• Karl A Sillay, Deborah Rusy, Laura Buyan-Dent, Nancy L Ninman, and Karl K Vigen.
• University of Wisconsin, Department of Neurosurgery and Biomedical Engineering, Madison, WI, USA; Semmes-Murphey Clinic, Memphis, TN, USA; University of Tennessee Department of Neurosurgery, Memphis, TN, USA; University of Tennessee Department of Electrical Engineering and Computer Science, Knoxville, TN, USA. Electronic address: ksillay@uthsc.edu.
• Clin Neurol Neurosurg. 2014 Dec 1;127:79-85.

ObjectWe report results of the initial experience with magnetic resonance image (MRI)-guided implantation of subthalamic nucleus (STN) deep brain stimulating (DBS) electrodes at the University of Wisconsin after having employed frame-based stereotaxy with previously available MR imaging techniques and microelectrode recording for STN DBS surgeries.MethodsTen patients underwent MRI-guided DBS implantation of 20 electrodes between April 2011 and March 2013. The procedure was performed in a purpose-built intraoperative MRI suite configured specifically to allow MRI-guided DBS, using a wide-bore (70 cm) MRI system. Trajectory guidance was accomplished with commercially available system consisting of an MR-visible skull-mounted aiming device and a software guidance system processing intraoperatively acquired iterative MRI scans.ResultsA total of 10 patients (5 male, 5 female)-representative of the Parkinson Disease (PD) population-were operated on with standard technique and underwent 20 electrode placements under MRI-guided bilateral STN-targeted DBS placement. All patients completed the procedure with electrodes successfully placed in the STN. Procedure time improved with experience.ConclusionOur initial experience confirms the safety of MRI-guided DBS, setting the stage for future investigations combining physiology and MRI guidance. Further follow-up is required to compare the efficacy of the MRI-guided surgery cohort to that of traditional frame-based stereotaxy.Copyright © 2014 Elsevier B.V. All rights reserved.

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