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Deep Brain Stimulation with Simultaneous fMRI in Rodents
Published on: February 15, 2014
Safety of MRI in patients with implanted deep brain stimulation devices
Michele Tagliati1, Joseph Jankovic, Fernando Pagan
1Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA. michele.tagliati@mssm.edu
Objective:
To survey the safety of MRI in PD patients implanted with DBS devices.
Background:
MRI in patients with DBS implants is useful to confirm electrode placement, optimize programming and investigating complications. However, several medical centers do not perform MRI studies in DBS patients because of safety concerns. The safety profile of MRI in DBS patients has not been documented in large clinical series.
Methods:
42 NPF Centers of Excellence (COEs) were asked to complete a questionnaire on MRI use and DBS.
Results:
Investigators from 40 of 42 (95%) NPF COEs completed the survey and 23 (58%) reported that they were currently performing brain MRI in DBS patients, while 3 (7.5%) had done it in the past. The 17 COEs currently not performing post-operative MRI for DBS listed the following reasons: 1) industry guidelines and/or warnings (53%); 2) decision deferred to outside department (29%); 3) liability/risk/safety (18%); 4) no active DBS program (18%); 5) no available MRI (12%); and 6) insurance and reimbursement concerns (6%). A total of 3304 PD patients with one or more DBS leads had a brain MRI scan, and 177 DBS patients had MRI of other body regions. In one case MRI was associated with an IPG failure without neurological sequelae after IPG replacement. No other complications were reported.
Conclusions:
these data provide evidence for a favorable risk/benefit ratio for brain MRI in patients with DBS implants. Further studies will need to address whether a re-assessment of more restrictive recommendations (i.e. very low SAR values) may be warranted.
Insights
Brain MRI is safe for Parkinson
Area of Science:
- Neurology
- Radiology
- Medical Devices
Background:
- Magnetic Resonance Imaging (MRI) is valuable for assessing Deep Brain Stimulation (DBS) implants in Parkinson's disease (PD) patients.
- Safety concerns and lack of large-scale data limit MRI use in this population.
- This study addresses the safety profile of MRI in patients with DBS devices.
Purpose of the Study:
- To survey the current practices and safety of MRI in patients with Parkinson's disease (PD) who have Deep Brain Stimulation (DBS) implants.
- To evaluate the risk-benefit ratio of performing MRI scans in patients with DBS devices.
Main Methods:
- A questionnaire was distributed to 42 National Parkinson Foundation (NPF) Centers of Excellence (COEs).
- The survey focused on the utilization of MRI in patients with DBS implants.
- Data were collected from 40 COEs regarding their MRI practices and reported complications.
Main Results:
- 58% of responding centers currently perform brain MRI in DBS patients; 7.5% have done so historically.
- Primary reasons for not performing MRI include industry guidelines, safety concerns, and liability.
- Over 3300 brain MRI scans were performed on PD patients with DBS leads, with only one reported incident of implantable pulse generator (IPG) failure and no neurological sequelae.
Conclusions:
- Brain MRI in patients with DBS implants demonstrates a favorable risk-benefit profile.
- Current data suggest that existing restrictive recommendations for MRI in DBS patients may warrant re-evaluation.
- Further research is needed to confirm these findings and potentially revise MRI guidelines.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...