Clinical response to Vim's thalamic stereotactic radiosurgery for essential tremor is associated with distinctive functional connectivity patterns.

TitreClinical response to Vim's thalamic stereotactic radiosurgery for essential tremor is associated with distinctive functional connectivity patterns.
Publication TypeJournal Article
Year of Publication2018
AuthorsTuleasca, C, Najdenovska, E, Régis, J, Witjas, T, Girard, N, Champoudry, J, Faouzi, M, Thiran, J-P, Cuadra, MBach, Levivier, M, Van De Ville, D
JournalActa neurochirurgica
Date Published03/2018
Mots-clés80 and over, Activities of Daily Living, Aged, Attention, Basal Ganglia/diagnostic imaging, Basal Ganglia/physiology, Brain/diagnostic imaging, Brain/physiology, Cerebellum/diagnostic imaging, Cerebellum/physiology, essential tremor, Essential Tremor/surgery, Female, fMRI, France, Frontal Lobe/diagnostic imaging, Frontal Lobe/physiology, Functional Neuroimaging, Hand, Humans, Independent component analysis, Magnetic Resonance Imaging/methods, Male, Middle Aged, Motor Cortex/diagnostic imaging, Motor Cortex/physiology, Neural Pathways/diagnostic imaging, Neural Pathways/physiology, Prefrontal Cortex/diagnostic imaging, Prefrontal Cortex/physiology, Prospective Studies, Putamen/diagnostic imaging, Putamen/physiology, Radiosurgery, Radiosurgery/methods, Resting-state, Temporal Lobe/diagnostic imaging, Temporal Lobe/physiology, thalamotomy, Thalamus/surgery, Treatment Outcome, Ventral Thalamic Nuclei/surgery, Ventro-intermediate nucleus

INTRODUCTION: Essential tremor (ET) is the most common movement disorder. Drug-resistant ET can benefit from standard surgical stereotactic procedures (deep brain stimulation, thalamotomy) or minimally invasive high-intensity focused ultrasound (HIFU) or stereotactic radiosurgical thalamotomy (SRS-T). Resting-state fMRI (rs-fMRI) is a non-invasive imaging method acquired in absence of a task. We examined whether rs-fMRI correlates with tremor score on the treated hand (TSTH) improvement 1 year after SRS-T.

METHODS: We included 17 consecutive patients treated with left unilateral SRS-T in Marseille, France. Tremor score evaluation and rs-fMRI were acquired at baseline and 1 year after SRS-T. Resting-state data (34 scans) were analyzed without a priori hypothesis, in Lausanne, Switzerland. Based on degree of improvement in TSTH, to consider SRS-T at least as effective as medication, we separated two groups: 1, ≤ 50% (n = 6, 35.3%); 2, > 50% (n = 11, 64.7%). They did not differ statistically by age (p = 0.86), duration of symptoms (p = 0.41), or lesion volume at 1 year (p = 0.06).

RESULTS: We report TSTH improvement correlated with interconnectivity strength between salience network with the left claustrum and putamen, as well as between bilateral motor cortices, frontal eye fields and left cerebellum lobule VI with right visual association area (the former also with lesion volume). Longitudinal changes showed additional associations in interconnectivity strength between right dorsal attention network with ventro-lateral prefrontal cortex and a reminiscent salience network with fusiform gyrus.

CONCLUSIONS: Brain connectivity measured by resting-state fMRI relates to clinical response after SRS-T. Relevant networks are visual, motor, and attention. Interconnectivity between visual and motor areas is a novel finding, revealing implication in movement sensory guidance.

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Alternate JournalActa Neurochir (Wien)
Citation Key / SERVAL ID8556
Peer reviewRefereed
PubMed ID29335882
Grant ListSNSF-205321-157040 / / Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung / United States


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