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

Emily D. R. Pohl, Neeraj Upadhyay, Xenia Kobeleva, Veronika Purrer, Angelika Maurer, Vera C. Keil, Christine Kindler, Valeri Borger, Claus C. Pieper, Simon Groetz, Lukas Scheef, Jaroslaw Maciaczyk, Hans Schild, Hartmut Vatter, Thomas Klockgether, Alexander Radbruch, Ulrike Attenberger, Ullrich Wüllner, Henning Boecker

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1924-1929
Number of pages6
JournalMovement disorders
Volume37
Issue number9
Early online date2022
DOIs
Publication statusPublished - Sept 2022

Keywords

  • brain networks
  • essential tremor
  • magnetic resonance imaging
  • magnetic resonance–guided focused ultrasound
  • ventral intermediate nucleus

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