Feasibility of cerebral magnetic resonance imaging in patients with externalised spinal cord stimulator.
OBJECTIVE
Spinal cord stimulation (SCS) is a well-known treatment option for intractable neuropathic pain after spinal surgery, but its pathophysiological mechanisms are poorly stated. The goal of this study is to analyse the feasibility of using brain MRI, functional MRI (fMRI) and Magnetic Resonance Spectroscopy (MRS) as tools to analyse these mechanisms in patients with externalised neurostimulators during trial period.


METHODS
The authors conducted in an in vitro and in vivo study analysing safety issues when performing brain MRI, fMRI and MRS investigations in human subjects with externalised SCS. Temperature measurements in vitro were performed simulating SCS during MRI sequences using head transmit-receive coils in 1.5 and 3 T MRI systems. 40 Patients with externalised SCS were included in the in vivo study. 20 patients underwent brain MRI, fMRI and another 20 patients underwent brain MRI and MRS.


RESULTS
A maximal temperature increase of 0.2°C was measured and neither electrode displacements nor hardware failures were observed. None of the patients undergoing the MRS sequences at the 1.5 or 3 T MRI scanners described any discomfort or unusual sensations.


CONCLUSIONS
We can conclude that brain MRI, fMRI and MRS studies performed in patients with externalised SCS can be safely executed.
Department of Neurosurgery, Center for Neurosciences, UZ Brussel, Brussels, Belgium. mtmoens@gmail.com
Maarten
M
Moens
Steven
S
Droogmans
Herbert
H
Spapen
Ann
A
De Smedt
Raf
R
Brouns
Peter
P
Van Schuerbeek
Robert
R
Luypaert
Jan
J
Poelaert
Bart
B
Nuttin
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D002985:Clinical Protocols; D004599:Electric Stimulation Therapy; D004566:Electrodes; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000379:methods; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D010148:Intractable Pain / Q000150:complications / Q000628:therapy; D061214:Patient Safety; D019047:Phantoms, Imaging; D013116:Spinal Cord; D013696:Temperature