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Deep Brain Stimulation with Simultaneous fMRI in Rodents
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Functional MRI with active, fully implanted, deep brain stimulation systems: safety and experimental confounds.

David W Carmichael1, Serge Pinto, Patricia Limousin-Dowsey

  • 1Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK. d.carmichael@ion.ucl.ac.uk

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Summary

Functional magnetic resonance imaging (fMRI) is safe for individuals with deep brain stimulation (DBS) systems. Studies show minimal temperature increases and no significant experimental confounds, suggesting fMRI can be safely performed with implanted DBS devices.

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Area of Science:

  • Neuroimaging
  • Biomedical Engineering
  • Medical Physics

Background:

  • Deep brain stimulation (DBS) is a therapeutic intervention involving implanted electronic devices.
  • Functional magnetic resonance imaging (fMRI) is a neuroimaging technique used to study brain activity.
  • Investigating the safety and potential confounds of combining fMRI with active DBS systems is crucial for research and clinical applications.

Purpose of the Study:

  • To assess the safety of fMRI in subjects with fully implanted, active deep brain stimulation (DBS) systems.
  • To evaluate potential experimental confounds, specifically thermal and electromagnetic interference, during fMRI with DBS.
  • To compare the safety of fMRI with fully implanted DBS versus externalized DBS stimulator units.

Main Methods:

  • In vitro measurements of temperature and induced voltage were performed simulating bilateral DBS during MRI at 1.5 T and 3.0 T.
  • MRI sequences typical for fMRI studies with varying specific absorption rates (SARs) were used.
  • Perturbations in DBS equipment performance were assessed during echo planar MRI at both field strengths.

Main Results:

  • At typical fMRI SARs (<0.4 W/kg), MRI-induced temperature changes were below safety limits (<0.1°C at 1.5 T, <0.5°C at 3 T).
  • Higher SARs (>1 W/kg) elicited unsafe temperature increases (>1°C), independent of active pulsing.
  • DBS equipment performance perturbations were minimal, and temperature increases were low, suggesting fMRI with DBS is unlikely to cause thermal or electromagnetic confounds.

Conclusions:

  • fMRI studies in subjects with subcutaneously implanted DBS units are safe and free from DBS-specific experimental confounds.
  • Fully implanted DBS stimulator units offer a significant safety advantage over externalized units for fMRI.
  • Further research is needed to confirm safety across different MRI systems, coil configurations, and DBS arrangements.