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Functional neurosurgery in the MRI environment.

A A F De Salles1, L Frighetto, E Behnke

  • 1Division of Neurosurgery, School of Medicine, University of California-Los Angeles, 200 UCLA Medical Plaza Suite 504, Los Angeles, CA 90095-7182, USA. adesalles@mednetucla.edu

Minimally Invasive Neurosurgery : MIN
|December 4, 2004
PubMed
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This study demonstrates that microelectrode recording and electrical stimulation are feasible during deep brain stimulation (DBS) and lesioning surgeries within an interventional MRI (iMRI) setting. The iMRI environment allows for electrode localization and placement confirmation during functional neurosurgery.

Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Electrophysiology

Background:

  • Functional neurosurgery, including deep brain stimulation (DBS) and lesioning, requires precise electrode placement.
  • Interventional magnetic resonance imaging (iMRI) offers real-time visualization during surgical procedures.
  • Integrating electrophysiological techniques with iMRI presents unique technical challenges.

Purpose of the Study:

  • To assess the feasibility of microelectrode recording, electrical stimulation, and electrode position verification within an iMRI environment.
  • To evaluate the safety and efficacy of these techniques during functional neurosurgical procedures.
  • To determine the utility of iMRI for guiding stereotactic interventions.

Main Methods:

  • Seventy-six functional neurosurgical procedures (54 DBS, 3 lesioning) were conducted in an open 0.2 T iMRI suite.

Related Experiment Videos

  • Electrophysiological studies, including microelectrode recordings and macrostimulation, were performed in 51 surgeries.
  • Intraoperative MRI was used for electrode position confirmation, often fused with pre-operative scans.

    • Main Results:

    • Microelectrode recordings were not significantly affected by MRI-related magnetic field noise.
    • Electrode position was confirmed intraoperatively, despite MRI artifacts from DBS hardware.
    • Two patients (2.6%) experienced symptomatic hemorrhage; overall image quality was sub-optimal but improved with image fusion.

    Conclusions:

    • Conventional stereotactic localization, electrophysiological recordings, stimulation, DBS hardware implantation, and lesion placement are feasible in a 0.2 T iMRI setting.
    • The ability to visualize the brain during surgery is highly beneficial for stereotactic procedures.
    • iMRI provides a valuable tool for enhancing precision and safety in functional neurosurgery.