Intraoperative functional MRI as a new approach to monitor deep brain stimulation in Parkinson's disease

Heßelmann, Volker; Sorger, Bettina; Girnus, R; Lasek, K.; Maarouf, Mohammad; Wedekind, Christoph; Bunke, J.; Schulte, Oliver; Krug, Barbara; Lackner, K.; Sturm, Volker

doi:10.1007/s00330-003-2051-0

Cited by 39 publications

(16 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus far, DBS-fMRI studies have been conducted in rats (Lai et al, 2015; Lai et al, 2014; Shih et al, 2014; Van Den Berge et al, 2015; Yang et al, 2013), pigs (Knight et al, 2013; Min et al, 2012; Paek et al, 2015) and humans (Hesselmann et al, 2004; Jech et al, 2001; Kahan et al, 2014; Phillips et al, 2006; Rezai et al, 1999) using gradient-echo echo planar imaging (GE-EPI). For optimal contrast based on the blood oxygenation level dependent (BOLD) effect (Kim and Ogawa, 2012; Ogawa et al, 1990), the echo time (TE) of the EPI sequence is usually set equal to the transverse relaxation time.…”

Section: Introductionmentioning

confidence: 99%

MB-SWIFT functional MRI during deep brain stimulation in rats

et al. 2017

View full text Add to dashboard Cite

Recently introduced 3D radial MRI pulse sequence entitled Multi-Band SWeep Imaging with Fourier Transformation (MB-SWIFT) having inherently zero acquisition delay was used to obtain functional MRI (fMRI) contrast in rat’s brain at 9.4 Tesla during deep brain stimulation (DBS). The results demonstrate that MB-SWIFT allows images free of susceptibility artefacts, and provides an excellent fMRI activation contrast in the brain. Flip angle dependence of the MB-SWIFT fMRI signal and elimination of the fMRI contrast while using saturation bands, indicate a blood flow origin of the observed fMRI contrast. MB-SWIFT fMRI modality permits activation studies in the close proximity to the implanted lead, which is not possible to achieve with conventionally used gradient echo and spin echo - echo planar imaging fMRI techniques. We conclude that MB-SWIFT fMRI is a powerful imaging modality for investigations of functional responses during DBS.

show abstract

Section: Introductionmentioning

confidence: 99%

MB-SWIFT functional MRI during deep brain stimulation in rats

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Nuttin et al [8] proposed an excitation of frontopontine pathways under DBS, which was also seen in our case (BA 9 and 10). Although the striatal activation may be related to stimulation, its needs to be distinguished from artifactual activation near the electrode with alternate stimulation [15,20]. Compared to our study, Nuttin et al [8] used a higher stimulation current (10.5 V) and the internal capsule as target.…”

Section: Discussionmentioning

confidence: 80%

“…Thus, intraoperative fMRI may provide a new technique to assess changes in cortical activity distant from the stimulating electrode comparable to the findings of patients with Parkinson's disease that are treated by DBS [15]. In the case of DBS of the subthalamic nucleus, a decrease in activation in the primary motor cortex could be seen, separate from the stimulated target.…”

Section: Discussionmentioning

confidence: 99%

“…Functional magnetic resonance imaging (fMRI), on the other hand, was introduced in 1991 [13] and is well established for detecting cortical activity in a preoperative setting [14]. A clinical MRI unit allows intraoperative acquisition of high-quality anatomical and functional data [14,15]. Reports on intraoperative fMRI for monitoring functional changes in patients with Parkinson's disease after DBS show the feasibility of this technique [15,16].…”

Section: Introductionmentioning

confidence: 99%

“…A clinical MRI unit allows intraoperative acquisition of high-quality anatomical and functional data [14,15]. Reports on intraoperative fMRI for monitoring functional changes in patients with Parkinson's disease after DBS show the feasibility of this technique [15,16]. However, important aspects regarding patient safety have to be considered.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intraoperative Functional Magnetic Resonance Imaging for Monitoring the Effect of Deep Brain Stimulation in Patients with Obsessive-Compulsive Disorder

Hiss

Heßelmann²,

Hunsche³

et al. 2015

Stereotact Funct Neurosurg

Self Cite

View full text Add to dashboard Cite

Objectives: To investigate the effects of low- and high-frequency deep brain stimulation (DBS) on the nucleus accumbens (ACC) and the adjacent internal capsule in 3 patients with obsessive-compulsive disorder (OCD) using blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) under intraoperative conditions. Methods: After placement of the electrode in the right ACC, the patients underwent an MR scan inside the operating room. BOLD imaging was performed and interpreted using a boxcar paradigm with alternating high-frequency stimulation of the ACC and the internal capsule versus rest. Correlation maps were calculated employing SPM99. Results: During high-frequency stimulation of the right ACC, focal activation could be found in the right striatum, the right frontal lobe and the right hippocampus, whereas low-frequency stimulation was correlated to right insular activation. Interpretation: Intraoperative BOLD-fMRI is feasible during DBS surgery of OCD patients. Our results support the existence of an ipsilateral hemispheric circuit involving the frontal lobe, anterior cingulate, parahippocampal gyrus and striatum. Intraoperative fMRI may be used to acquire additional information regarding the pathophysiology of OCD that can be used to improve the results of DBS in OCD.

show abstract

Subthalamic Nucleus Deep Brain Stimulation Modulates 2 Distinct Neurocircuits

Shen

Jiang

Hubbard

et al. 2020

Annals of Neurology

View full text Add to dashboard Cite

Objective: Current understanding of the neuromodulatory effects of deep brain stimulation (DBS) on large-scale brain networks remains elusive, largely due to the lack of techniques that can reveal DBS-induced activity at the whole-brain level. Using a novel 3T magnetic resonance imaging (MRI)-compatible stimulator, we investigated whole-brain effects of subthalamic nucleus (STN) stimulation in patients with Parkinson disease. Methods: Fourteen patients received STN-DBS treatment and participated in a block-design functional MRI (fMRI) experiment, wherein stimulations were delivered during "ON" blocks interleaved with "OFF" blocks. fMRI responses to low-frequency (60Hz) and high-frequency(130Hz) STN-DBS were measured 1, 3, 6, and 12 months postsurgery. To ensure reliability, multiple runs (48 minutes) of fMRI data were acquired at each postsurgical visit. Presurgical resting-state fMRI (30 minutes) data were also acquired. Results: Two neurocircuits showed highly replicable, but distinct responses to STN-DBS. A circuit involving the globus pallidus internus (GPi), thalamus, and deep cerebellar nuclei was significantly activated, whereas another circuit involving the primary motor cortex (M1), putamen, and cerebellum showed DBS-induced deactivation. These 2 circuits were dissociable in terms of their DBS-induced responses and resting-state functional connectivity. The GPi circuit was frequency-dependent, selectively responding to high-frequency stimulation, whereas the M1 circuit was responsive in a time-dependent manner, showing enhanced deactivation over time. Finally, activation of the GPi circuit was associated with overall motor improvement, whereas M1 circuit deactivation was related to reduced bradykinesia. Interpretation: Concurrent DBS-fMRI using 3T revealed 2 distinct circuits that responded differentially to STN-DBS and were related to divergent symptoms, a finding that may provide novel insights into the neural mechanisms underlying DBS.

show abstract

Intraoperative functional MRI as a new approach to monitor deep brain stimulation in Parkinson's disease

Cited by 39 publications

References 16 publications

MB-SWIFT functional MRI during deep brain stimulation in rats

MB-SWIFT functional MRI during deep brain stimulation in rats

Intraoperative Functional Magnetic Resonance Imaging for Monitoring the Effect of Deep Brain Stimulation in Patients with Obsessive-Compulsive Disorder

Subthalamic Nucleus Deep Brain Stimulation Modulates 2 Distinct Neurocircuits

Contact Info

Product

Resources

About