Patient-adjustable MRI technology for high-resolution imaging of deep brain stimulation

Deep brain stimulation (DBS) is an FDA-approved neurosurgical procedure that has emerged as the gold-standard treatment for drug-resistant Parkinson’s disease (PD). Despite the general effectiveness of DBS, its underlying mechanisms of action are still unclear. Uncertainties remain about which circuits are affected, which exact fiber bundles need to be targeted, and the most efficacious stimulation protocol. The meticulous use of neuroimaging, both for target verification and for monitoring treatment-induced changes in the functional connectivity of affected brain networks is an essential step in interpreting clinical outcomes, testing new hypotheses and, consequently, designing enhanced therapeutic protocols. In this regard, magnetic resonance imaging (MRI) appears excellently poised as a high-resolution, non-invasive imaging tool, which could help address these open questions. However, the interaction of the radiofrequency (RF) fields of MRI scanners and the implanted electrodes imposes serious safety hazards that restrict the applicability of MRI for DBS patients. As a result, available MRI methodologies for DBS patients are limited in resolution and suffer from severe image artifacts that confound studies of the functional connectivity of affected brain networks. This program develops and validates novel MRI methodologies tailored and validated for patient-specific geometries, which will bring MRI to bear on the clinical questions regarding the mechanism and targeting of DBS treatment. The specific aims of this R00 project are, therefore: (1) to characterize the performance and safety margins of the developed reconfigurable coil technology in a cohort of realistic patient models; we will develop a database of patient-derived realistic DBS leads models and perform numerical simulations and phantom measurements to characterize the SAR-reduction performance of the coil for (a) unilateral, and (b) bilateral DBS implants; (2) to investigate the feasibility of ex