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Transcranial Magnetic Stimulation in the Presence of Deep Brain Stimulation Implants: Induced Electrode Currents

机译:在深脑刺激植入物存在下的经颅磁刺激:诱导电极电流

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The safety of transcranial magnetic stimulation (TMS) in patients with an implanted deep brain stimulation (DBS) systems has not been thoroughly investigated. One potential safety hazard is the induction of significant voltages in the subcutaneous leads in the scalp that could result in unintended electrical currents in the DBS electrode contacts. We measured ex-vivo the TMS-induced voltages and currents in DBS electrodes with the implantable pulse generator (IPG) set in various modes of operation. We show that voltages as high as 100 V resulting in currents as high as 83 mA can be induced in the DBS leads by a TMS pulse in all IPG modes. These currents are an order of magnitude higher than the normal DBS pulses, and could result in tissue damage. When the IPG is turned off, electrode currents flow only if the TMS-induced voltage exceeds 5V.
机译:植入深脑刺激(DBS)系统患者的经颅磁刺激(TMS)的安全性尚未得到彻底调查。一个潜在的安全危害是头皮中皮下引线中的显着电压的诱导,其可能导致DBS电极触点中的非预期电流。我们测量了与各种操作模式中的可植入脉冲发生器(IPG)中的DBS电极中的TMS引起的电极和电流测量。我们表明,通过所有IPG模式的TMS脉冲在DBS引线中,可以在DBS引线中引起高达100 V的电压。这些电流比正常DBS脉冲高的数量级,并且可能导致组织损伤。当IPG被关闭时,如果TMS感应电压超过5V,则电极电流才流动。

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