Neurostimulation system used for deep brain stimulation (DBS): MR safety issues and implications of failing to follow safety recommendations.
The use of magnetic resonance imaging (MRI) in patients with neurostimulation systems used for deep brain stimulation requires the utmost care, and no individual should undergo an MR examination in the absence of empirical evidence that the procedure can be performed safely. The risks of performing MRI in patients with neurostimulators include those associated with heating, magnetic field interactions, induced currents, and the functional disruption of these devices. The exact safety recommendations for the particular neurostimulation system with regard to the pulse generator, leads, electrodes, operational conditions for the device, the positioning of these components, and the MR system conditions must be carefully followed for MRI. As highlighted by 2 recent accidents, the failure to strictly follow safety recommendations (eg, use a 1.5-T MR system with a send/receive head radiofrequency coil only; limit the specific absorption rate to 0.4 W/kg; etc.) may result in serious, temporary, or permanent injury to the patient including the possibility of transient dystonia, paralysis, coma, or even death.
Rezai
Ali R
AR
The Cleveland Clinic Foundation, Cleveland, OH, USA.
Phillips
Michael
M
Baker
Kenneth B
KB
Sharan
Ashwini D
AD
Nyenhuis
John
J
Tkach
Jean
J
Henderson
Jaimie
J
Shellock
Frank G
FG
D001927:Brain Diseases / Q000628:therapy*; D004553:Electric Conductivity / Q000009:adverse effects; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000295:instrumentation*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004574:Electromagnetic Fields / Q000009:adverse effects; D004869:Equipment Safety / Q000592:standards*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D014947:Wounds and Injuries / Q000209:etiology