Functional MRI Safety and Artifacts during Deep Brain Stimulation: Experience in 102 Patients

Area of Science:

• Radiology and Medical Imaging
• Neurology and Neurosurgery
• Biomedical Engineering

Background:

• Increasing use of deep brain stimulation (DBS) devices presents challenges for MRI access due to safety concerns.
• Existing MRI safety guidelines often restrict imaging for patients with active neuromodulation systems.
• Need for comprehensive data on MRI safety and artifact characteristics in DBS patients.

Purpose of the Study:

• To evaluate the safety and MRI experience in a large cohort of patients with active deep brain stimulation systems.
• To characterize the hardware-related artifacts on functional MRI images at 1.5 T and 3 T.
• To assess the impact of DBS hardware on image quality and potential adverse events.

Main Methods:

• Prospective study involving 102 participants with active DBS undergoing 1.5-T or 3-T MRI (T1-weighted and GRE-EPI sequences).
• Tracking of short- and long-term adverse events related to MRI exposure.
• Quantification and spatial analysis of DBS hardware artifacts on functional MRI, comparing 1.5 T and 3 T.

Main Results:

• No MRI-related short- or long-term adverse events were observed in any participant.
• Deep brain stimulation hardware artifacts were most prominent near electrode contacts and in the frontoparietal cortex.
• Artifacts obscured a small proportion of the brain (1.9% ± 0.8%), with larger artifacts at 3 T compared to 1.5 T (2.1% vs. 1.4%).

Conclusions:

• Patients with deep brain stimulation systems can safely undergo 1.5-T and 3-T MRI after local safety testing.
• Deep brain stimulation hardware-induced artifacts are localized and affect a limited volume of brain tissue.
• The findings support expanded MRI access for patients with DBS, with careful consideration of artifact patterns.