MRI-Related Heating near Deep Brain Stimulation Electrodes: More Data Are Needed

Abstract

Magnetic resonance imaging (MRI) of patients with implanted deep brain stimulation (DBS) devices poses a challenge for healthcare providers. As a consequence of safety concerns about magnetic field interactions with the device, induced electrical currents and thermal damage due to radiofrequency heating, a number of stringent guidelines have been proposed by the device manufacturer. Very few detailed investigations of these safety issues have been published to date, and the stringent manufacturer guidelines have gone unchallenged, leading some hospitals and imaging centers around the world to ban or restrict the use of MRI in DBS patients. The purpose of this review is to stimulate research towards defining appropriate guidelines for the use of MRI in patients with DBS. Additionally, this review is intended to help healthcare providers and researchers make sound clinical judgments about the use of MRI in the setting of implanted DBS devices.

A personalized history of EEG–fMRI integration

“…Of course, irrespective of the pathological condition, the fundamentals of the relationship between electrical and neuronal BOLD activity can be studied in humans . Linked to this, with the growing success of therapeutic brain stimulation in clinical neurology (Bronstein et al, 2011;Holtzheimer and Mayberg, 2011;Rasche et al, 2006;Salanova and Worth, 2007), the vision of imaging safely with fMRI the entire brain circuitry in response to in vivo stimulation appears a fascinating goal to work for (Gupte et al, 2011).…”

Electro‐optic probe for real‐time assessments of RF electric field produced in an MRI scanner: Feasibility tests at 3 and 4.7 T

“…For example, such an EO probe could be placed into the brain in close vicinity to the deep brain stimulation (DBS) electrode to measure precisely the E‐field produced in real time during an MR examination . This fully optical probe could replace the thermal sensors commonly used as an alternative method for MR‐related heating measurements, but which cause additional measurement errors because of the diffusion of the temperature in the medium nearby …”

Risk Assessment of Magnetic Resonance Imaging in Chronically Implanted Paddle Electrodes for Cortical Stimulation

“…These authors used DBS leads of 40 cm in their experimental setup and with their patients making several loops, especially on the side of the implanted IPG. It is well known that the electromagnetic forces decrease with increasing distance from the head coil, meaning that loops underneath the galea at the side of the patients can cause more problems than loops around the burr holes [25,26]. We always used shorter leads (28 cm) with one loop at the side contralateral to the IPG and not more than two small loops around the burr hole device.…”