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 language | English |
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Pages (from-to) | 1924-1929 |
Number of pages | 6 |
Journal | Movement disorders |
Volume | 37 |
Issue number | 9 |
Early online date | 2022 |
DOIs | |
Publication status | Published - Sept 2022 |
Keywords
- brain networks
- essential tremor
- magnetic resonance imaging
- magnetic resonance–guided focused ultrasound
- ventral intermediate nucleus