Gadolinium deposition in the brain following gadolinium-based contrast agents (GBCA) application has become an important safety concern, however investigations into the effect of gadolinium deposition remain limited. We performed neurological and neuropsychological evaluation in four patients that received very high cumulative doses of linear and macrocyclic GBCAs (mean 728.25 ml, range 562–915 ml) over a range of 14–16 years. Although increased T1 signal was observed in the globus pallidus and dentate nuclei of all patients, the neurological status did not change. No signs of extrapyramidal symptomatology were detected, nor did neuropsychological testing reveal any relevant impairment implicating involvement.
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