Karl A Sillay1, Deborah Rusy2, Laura Buyan-Dent3, Nancy L Ninman3, Karl K Vigen4. 1. University of Wisconsin, Department of Neurosurgery and Biomedical Engineering, Madison, WI, USA; Semmes-Murphey Clinic, Memphis, TN, USA; University of Tennessee Department of Neurosurgery, Memphis, TN, USA; University of Tennessee Department of Electrical Engineering and Computer Science, Knoxville, TN, USA. Electronic address: ksillay@uthsc.edu. 2. University of Wisconsin, Department of Anesthesiology, Madison, WI, USA. 3. University of Wisconsin, Department of Neurology, Madison, WI, USA. 4. University of Wisconsin, Department of Radiology, Madison, WI, USA.
Abstract
OBJECT: We 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. METHODS: Ten 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. RESULTS: A 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. CONCLUSION: Our 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.
OBJECT: We 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. METHODS: Ten 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. RESULTS: A 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. CONCLUSION: Our 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.
Authors: Dong-Wook Park; Sarah K Brodnick; Jared P Ness; Farid Atry; Lisa Krugner-Higby; Amelia Sandberg; Solomon Mikael; Thomas J Richner; Joseph Novello; Hyungsoo Kim; Dong-Hyun Baek; Jihye Bong; Seth T Frye; Sanitta Thongpang; Kyle I Swanson; Wendell Lake; Ramin Pashaie; Justin C Williams; Zhenqiang Ma Journal: Nat Protoc Date: 2016-10-13 Impact factor: 13.491