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. 2022 Sep;37(9):1924-1929.
doi: 10.1002/mds.29130. Epub 2022 Jun 23.

Coherent Structural and Functional Network Changes after Thalamic Lesions in Essential Tremor

Emily D R Pohl  1 , Neeraj Upadhyay  1 , Xenia Kobeleva  2   3 , Veronika Purrer  2   3 , Angelika Maurer  1   3 , Vera C Keil  4   5 , Christine Kindler  2   3 , Valeri Borger  6 , Claus C Pieper  7 , Simon Groetz  4 , Lukas Scheef  1 , Jaroslaw Maciaczyk  8   9 , Hans Schild  7 , Hartmut Vatter  6 , Thomas Klockgether  2   3 , Alexander Radbruch  3   4 , Ulrike Attenberger  7 , Ullrich Wüllner  2   3 , Henning Boecker  1   3
Affiliations

Coherent Structural and Functional Network Changes after Thalamic Lesions in Essential Tremor

Emily D R Pohl et al. Mov Disord. 2022 Sep.

Abstract

Background: Magnetic resonance-guided focused ultrasound of the ventral intermediate nucleus is a novel incisionless ablative treatment for essential tremor (ET).

Objective: The aim was to study the structural and functional network changes induced by unilateral sonication of the ventral intermediate nucleus in ET.

Methods: Fifteen essential tremor patients (66.2 ± 15.4 years) underwent probabilistic tractography and functional magnetic resonance imaging (MRI) during unilateral postural tremor-eliciting tasks using 3-T MRI before, 1 month (N = 15), and 6 months (N = 10) post unilateral sonication.

Results: Tractography identified tract-specific alterations within the dentato-thalamo-cortical tract (DTCT) affected by the unilateral lesion after sonication. Relative to the treated hand, task-evoked activation was significantly reduced in contralateral primary sensorimotor cortex and ipsilateral cerebellar lobules IV/V and VI, and vermis. Dynamic causal modeling revealed a significant decrease in excitatory drive from the cerebellum to the contralateral sensorimotor cortex.

Conclusions: Thalamic lesions induced by sonication induce specific functional network changes within the DTCT, notably reducing excitatory input to ipsilateral sensorimotor cortex in ET. ©[2022] International Parkinson and Movement Disorder Society. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keywords: brain networks; essential tremor; magnetic resonance imaging; magnetic resonance-guided focused ultrasound; ventral intermediate nucleus.

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