Implantation of deep brain stimulator electrodes using interventional MRI

Neurosurg Clin N Am. 2009 Apr;20(2):193-203. doi: 10.1016/j.nec.2009.04.010.

Abstract

The authors describe a method for placement of deep brain stimulator electrodes using interventional MRI in conjunction with a skull-mounted aiming device (Medtronic Nexframe). This approach adapts the procedure to a standard-configuration 1.5-T diagnostic MRI scanner in a radiology suite. Preoperative imaging, device implantation, and postimplantation MRI are integrated into a single procedure performed under general anesthesia, providing real-time, high-resolution magnetic resonance confirmation of electrode position. The method is conceptually simpler than the current standard technique for deep brain stimulator placement, as it eliminates the stereotactic frame, the subsequent requirement for registration of the brain in stereotactic space, physiologic testing, and the need for patient cooperation. With further technical refinement, the interventional MRI method should improve the accuracy, safety, and speed of deep brain stimulator electrode placement.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / anatomy & histology
  • Brain / physiology
  • Deep Brain Stimulation / instrumentation*
  • Electrodes, Implanted*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / trends
  • Prosthesis Implantation / adverse effects
  • Prosthesis Implantation / instrumentation
  • Prosthesis Implantation / methods*
  • Prosthesis Implantation / trends