interfere with these oscillations at the stimulated target level, but it is unknown whether the stimulation modulates the activity of the cerebello-thalamo-cerebral circui...
Source: NeuroImage - Category: Neuroscience Source Type: research
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