| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3040060 | Clinical Neurology and Neurosurgery | 2014 | 7 Pages |
•Neuromodulation in the form of deep brain stimulation (DBS) is an approved therapy for treating movement disorders, such as Parkinson disease (PD), essential tremor, dystonia, and psychiatric disorders.•Magnetic resonance imaging (MRI)-guided prospective stereotaxy is an emerging surgical implantation technique that is poised to provide a future platform for treatment delivery.•MRI-guided prospective stereotaxy could help patients avoid awake surgery, minimize time-off medication, minimize brain shift and implant variance, and minimize brain penetrations as a means of reducing hemorrhage risk.•Team learning and proficiency, as well as optimized technical workflow, may lead to performance increases over time.•Future MR-guidance systems may allow MRI-scanner coupling to surgical guidance systems to decrease procedure time and improve efficiency and allow novel and dynamic real-time imaging techniques.
ObjectWe report results of the initial experience with magnetic resonance image (MRI)-guided implantation of subthalamic nucleus (STN) deep brain stimulating (DBS) electrodes at the University of Wisconsin after having employed frame-based stereotaxy with previously available MR imaging techniques and microelectrode recording for STN DBS surgeries.MethodsTen patients underwent MRI-guided DBS implantation of 20 electrodes between April 2011 and March 2013. The procedure was performed in a purpose-built intraoperative MRI suite configured specifically to allow MRI-guided DBS, using a wide-bore (70 cm) MRI system. Trajectory guidance was accomplished with commercially available system consisting of an MR-visible skull-mounted aiming device and a software guidance system processing intraoperatively acquired iterative MRI scans.ResultsA total of 10 patients (5 male, 5 female)—representative of the Parkinson Disease (PD) population—were operated on with standard technique and underwent 20 electrode placements under MRI-guided bilateral STN-targeted DBS placement. All patients completed the procedure with electrodes successfully placed in the STN. Procedure time improved with experience.ConclusionOur initial experience confirms the safety of MRI-guided DBS, setting the stage for future investigations combining physiology and MRI guidance. Further follow-up is required to compare the efficacy of the MRI-guided surgery cohort to that of traditional frame-based stereotaxy.
