ISMRM21 - MRI Techniques for Deep Brain Stimulation: Clinical Application & Challenges

MRI Techniques for Deep Brain Stimulation: Clinical Application & Challenges

Sunrise Session

ORGANIZERS: Marta Bianciardi, Susie Huang

Wednesday, 19 May 2021

Concurrent 7

14:00 - 15:00

Moderators: Bastien Guerin

Skill Level: Basic to Intermediate

Session Number: S-04c

Parent Session: Hot Topics in MRI of the Brain

Session Number: S-04c

Overview
Deep brain stimulation (DBS) is an invasive therapy used for treating movement disorders, including Parkinson’s disease, essential tremor, and dystonia. It aims to retune abnormal brain network activity by local high frequency stimulation of specific subcortical brain regions.

Successful DBS surgery is critically dependent on precise placement of DBS electrodes into target structures. During this educational course, we will address recent advances in ultra-high field MRI technology and methods, which allow for superior image resolution and dramatically improve anatomical delineation of DBS targets. Beyond clinical utility, DBS represents a powerful research platform to study functional connectomics and the modulation of distributed brain networks in the human brain. Yet, MRI of DBS patients is challenging. This educational course will cover safety and technical challenges of MRI of DBS patients.

Target Audience
This course is designed for both basic and clinical researchers interested in learning about MRI of DBS patients.

Educational Objectives
As a result of attending this course, participants should be able to:
- Explain the safety of MRI of DBS patients;
- Explain the technical challenges of MRI of DBS patients; and
- Describe applications of MRI of DBS patients.

		MRI of DBS Patients: Safety & Technical Challenges Watch the Video Laleh Golestani Rad MRI is useful in patients with DBS devices for electrode localization and monitoring functional effects of the stimulation. This talk gives an overview of safety issues and technical challenges of MRI in patients with DBS implants. Major risks of off label use of MRI are discussed in the light of recent studies that highlight the effect of lead trajectory and patient’s body composition on RF heating of DBS leads and recommendations are provided to mitigate the risks through surgical lead management.
		Application of MRI to DBS Patients Watch the Video Noam Harel Deep brain stimulation (DBS) can be highly effective at improving symptoms and enhancing the patient’s quality of life. However, clinical outcomes can vary greatly within- and across-studies. Much of this variability can likely be accounted for by differences in the stimulating lead location. High resolution 7T MRI data provides a unique opportunity to create an accurate, patient-specific, 3D anatomical model for visualization of the target structures. Accurate lead location, in respect to the anatomical borders of the intended target structure and its functional domains, is a crucial information for an efficient programming for patient optimal benefits.