This book describes the roles magnetic resonance imaging (MRI) can play in deep brain stimulation (DBS). DBS therapeutically modulates aberrant neural circuits implicated in a broad range of neurological disorders. Following surgical insertion, an electrode placed into the desired brain target generates constant electricity, analogous to a cardiac pacemaker. Most commonly employed in movement disorders such as Parkinson’s disease, dystonia, and tremor, DBS is also being investigated for use in psychiatric and cognitive disorders, including depression and Alzheimer’s disease. It is estimated that more than 230,000 patients have undergone DBS surgery worldwide. Imaging techniques, specifically MRI, have played key roles in the preoperative and postoperative aspects of DBS.
This book focuses on the established as well as the innovative roles of MRI in DBS. MRI and DBS are first introduced from an historical perspective and a review of the clinical aspects of DBS is performed. Then, the preoperative and postoperative applications of MRI in DBS are covered. The crucial aspect of MRI safety in these patients is also discussed. Finally, possible upcoming MRI applications for patients with DBS are discussed in a future directions chapter. Chapters are written by experts from the University of Toronto, a world leader in the field of DBS, alongside international co-authors to ensure a thorough review of the topics.
This is an ideal guide for both clinicians (neurosurgeons, neurologists, psychiatrists, and neuroradiologists) and researchers as well as trainees interested in neuroimaging for DBS.
Author(s): Alexandre Boutet, Andres M. Lozano
Publisher: Springer
Year: 2023
Language: English
Pages: 126
City: Cham
Preface
Contents
1: Deep Brain Stimulation and Magnetic Resonance Imaging: Introduction
References
2: A Historical Perspective on the Role of Imaging in Deep Brain Stimulation
Introduction
Ventriculography
Modern Neuroimaging Techniques: Magnetic Resonance Imaging and Computed Tomography
Recent Advances in DBS Neuroimaging
References
3: Overview of the Clinical Aspects of DBS
Overview and History of DBS
Brief History of Neurostimulation in Functional Neurosurgery
DBS for Psychosurgery
DBS for Pain
DBS for Epilepsy
DBS for Movement Disorders
Other Indications
Regulation of DBS Implants
Patient Selection and Referral
Neurology Screening
Neurosurgical Evaluation
Neuropsychiatric Testing
Neuroimaging
Contraindications to Surgery
Clinical Considerations and Target Selection
DBS for Essential Tremor
DBS for Idiopathic Parkinson’s Disease
STN DBS
GPi DBS
ViM/cZi for Tremor-Dominant PD
DBS for Dystonia
DBS for Epilepsy
DBS for Other Indications
Surgical Considerations
Intraoperative Considerations
Postoperative Considerations
Future Directions and Innovations
References
4: Preoperative Planning of DBS Surgery with MRI
Introduction
Methods
Search
Sequence Evaluation
Most Common DBS Targets
Subthalamic Nucleus
Visualizing the STN
Globus Pallidus
Visualizing the GP
Thalamus
Direct MRI Visualization
Limitations
Future Directions
Conclusions
References
5: Safety of Magnetic Resonance Imaging in Patients with Deep Brain Stimulation
Introduction
Standards of Safety Testing
Magnetic Field Components within the Suite
Heterogeneity in Implanted Configurations and Positioning
MR-Induced Heating Concerns
The Unpredictable Nature of Heating
Measuring Heating
Other Potential MRI-Related Risks
Unintended Stimulation
Magnetically Induced Displacement or Vibrations
Internal Pulse Generator Malfunctioning
Magnetic Resonance Imaging Safety Studies with Humans
Special Considerations
The Impetus for Using High-Field MRI
High-Performance Sequences
Future Directions
Magnetic Resonance Safety Innovations
Possibilities for a New MR Safety Process
Conclusion
References
6: Postoperative MRI Applications in Patients with DBS
Introduction
Electrode Localisation and Mapping of Optimal DBS Target Using Pre- and Postoperative Imaging
MNI Space and Investigating Potential Mechanisms of DBS
Connectomics to Investigate Brain Networks of DBS
Summary and Conclusion
References
7: Acquiring Functional Magnetic Resonance Imaging in Patients Treated with Deep Brain Stimulation
Introduction
Challenges Associated with Acquiring fMRI in DBS Patients
fMRI Study Results
fMRI Acquisition, Experimental Design Paradigms and Analysis
Movement Disorders
Parkinson’s Disease (PD)
Essential Tremor (ET)
Neuropsychiatric Disorders
Obsessive-Compulsive Disorder (OCD)
Depression, Anorexia, and Bipolar
Pain
Epilepsy
Other DBS Indications
Potential Applications and Future Directions
References
8: MRI in Pediatric Patients Undergoing DBS
Introduction
Indications for Pediatric DBS
Imaging Considerations for Children
MR Imaging Acquisition for Planning DBS
Neuroimaging and the Developing Brain
Clinical Decision-Making for Children Based on Neuroimaging
DBS Targeting in Children
Postoperative DBS Imaging
Ethics of Pediatric DBS and Neuroimaging
Conclusions
References
9: Deep Brain Stimulation and Magnetic Resonance Imaging: Future Directions
References
Index
