Abstract
ObjectiveThe purpose of this study was to investigate the pathological alterations and the stress responses around deep brain stimulation (DBS) electrodes after magnetic resonance imaging (MRI) scans at 7.0T, 3.0T and 1.5T.Materials and MethodsDBS devices were stereotactically implanted into the brains of New Zealand rabbits, targeting the left nucleus ventralis posterior thalami, while on the right side, a puncture passage pointing to the same target was made. MRI scans at 7.0T, 3.0T and 1.5T were performed using transmit/receive head coils. The pathological alterations of the surrounding tissue were evaluated by hematoxylin and eosin staining (H&E staining) and transmission electron microscopy (TEM). The levels of the 70 kDa heat shock protein (HSP-70), Neuronal Nuclei (NeuN) and Caspase-3 were determined by western-blotting and quantitative polymerase chain reaction (QPCR) to assess the stress responses near the DBS electrodes.ResultsH&E staining and TEM showed that the injury around the DBS electrodes was featured by a central puncture passage with gradually weakened injurious alterations. Comparisons of the injury across the groups manifested similar pathological alterations near the DBS electrodes in each group. Moreover, western-blotting and QPCR assay showed that the level of HSP-70 was not elevated by MRI scans (p>0.05), and the levels of NeuN and Caspase-3 were equal in each group, regardless of the field strengths applied (p>0.05).ConclusionsBased on these findings, it is reasonable to conclude that in this study the MRI scans at multiple levels failed to induce additional tissue injury around the DBS electrodes. These preliminary data furthered our understanding of MRI-related DBS heating and encouraged revisions of the current MRI guidelines for patients with DBS devices.
Highlights
Deep brain stimulation (DBS) is a surging neurostimulation technique, and its effectiveness has been verified [1]
Western-blotting and quantitative polymerase chain reaction (QPCR) assay showed that the level of HSP-70 was not elevated by magnetic resonance imaging (MRI) scans (p.0.05), and the levels of Neuronal Nuclei (NeuN) and Caspase-3 were equal in each group, regardless of the field strengths applied (p.0.05)
More in-depth studies are required to study the MRI-induced DBS heating in more universal conditions, i.e., using other placements of the DBS extension and other DBS devices with different dimensions, using larger animals, et al Conclusions. This preliminary investigation is the first randomized controlled multi-animal study assessing the heating of DBS leads during MRI scanning as well as being the first in vivo study that compared the pathological and molecular responses of the brain tissue surrounding the DBS leads in MRI scans at 7.0T, 3.0T and 1.5T field strengths
Summary
Deep brain stimulation (DBS) is a surging neurostimulation technique, and its effectiveness has been verified [1]. If MRI is irreplaceable, only 1.5T MRI with an RF of 64 MHz frequency is considered relatively safe when specific guidelines are followed [5,6,7,8]. In view of the former cases with terrible results induced by the MRI-related DBS heating, any violations from the guidelines are considered dangerous [2,3,9]. Reassessment of the current guidelines related to the safety of patients with DBS devices in MRI scans may be required [5]
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