Improving MRT Image Quality in Patients with Movement Disorders

  • Elisabeth SchültkeEmail author
  • Norbert Nanko
  • Marcus Pinsker
  • Michael Katzev
  • Alexandra Sebastian
  • Bernd Feige
  • Guido Nikkhah
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 117)


Objective: In order to improve image quality in a simultaneous fMRI-EEG study with patients suffering from the involuntary movements typical for Huntington’s disease, the aim was to develop a technique for immobilizing the heads of our patients inside an MRI head coil.

Methods: We modified a mask technique previously used for reliable repositioning in temporally fractionated radiotherapy. The mask was tested in three patients with Huntington’s disease, acquiring structural and functional MR images with simultaneous EEG with and without the mask.

Results: Image as well as EEG signal quality were significantly improved in patients wearing the mask. However, the image quality with mask was comparable to acquisitions from patients without movement disorders only in patients with light to moderate dyskinesia. Although image quality was also significantly improved in a patient suffering from severe dyskinesia with quasi-continuous involuntary movements, the quality of both the MR images as well as the EEG signal was lower than what would be expected in a healthy control person.

Conclusion: We have succeeded in developing a mask that fits into the MRI head coil, does not disturb the MRI signal, and significantly improves both fMRI and EEG signal quality.


fMRI Dyskinesia EEG Huntington’s disease Immobilization Mask 



We would like to thank Dipl. Physiol. Christoph Weis, who made the initial suggestion for the development of the mask, and Dr. Oliver Tüscher for encouraging us to go ahead with the idea. We also thank Mr. Kraft, Mr. Salvatore Fresta, and Mr. Benjamin Grunert of the Department of Radiotherapy for their time and enthusiasm during the development phase of our mask technique, as well as for their continued and ongoing support in fitting masks for our patients. Prof. A. Grosu, director of the Department of Radiotherapy, is thanked for allowing us to conduct this development work in the departmental workshop. EEG and fMRI data were acquired as part of a larger project supported by the Ministry of Education and Research of Germany (BMBF).

Conflict of Interest The authors declare that they have no conflict of interest.

Supplementary material

Video 1

(MPG 46380 kb)


  1. 1.
    Bettinardi V, Scardaoni R, Gilardi MC, Rizzo G, Perani D, Paulesu E, Striano G, Triluzi F, Fazio F (1991) Head holder for PET, CT and MR studies. J Comput Assist Tomogr 15(5):886–892PubMedCrossRefGoogle Scholar
  2. 2.
    Beyer T, Tellmann L, Nickel I, Uwe Pietrzyk U (2005) On the use of positioning aids to reduce misregistration in the head and neck in whole-body PET/CT studies. J Nucl Med 46:596–602PubMedGoogle Scholar
  3. 3.
    de Bie HM, Boersma M, Wattjes MP, Adriaanse S, Vermeulen RJ, Oostrom KJ, Huisman J, Veltman DJ, Delemarre-Van de Waal HA (2010) Preparing children with a mock scanner training protocol results in high quality structural and functional MRI scans. Eur J Pediatr 169(9):1079–1085PubMedCrossRefGoogle Scholar
  4. 4.
    Epstein JN, Casey BJ, Tonev ST, Davidson M, Reiss AL, Garrett A, Hinshaw SP, Greenhill LL, Vitolo A, Kotler LA, Jarrett MA, Spicer J (2007) Assessment and prevention of head motion during imaging of patients with attention deficit hyperactivity disorder. Psychiatry Res 155(1):75–82PubMedCrossRefGoogle Scholar
  5. 5.
    Shrawder S, Lapin GD, Allen CV, Vick NA, Groothuis DR (1994) A new head holder for reducing axial movement and repositioning errors during physiological CT imaging. J Comput Assist Tomogr 18(2):329–336PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Elisabeth Schültke
    • 1
    Email author
  • Norbert Nanko
    • 2
  • Marcus Pinsker
    • 3
    • 4
  • Michael Katzev
    • 5
  • Alexandra Sebastian
    • 6
  • Bernd Feige
    • 6
  • Guido Nikkhah
    • 3
    • 7
  1. 1.Division of Stereotactic and Functional Neurosurgery, Department of General NeurosurgeryUniversity Medical Center FreiburgFreiburgGermany
  2. 2.Department of Radiooncology, NeurocentreAlbert-Ludwigs-UniversityFreiburgGermany
  3. 3.Division of Stereotactic and Functional Neurosurgery, Department of General Neurosurgery, Neurosurgical ClinicUniversity Medical Center FreiburgFreiburgGermany
  4. 4.Klinik für NeurochirurgieHELIOS Klinikum Berlin-BuchBerlinGermany
  5. 5.Department of Neurology, NeurocentreAlbert-Ludwigs-UniversityFreiburgGermany
  6. 6.Department of Psychiatry and Psychotherapy, NeurocentreAlbert-Ludwigs-UniversityFreiburgGermany
  7. 7.University Hospital ErlangenErlangenGermany

Personalised recommendations