Pretherapeutic resting-state fMRI profiles are associated with MR signature volumes after stereotactic radiosurgical thalamotomy for essential tremor.

TitrePretherapeutic resting-state fMRI profiles are associated with MR signature volumes after stereotactic radiosurgical thalamotomy for essential tremor.
Publication TypeJournal Article
Year of Publication2018
AuthorsTuleasca, C, Régis, J, Najdenovska, E, Witjas, T, Girard, N, Bolton, T, Delaire, F, Vincent, M, Faouzi, M, Thiran, J-P, Cuadra, MBach, Levivier, M, Van De Ville, D
JournalJournal of neurosurgery
Volume129
IssueSuppl1
Pagination63-71
Date Published12/2018
DOI10.3171/2018.7.GKS18752
ISSN1933-0693
Mots-clésAC = anterior commissure, ADL = activities of daily living, BOLD = blood oxygenation level–dependent, DBS = deep brain stimulation, DMN = default-mode network, DTI = diffusion tensor imaging, ET = essential tremor, FEW = family-wise error, Gamma Knife, IC = interconnectivity, ICA = independent component analysis, MNI = Montreal Neurological Institute, PC = posterior commissure, resting-state fMRI, rs-fMRI = resting-state functional MRI, SMA = supplementary motor area, SRS = stereotactic radiosurgery, SRS-T = SRS thalamotomy, stereotactic radiosurgery, thalamotomy, TSTH = tremor score on the treated hand, Vim, Vim = ventral intermediate nucleus
Abstract

OBJECTIVEEssential tremor (ET) is the most common movement disorder. Drug-resistant ET can benefit from standard stereotactic deep brain stimulation or radiofrequency thalamotomy or, alternatively, minimally invasive techniques, including stereotactic radiosurgery (SRS) and high-intensity focused ultrasound, at the level of the ventral intermediate nucleus (Vim). The aim of the present study was to evaluate potential correlations between pretherapeutic interconnectivity (IC), as depicted on resting-state functional MRI (rs-fMRI), and MR signature volume at 1 year after Vim SRS for tremor, to be able to potentially identify hypo- and hyperresponders based only on pretherapeutic neuroimaging data.METHODSSeventeen consecutive patients with ET were included, who benefitted from left unilateral SRS thalamotomy (SRS-T) between September 2014 and August 2015. Standard tremor assessment and rs-fMRI were acquired pretherapeutically and 1 year after SRS-T. A healthy control group was also included (n = 12). Group-level independent component analysis (ICA; only n = 17 for pretherapeutic rs-fMRI) was applied. The mean MR signature volume was 0.125 ml (median 0.063 ml, range 0.002-0.600 ml). The authors correlated baseline IC with 1-year MR signatures within all networks. A 2-sample t-test at the level of each component was first performed in two groups: group 1 (n = 8, volume < 0.063 ml) and group 2 (n = 9, volume ≥ 0.063 ml). These groups did not statistically differ by age, duration of symptoms, baseline ADL score, ADL point decrease at 1 year, time to tremor arrest, or baseline tremor score on the treated hand (TSTH; p > 0.05). An ANOVA was then performed on each component, using individual subject-level maps and continuous values of 1-year MR signatures, correlated with pretherapeutic IC.RESULTSUsing 2-sample t-tests, two networks were found to be statistically significant: network 3, including the brainstem, motor cerebellum, bilateral thalamus, and left supplementary motor area (SMA) (pFWE = 0.004, cluster size = 94), interconnected with the red nucleus (MNI -2, -22, -32); and network 9, including the brainstem, posterior insula, bilateral thalamus, and left SMA (pFWE = 0.002, cluster size = 106), interconnected with the left SMA (MNI 24, -28, 44). Higher pretherapeutic IC was associated with higher MR volumes, in a network including the anterior default-mode network and bilateral thalamus (ANOVA, pFWE = 0.004, cluster size = 73), interconnected with cerebellar lobule V (MNI -12, -70, -22). Moreover, in the same network, radiological hyporesponders presented with negative IC values.CONCLUSIONSThese findings have clinical implications for predicting MR signature volumes after SRS-T. Here, using pretherapeutic MRI and data processing without prior hypothesis, the authors showed that pretherapeutic network interconnectivity strength predicts 1-year MR signature volumes following SRS-T.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/30544321?dopt=Abstract

WOS ID (UT)

000453374900011

Alternate JournalJ. Neurosurg.
Citation Key / SERVAL ID9291
Peer reviewRefereed
PubMed ID30544321

                         

IUMSP | www.iumsp.ch
Institut universitaire de médecine sociale et préventive
Route de la Corniche 10, 1010 Lausanne - Switzerland
+41 21 314 72 72 | dess.info@unisante.ch

Go to top