scholarly journals Reconfigurable MRI coil technology can substantially reduce RF heating at the tips of bilateral deep brain stimulation implants

2018 ◽  
Author(s):  
Laleh Golestanirad ◽  
Boris Keil ◽  
Sean Downs ◽  
John Kirsch ◽  
Behzad Elahi ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Temperature Rise ◽  
Substantial Reduction ◽  
The Body ◽  
Rf Heating ◽  
Coil System ◽  
Body Coil ◽  
Magnetic Resonance Imaging Mri ◽  
Deep Brain

AbstractPatients with deep brain stimulation (DBS) implants can significantly benefit from magnetic resonance imaging (MRI) examination, however, access to MRI is restricted in this patients because of safety concerns due to RF heating of the leads. Recently we introduced a patient-adjustable reconfigurable MRI coil system to reduce the SAR at the tip of deep brain stimulation implants during MRI at 1.5T. A simulation study with realistic models of single (unilateral) DBS leads demonstrated a substantial reduction in the local SAR up to 500-fold could be achieved using the coil system compared to quadrature birdcage coils. Many patients however, have bilateral DBS implants and the question arises whether the rotating coil system can be used in for them. This work reports the results of phantom experiments measuring the temperature rise at the tips of bilateral DBS implants with realistic trajectories extracted from postoperative CT images of 10 patients (20 leads in total). A total of 200 measurements were performed to record temperature rise at the tips of the leads during 2 minutes of scanning with the coil rotated to cover all accessible rotation angles. In all patients, we were able to find an optimum coil rotation angle and reduced the heating of both left and right leads to a level below the heating produced by the body coil. An average heat reduction of 65% was achieved for bilateral leads. Reconfigurable coil technology introduces a promising approach for imaging of patients with DBS implants.

scholarly journals Towards Tracking of Deep Brain Stimulation Electrodes Using an Integrated Magnetometer

Sensors ◽  
2021 ◽  
Vol 21 (8) ◽  
pp. 2670
Author(s):  
Thomas Quirin ◽  
Corentin Féry ◽  
Dorian Vogel ◽  
Céline Vergne ◽  
Mathieu Sarracanie ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Mean Absolute Error ◽  
Tracking System ◽  
Three Dimensional ◽  
Absolute Error ◽  
Magnetic Tracking ◽  
Magnetic Camera ◽  
Magnetic Resonance Imaging Mri ◽  
Deep Brain

This paper presents a tracking system using magnetometers, possibly integrable in a deep brain stimulation (DBS) electrode. DBS is a treatment for movement disorders where the position of the implant is of prime importance. Positioning challenges during the surgery could be addressed thanks to a magnetic tracking. The system proposed in this paper, complementary to existing procedures, has been designed to bridge preoperative clinical imaging with DBS surgery, allowing the surgeon to increase his/her control on the implantation trajectory. Here the magnetic source required for tracking consists of three coils, and is experimentally mapped. This mapping has been performed with an in-house three-dimensional magnetic camera. The system demonstrates how magnetometers integrated directly at the tip of a DBS electrode, might improve treatment by monitoring the position during and after the surgery. The three-dimensional operation without line of sight has been demonstrated using a reference obtained with magnetic resonance imaging (MRI) of a simplified brain model. We observed experimentally a mean absolute error of 1.35 mm and an Euclidean error of 3.07 mm. Several areas of improvement to target errors below 1 mm are also discussed.

Effectiveness of Deep Brain Stimulation in Reducing Body Mass Index and Weight: A Systematic Review

2021 ◽  
pp. 1-11
Author(s):  
William Omar Contreras López ◽  
Paula Alejandra Navarro ◽  
Santiago Crispín
Keyword(s):  
Systematic Review ◽  
Body Mass Index ◽  
Deep Brain Stimulation ◽  
Body Mass ◽  
Brain Stimulation ◽  
The Body ◽  
Health Concern ◽  
Prader Willi Syndrome ◽  
Falling Asleep ◽  
Deep Brain

<b><i>Background:</i></b> Obesity has become a major public health concern worldwide, with current behavioral, pharmacological, and surgical treatments offering varying rates of success and adverse effects. Neurosurgical approaches to treatment of refractory obesity include deep brain stimulation (DBS) on either specific hypothalamic or reward circuitry nuclei, which might contribute to weight reduction through different mechanisms. We aimed to determine the safety and clinical effect of DBS in medical refractory obesity. <b><i>Summary:</i></b> Adhering to PRISMA guidelines, we performed a systematic review to identify all original studies – observational and experimental – in which DBS was performed to treat refractory obesity. From database inception to April 2021, we conducted our search in PubMed, Scopus, and LILACS databases using the following MeSH terms: “Obesity” OR “Prader-Willi Syndrome” AND “Deep Brain Stimulation.” The main outcomes were safety and weight loss measured with the body mass index (BMI). The Grading of Recommendations Assessment, Development, and Evaluation methods were applied to evaluate the quality of evidence. This study protocol was registered with PROSPERO ID: CRD42019132929. Seven studies involving 12 patients met the inclusion criteria; the DBS target was the nucleus accumbens in four (57.1%), the lateral hypothalamic area in two (29.6%), and the ventral hypothalamus in one (14.3%). Further, 33% of participants had obesity secondary to Prader-Willi syndrome (PWS) and 66.6% had primary obesity. The global BMI average at baseline was 46.7 (SD: 9.6, range: 32.2–59.1), and after DBS, 42.8 (SD: 8.8, range: 25–53.9), with a mean difference of 3.9; however, the delta in PWS patients was −2.3 and 10 in those with primary obesity. The incidence of moderate side effects was 33% and included manic symptoms (<i>N</i> = 2), electrode fracture (<i>N</i> = 1), and seizure (<i>N</i> = 1); mild complications (41.6%) included skin infection (<i>N</i> = 2), difficulties falling asleep (<i>N</i> = 1), nausea (<i>N</i> = 1), and anxiety (<i>N</i> = 1). <b><i>Key Messages:</i></b> Despite available small case series and case reports reporting a benefit in the treatment of refractory obesity with DBS, this study emphasizes the need for prospective studies with longer follow-ups in order to further address the efficacy and indications.

scholarly journals Exploring the effects of deep brain stimulation and vision on tremor in Parkinson’s disease - benefits from objective methods

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Per-Anders Fransson ◽  
Maria H. Nilsson ◽  
Diederick C. Niehorster ◽  
Marcus Nyström ◽  
Stig Rehncrona ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Motion Capture ◽  
Brain Stimulation ◽  
The Body ◽  
Motion Capture System ◽  
3D Motion ◽  
3D Motion Capture ◽  
Deep Brain

Abstract Background Tremor is a cardinal symptom of Parkinson’s disease (PD) that may cause severe disability. As such, objective methods to determine the exact characteristics of the tremor may improve the evaluation of therapy. This methodology study aims to validate the utility of two objective technical methods of recording Parkinsonian tremor and evaluate their ability to determine the effects of Deep Brain Stimulation (DBS) of the subthalamic nucleus and of vision. Methods We studied 10 patients with idiopathic PD, who were responsive to L-Dopa and had more than 1 year use of bilateral subthalamic nucleus stimulation. The patients did not have to display visible tremor to be included in the study. Tremor was recorded with two objective methods, a force platform and a 3 dimensional (3D) motion capture system that tracked movements in four key proximal sections of the body (knee, hip, shoulder and head). They were assessed after an overnight withdrawal of anti-PD medications with DBS ON and OFF and with eyes open and closed during unperturbed and perturbed stance with randomized calf vibration, using a randomized test order design. Results Tremor was detected with the Unified Parkinson’s Disease Rating Scale (UPDRS) in 6 of 10 patients but only distally (hands and feet) with DBS OFF. With the force platform and the 3D motion capture system, tremor was detected in 6 of 10 and 7 of 10 patients respectively, mostly in DBS OFF but also with DBS ON in some patients. The 3D motion capture system revealed that more than one body section was usually affected by tremor and that the tremor amplitude was non-uniform, but the frequency almost identical, across sites. DBS reduced tremor amplitude non-uniformly across the body. Visual input mostly reduced tremor amplitude with DBS ON. Conclusions Technical recording methods offer objective and sensitive detection of tremor that provide detailed characteristics such as peak amplitude, frequency and distribution pattern, and thus, provide information that can guide the optimization of treatments. Both methods detected the effects of DBS and visual input but the 3D motion system was more versatile in that it could detail the presence and properties of tremor at individual body sections.

scholarly journals Globus Pallidus Internus Deep Brain Stimulation for Disabling Diabetic Hemiballism/Hemichorea

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Byung-chul Son ◽  
Jin-gyu Choi ◽  
Hak-cheol Ko
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Glucose Levels ◽  
Magnetic Resonance Imaging Mri ◽  
T1 Hyperintensity ◽  
The Right ◽  
Almost All ◽  
Deep Brain

Unilateral hemichorea/hemiballism (HH) associated with contralateral neuroimaging abnormalities of the basal ganglia, which is characterized by T1 hyperintensity on magnetic resonance imaging (MRI) and is secondary to diabetic nonketotic hyperglycemia, is a rare and unique complication of poorly controlled diabetes mellitus (DM). Although almost all prior reports have documented rapid resolution of HH within days after normalization of blood glucose levels, medically refractory persistent HH has been noted. The experience of surgical intervention for persistent HH is limited. A 46-year-old, right-handed female patient with type 2 DM presented with refractory diabetic HH on the left side of 6 months’ duration despite DM control and neuroleptic medication usage. Image-guided deep brain stimulation (DBS) on the right globus pallidus internus (GPi) was performed. A mechanical micropallidotomy effect was observed and chronic stimulation of GPi was quite effective in symptomatic control of diabetic HH until a 16-month follow-up visit. DBS of the GPi can be an effective treatment for medically refractory diabetic HH.

Operative Technique and Workflow of Deep Brain Stimulation Surgery With Pre-existing Cochlear Implants

2019 ◽  
Vol 19 (2) ◽  
pp. 143-149
Author(s):  
Erik Bolier ◽  
Jessica A Karl ◽  
R Mark Wiet ◽  
Alireza Borghei ◽  
Leo Verhagen Metman ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cochlear Implants ◽  
Brain Stimulation ◽  
Operative Technique ◽  
Case Reports ◽  
Time Frame ◽  
Lead Placement ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Deep Brain

Abstract Background Deep brain stimulation (DBS) surgery in patients with pre-existing cochlear implants (CIs) poses various challenges. We previously reported successful magnetic resonance imaging (MRI)-based, microelectrode recording (MER)-guided subthalamic DBS surgery in a patient with a pre-existing CI. Other case reports have described various DBS procedures in patients with pre-existing CIs using different techniques, leading to varying issues to address. A standardized operative technique and workflow for DBS surgery in the setting of pre-existing CIs is much needed. Objective To provide a standardized operative technique and workflow for DBS lead placement in the setting of pre-existing CIs. Methods Our operative technique is MRI-based and MER-guided, following a workflow involving coordination with a neurotology team to remove and re-implant the internal magnets of the CIs in order to safely perform DBS lead placement, altogether within a 24-h time frame. Intraoperative nonverbal communication with the patient is easily possible using a computer monitor. Results A 65-yr old woman with a 10-yr history of craniocervical dystonia and pre-existing bilateral CIs underwent successful bilateral pallidal DBS surgery at our institution. No merging errors or difficulties in targeting globus pallidus internus were experienced. Also, inactivated CIs do not interfere with MER nor with stimulation, and intraoperative communication with the patient using a computer monitor proved feasible and satisfactory. Conclusion DBS procedures are safe and feasible in patients with pre-existing CIs if precautions are taken following our workflow.

scholarly journals Magnetothermal genetic deep brain stimulation of motor behaviors in awake, freely moving mice

eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Rahul Munshi ◽  
Shahnaz M Qadri ◽  
Qian Zhang ◽  
Idoia Castellanos Rubio ◽  
Pablo del Pino ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Motor Behavior ◽  
Freezing Of Gait ◽  
Dorsal Striatum ◽  
Field Application ◽  
The Body ◽  
Superparamagnetic Nanoparticles ◽  
Neuronal Membrane ◽  
Deep Brain

Establishing how neurocircuit activation causes particular behaviors requires modulating the activity of specific neurons. Here, we demonstrate that magnetothermal genetic stimulation provides tetherless deep brain activation sufficient to evoke motor behavior in awake mice. The approach uses alternating magnetic fields to heat superparamagnetic nanoparticles on the neuronal membrane. Neurons, heat-sensitized by expressing TRPV1 are activated with magnetic field application. Magnetothermal genetic stimulation in the motor cortex evoked ambulation, deep brain stimulation in the striatum caused rotation around the body-axis, and stimulation near the ridge between ventral and dorsal striatum caused freezing-of-gait. The duration of the behavior correlated tightly with field application. This approach provides genetically and spatially targetable, repeatable and temporarily precise activation of deep-brain circuits without the need for surgical implantation of any device.

scholarly journals Application of Surgical Lead Management and Reconfigurable Coil Technology to Reduce RF Heating of DBS Implants during MRI at 3T Under Variant Body Compositions

2020 ◽  
Author(s):  
Bhumi Bhusal ◽  
Behzad Elahi ◽  
Boris Keil ◽  
Joshua Rosenow ◽  
Ehsan Kazemivalipour ◽  
...  
Keyword(s):  
Electric Fields ◽  
The Body ◽  
Mitigation Strategies ◽  
Rf Heating ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Lead Management ◽  
Body Compositions ◽  
Phantom Experiments ◽  
Deep Brain

AbstractPatients with active implants such as deep brain stimulation (DBS) devices, have limited access to magnetic resonance imaging (MRI) due to risks of RF heating. With an aging population, the prevalence of neurodegenerative and vascular disease increases; and so does the indication for MRI exams in patients with such implants. In response to this growing need for MRI, many groups have investigated strategies to mitigate the RF heating of the implants. These efforts, however, have relied either on simulations with homogenous body models or simplified phantom experiments (box shaped phantom with single tissue). It is well established, however, that the shape and heterogeneity of human body affects the distribution of MRI electric fields, which by proxy, alters the RF heating of an implant inside the body. In this contribution, we applied numerical simulations and phantom experiments to examine the effectiveness of RF heating mitigation strategies under variant patient body compositions, focusing on two recently proposed techniques: (a) surgical modification of DBS lead trajectories inside the body, and (b) use of a patient-adjustable reconfigurable MRI coil, both aiming to reduce the coupling of implanted leads and MRI electric fields. Our results demonstrated that both techniques perform well under variant body compositions.

Hacking Human Beings

2022 ◽  
pp. 113-129
Keyword(s):  
Deep Brain Stimulation ◽  
Infrared Spectrum ◽  
Brain Stimulation ◽  
Human Enhancement ◽  
The Body ◽  
Human Beings ◽  
Emotional Level ◽  
Deep Brain

This chapter discusses the various areas of human enhancement application where such concerns arise, including physical (chip self-identification and payment, improving hearing with magnetic headphones, improving vision in the infrared spectrum, and use of chips for monitoring bodily functions), cognitive (deep brain stimulation, memory chips, manipulation of neurons and neural dust), and emotional level (mood-fixing, neuroprosthetics) and life-extending technologies (cyborg digital mind, cyborg digital body, cryonic preservation of the body).

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