Safety of MRI in patients with implanted deep brain stimulation devices.
OBJECTIVE
To survey the safety of MRI in PD patients implanted with DBS devices.


BACKGROUND
MRI in patients with DBS implants is useful to confirm electrode placement, optimize programming and investigating complications. However, several medical centers do not perform MRI studies in DBS patients because of safety concerns. The safety profile of MRI in DBS patients has not been documented in large clinical series.


METHODS
42 NPF Centers of Excellence (COEs) were asked to complete a questionnaire on MRI use and DBS.


RESULTS
Investigators from 40 of 42 (95%) NPF COEs completed the survey and 23 (58%) reported that they were currently performing brain MRI in DBS patients, while 3 (7.5%) had done it in the past. The 17 COEs currently not performing post-operative MRI for DBS listed the following reasons: 1) industry guidelines and/or warnings (53%); 2) decision deferred to outside department (29%); 3) liability/risk/safety (18%); 4) no active DBS program (18%); 5) no available MRI (12%); and 6) insurance and reimbursement concerns (6%). A total of 3304 PD patients with one or more DBS leads had a brain MRI scan, and 177 DBS patients had MRI of other body regions. In one case MRI was associated with an IPG failure without neurological sequelae after IPG replacement. No other complications were reported.


CONCLUSIONS
these data provide evidence for a favorable risk/benefit ratio for brain MRI in patients with DBS implants. Further studies will need to address whether a re-assessment of more restrictive recommendations (i.e. very low SAR values) may be warranted.
Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA. michele.tagliati@mssm.edu
Michele
M
Tagliati
Joseph
J
Jankovic
Fernando
F
Pagan
Frandy
F
Susatia
Ioannis U
IU
Isaias
Michael S
MS
Okun
D001921:Brain / Q000033:anatomy & histology; D046690:Deep Brain Stimulation / Q000295:instrumentation*; D004567:Electrodes, Implanted; D004869:Equipment Safety; D006801:Humans; D007348:Insurance, Health; D016365:Liability, Legal; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D012306:Risk; D012449:Safety / Q000331:legislation & jurisprudence; D011795:Surveys and Questionnaires