{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:05:42Z","timestamp":1753891542486,"version":"3.41.2"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Object:<\/jats:bold> A real-time functional magnetic resonance imaging (fMRI) feedback during ventral intermediate nucleus (VIM) deep brain stimulation (DBS) under general anesthesia (or \u201casleep\u201d DBS) does not exist. We hypothesized that it was feasible to acquire a reliable and responsive fMRI during asleep VIM DBS surgery.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We prospectively enrolled 10 consecutive patients who underwent asleep DBS for the treatment of medication-refractory essential tremor. Under general anesthesia, we acquired resting-state functional MRI immediately before and after the cannula insertion. Reliability was determined by a temporal signal-to-noise-ratio &amp;gt;100. Responsiveness was determined based on the fMRI signal change upon insertion of the cannula to the VIM.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> It was feasible to acquire reliable fMRI during asleep DBS surgery. The fMRI signal was responsive to the brain cannula insertion, revealing a reduction in the tremor network's functional connectivity, which did not reach statistical significance in the group analysis.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> It is feasible to acquire a reliable and responsive fMRI signal during asleep DBS. The acquisition steps and the preprocessing pipeline developed in these experiments will be useful for future investigations to develop fMRI-based feedback for asleep DBS surgery.<\/jats:p>","DOI":"10.3389\/fneur.2021.659002","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T04:23:46Z","timestamp":1624854226000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Functional Neuroimaging During Asleep DBS Surgery: A Proof of Concept Study"],"prefix":"10.3389","volume":"12","author":[{"given":"Francesco","family":"Sammartino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard C.","family":"Reynolds","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Glen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vibhor","family":"Krishna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1097\/00006123-199710000-00013","article-title":"Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications","volume":"41","author":"Black","year":"1997","journal-title":"Neurosurgery."},{"key":"B2","doi-asserted-by":"publisher","first-page":"479","DOI":"10.3171\/2009.6.JNS081161","article-title":"Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy","volume":"112","author":"Starr","year":"2010","journal-title":"J Neurosurg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1944","DOI":"10.1212\/WNL.0000000000004630","article-title":"Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease","volume":"89","author":"Brodsky","year":"2017","journal-title":"Neurology."},{"key":"B4","doi-asserted-by":"publisher","first-page":"908","DOI":"10.3171\/2015.4.JNS15173","article-title":"Clinical outcomes using ClearPoint interventional MRI for deep brain stimulation lead placement in Parkinson's disease","volume":"124","author":"Ostrem","year":"2016","journal-title":"J Neurosurg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.nec.2013.08.008","article-title":"Image-guided deep brain stimulation","volume":"25","author":"Vega","year":"2014","journal-title":"Neurosurg Clin North Am."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.3171\/2016.3.JNS151992","article-title":"Microelectrode recording findings within the tractography-defined ventral intermediate nucleus","volume":"126","author":"King","year":"2017","journal-title":"J Neurosurg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1002\/mds.26633","article-title":"Tractography-based ventral intermediate nucleus targeting: novel methodology and intraoperative validation","volume":"31","author":"Sammartino","year":"2016","journal-title":"Mov Disord."},{"key":"B8","doi-asserted-by":"publisher","first-page":"54","DOI":"10.3389\/fnhum.2020.00054","article-title":"Proceedings of the seventh annual deep brain stimulation think tank: advances in neurophysiology, adaptive DBS, virtual reality, neuroethics and technology","volume":"14","author":"Ramirez-Zamora","year":"2020","journal-title":"Front Hum Neurosci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"401","DOI":"10.3171\/2015.7.JNS15617","article-title":"Resting-state functional MRI in an intraoperative MRI setting: proof of feasibility and correlation to clinical outcome of patients","volume":"125","author":"Roder","year":"2016","journal-title":"J Neurosurg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"892","DOI":"10.3171\/2016.9.JNS16908","article-title":"3-tesla MRI in patients with fully implanted deep brain stimulation devices: a preliminary study in 10 patients","volume":"127","author":"Sammartino","year":"2017","journal-title":"J Neurosurg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"491","DOI":"10.3171\/2009.7.JNS09150","article-title":"Brain penetration effects of microelectrodes and deep brain stimulation leads in ventral intermediate nucleus stimulation for essential tremor","volume":"112","author":"Morishita","year":"2010","journal-title":"J Neurosurg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1002\/mrm.1240","article-title":"Physiological noise in oxygenation-sensitive magnetic resonance imaging","volume":"46","author":"Kruger","year":"2001","journal-title":"Magn Reson Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.neuroimage.2006.09.032","article-title":"How long to scan? The relationship between fMRI temporal signal to noise ratio and necessary scan duration","volume":"34","author":"Murphy","year":"2007","journal-title":"Neuroimage."},{"key":"B14","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1006\/cbmr.1996.0014","article-title":"AFNI: software for analysis and visualization of functional magnetic resonance neuroimages","volume":"29","author":"Cox","year":"1996","journal-title":"Comput Biomed Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1002\/hbm.23909","article-title":"Intraclass correlation: improved modeling approaches and applications for neuroimaging","volume":"39","author":"Chen","year":"2018","journal-title":"Hum Brain Mapp."},{"key":"B16","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/j.neuroimage.2006.04.204","article-title":"Testing anatomically specified hypotheses in functional imaging using cytoarchitectonic maps","volume":"32","author":"Eickhoff","year":"2006","journal-title":"Neuroimage"},{"key":"B17","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.neuroimage.2007.03.060","article-title":"Assignment of functional activations to probabilistic cytoarchitectonic areas revisited","volume":"36","author":"Eickhoff","year":"2007","journal-title":"Neuroimage."},{"key":"B18","first-page":"1325","article-title":"A new SPM toolbox for combining probabilistic cytoarchitectonic maps and functional imaging data","volume-title":"Neuroimage.","author":"Eickhoff","year":"2005"},{"key":"B19","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.clinph.2011.09.024","article-title":"The oscillating central network of essential tremor","volume":"123","author":"Raethjen","year":"2012","journal-title":"Clin Neurophysiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.neuroimage.2014.12.002","article-title":"Lead-DBS: a toolbox for deep brain stimulation electrode localizations and visualizations","volume":"107","author":"Horn","year":"2015","journal-title":"Neuroimage."},{"key":"B21","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1002\/mds.21412","article-title":"Assessment of interrater and intrarater reliability of the fahn\u2013tolosa\u2013marin tremor rating scale in essential tremor","volume":"22","author":"Stacy","year":"2007","journal-title":"Mov Disord"},{"key":"B22","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1109\/JERM.2019.2904024","article-title":"Passive impedance matching for implanted brain\u2013electrode interfaces","volume":"3","author":"Chen","year":"2019","journal-title":"IEEE J Electromagn RF Microwaves Med Biol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/0140-6736(91)91175-T","article-title":"Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus","volume":"337","author":"Benabid","year":"1991","journal-title":"Lancet."},{"key":"B24","doi-asserted-by":"publisher","first-page":"e543","DOI":"10.1212\/WNL.0000000000005956","article-title":"DBS of the PSA and the VIM in essential tremor: a randomized, double-blind, crossover trial","volume":"91","author":"Barbe","year":"2018","journal-title":"Neurology."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.3171\/2015.6.JNS15526","article-title":"\u201cAsleep\u201d deep brain stimulation for essential tremor","volume":"124","author":"Chen","year":"2016","journal-title":"J Neurosurg."},{"key":"B26","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1159\/000442425","article-title":"Awake neurophysiologically guided versus asleep MRI-guided STN DBS for parkinson disease: a comparison of outcomes using levodopa equivalents","volume":"93","author":"Saleh","year":"2015","journal-title":"Stereotact Funct Neurosurg."},{"key":"B27","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1111\/ner.13081","article-title":"Reliability of intraoperative testing during deep brain stimulation surgery","volume":"23","author":"Sammartino","year":"2019","journal-title":"Neuromodulation."},{"key":"B28","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1002\/1522-2594(200007)44:1<162::AID-MRM23>3.0.CO;2-E","article-title":"Image-based method for retrospective correction of physiological motion effects in fMRI: RETROICOR","volume":"44","author":"Glover","year":"2000","journal-title":"Magn Reson Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.neuroimage.2005.07.005","article-title":"Non-white noise in fMRI: does modelling have an impact?","volume":"29","author":"Lund","year":"2006","journal-title":"Neuroimage."},{"key":"B30","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.neuroimage.2013.02.016","article-title":"Internal ventilation system of MR scanners induces specific EEG artifact during simultaneous EEG-fMR74 I","volume":"74","author":"Nierhaus","year":"2013","journal-title":"Neuroimage."},{"key":"B31","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/j.brs.2017.12.014","article-title":"Predictors of deep brain stimulation outcome in tremor patients","volume":"11","author":"Sandoe","year":"2018","journal-title":"Brain Stimul."},{"key":"B32","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1016\/j.clinph.2018.07.024","article-title":"Microlesion effects, suboptimal lead placement and disease progression are critical determinants for DBS tolerance in essential tremor","volume":"129","author":"Wagle Shukla","year":"2018","journal-title":"Clin Neurophysiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1006\/ccog.1999.0423","article-title":"Toward a unified theory of narcosis: brain imaging evidence for a thalamocortical switch as the neurophysiologic basis of anesthetic-induced unconsciousness","volume":"9","author":"Alkire","year":"2000","journal-title":"Conscious Cogn."},{"key":"B34","doi-asserted-by":"publisher","first-page":"101923","DOI":"10.1016\/j.nicl.2019.101923","article-title":"Acquisition of sensorimotor fMRI under general anaesthesia: assessment of feasibility, the BOLD response and clinical utility","volume":"23","author":"Yamamoto","year":"2019","journal-title":"Neuroimage."},{"key":"B35","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1016\/j.brs.2014.04.007","article-title":"Subthalamic nucleus deep brain stimulation induces motor network BOLD activation: use of a high precision MRI guided stereotactic system for nonhuman primates","volume":"7","author":"Min","year":"2014","journal-title":"Brain Stimul."},{"key":"B36","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1148\/radiol.2391041990","article-title":"Parkinson disease: pattern of functional MR imaging activation during deep brain stimulation of subthalamic nucleus\u2013initial experience","volume":"239","author":"Phillips","year":"2006","journal-title":"Radiology."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1227\/01.NEU.0000186935.87971.2a","article-title":"Is magnetic resonance imaging safe for patients with neurostimulation systems used for deep brain stimulation?","volume":"57","author":"Rezai","year":"2005","journal-title":"Neurosurgery."},{"key":"B38","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1002\/mdc3.12955","article-title":"Asleep deep brain stimulation of the nucleus ventralis intermedius for essential tremor using indirect targeting and interventional magnetic resonance imaging: single-institution case series","volume":"7","author":"Gravbrot","year":"2020","journal-title":"Mov Disord Clin Pract"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.659002\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T04:23:49Z","timestamp":1624854229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.659002\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,28]]},"references-count":38,"alternative-id":["10.3389\/fneur.2021.659002"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.659002","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2021,6,28]]},"article-number":"659002"}}