A pilot study of human brain tissue post-magnetic resonance imaging: Information from the National Deep Brain Stimulation Brain Tissue Network (DBS-BTN)

Abstract

Introduction The safety of magnetic resonance imaging (MRI) for deep brain stimulation (DBS) patients is of great importance to both movement disorders clinicians and to radiologists. The present study utilized the Deep Brain Stimulation Brain Tissue Network's (DBS-BTN's) clinical and neuropathological database to search for evidence of adverse effects of MRI performed on implanted DBS patients. Hypothesis Performing a 1.5 T MRI with a head receive coil on patients with implanted DBS devices should not result in evidence of adverse clinical or pathological effects in the DBS-BTN cohort. Further, exposing post-mortem DBS-BTN brains with DBS leads to extended 3 T MRI imaging should not result in pathological adverse effects. Methods An electronic literature search was performed to establish clinical and neuropathological criteria for evidence of MRI-related adverse reactions in DBS patients. A retrospective chart review of the DBS-BTN patients was then performed to uncover potential adverse events resulting from MRI scanning. DBS patient characteristics and MRI parameters were recorded for each patient. In addition, 3 T MRI scans were performed on 4 post-mortem brains with DBS leads but without batteries attached. Detailed neuropathological studies were undertaken to search for evidence of MRI-induced adverse tissue changes. Results No clinical signs or symptoms or MRI-induced adverse effects were discovered in the DBS-BTN database, and on detailed review of neuroimaging studies. Neuropathological examination did not reveal changes consistent with MRI-induced heating damage. The novel study of four brains with prolonged 3 T post-mortem magnetic field exposure (DBS leads left in place) also did not reveal pathological changes consistent with heat related damage. Discussion The current study adds important information to the data on the safety of MRI in DBS patients. Novel post-mortem MRI studies provide additional information regarding the safety of 3 T MRI in DBS patients, and could justify additional studies especially post-mortem scans with battery sources in place. Conclusion The lack of pathological findings in the DBS-BTN database and the lack of tissue related changes following prolonged exposure to 3 T MRI in the post-mortem brains suggest that MRI scanning in DBS patients may be relatively safe, especially under current guidelines requiring a head receive coil. Subsequent studies exploring the safety of 1.5 T versus 3 T MRI in DBS patients should utilize more in depth post-mortem imaging to better simulate the human condition.