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Boutet A, Rashid T, Hancu I, Elias GJB, Gramer RM, Germann J, Dimarzio M, Li B, Paramanandam V, Prasad S, Ranjan M, Coblentz A, Gwun D, Chow CT, Maciel R, Soh D, Fiveland E, Hodaie M, Kalia SK, Fasano A, Kucharczyk W, Pilitsis J, Lozano AM. Functional MRI Safety and Artifacts during Deep Brain Stimulation: Experience in 102 Patients. Radiology 2019; 293:174-183. [PMID: 31385756 DOI: 10.1148/radiol.2019190546] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BackgroundWith growing numbers of patients receiving deep brain stimulation (DBS), radiologists are encountering these neuromodulation devices at an increasing rate. Current MRI safety guidelines, however, limit MRI access in these patients.PurposeTo describe an MRI (1.5 T and 3 T) experience and safety profile in a large cohort of participants with active DBS systems and characterize the hardware-related artifacts on images from functional MRI.Materials and MethodsIn this prospective study, study participants receiving active DBS underwent 1.5- or 3-T MRI (T1-weighted imaging and gradient-recalled echo [GRE]-echo-planar imaging [EPI]) between June 2017 and October 2018. Short- and long-term adverse events were tracked. The authors quantified DBS hardware-related artifacts on images from GRE-EPI (functional MRI) at the cranial coil wire and electrode contacts. Segmented artifacts were then transformed into standard space to define the brain areas affected by signal loss. Two-sample t tests were used to assess the difference in artifact size between 1.5- and 3-T MRI.ResultsA total of 102 participants (mean age ± standard deviation, 60 years ± 11; 65 men) were evaluated. No MRI-related short- and long-term adverse events or acute changes were observed. DBS artifacts were most prominent near the electrode contacts and over the frontoparietal cortical area where the redundancy of the extension wire is placed subcutaneously. The mean electrode contact artifact diameter was 9.3 mm ± 1.6, and 1.9% ± 0.8 of the brain was obscured by the coil artifact. The coil artifacts were larger at 3 T than at 1.5 T, obscuring 2.1% ± 0.7 and 1.4% ± 0.7 of intracranial volume, respectively (P < .001). The superficial frontoparietal cortex and deep structures neighboring the electrode contacts were most commonly obscured.ConclusionWith a priori local safety testing, patients receiving deep brain stimulation may safely undergo 1.5- and 3-T MRI. Deep brain stimulation hardware-related artifacts only affect a small proportion of the brain.© RSNA, 2019Online supplemental material is available for this article.See also the editorial by Martin in this issue.
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Affiliation(s)
- Alexandre Boutet
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Tanweer Rashid
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Ileana Hancu
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Gavin J B Elias
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Robert M Gramer
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Jürgen Germann
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Marisa Dimarzio
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Bryan Li
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Vijayashankar Paramanandam
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Sreeram Prasad
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Manish Ranjan
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Ailish Coblentz
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Dave Gwun
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Clement T Chow
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Ricardo Maciel
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Derrick Soh
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Eric Fiveland
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Mojgan Hodaie
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Suneil K Kalia
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Alfonso Fasano
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Walter Kucharczyk
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Julie Pilitsis
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
| | - Andres M Lozano
- From the Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., A.C., W.K.); Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.B., G.J.B.E., R.M.G., J.G., B.L., V.P., S.P., M.R., A.C., D.G., C.T.C., R.M., D.S., M.H., S.K.K., A.F., W.K., A.M.L.); Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY (T.R., M.D., J.P.); Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada (I.H., V.P., S.P., R.M., D.S., A.F.); GE Global Research Center, Niskayuna, NY (E.F.); Krembil Brain Institute, Toronto, Canada (A.F.); and Department of Neurosurgery, Albany Medical Center, Albany, NY (J.P.)
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