Assessing the clinical outcome of Vim radiosurgery with voxel-based morphometry: visual areas are linked with tremor arrest!

Tuleasca, Constantin; Witjas, Tatiana; Najdenovska, Elena; Verger, Antoine; Girard, Nadine; Champoudry, J.; Thiran, Jean‐Philippe; Ville, Dimitri Van De; Cuadra, Meritxell Bach; Levivier, Marc; Guedj, Éric; Régis, Jean

doi:10.1007/s00701-017-3317-7

Cited by 42 publications

(28 citation statements)

References 30 publications

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“…To co-ordinate the fine movements of patients with essential tremor with arm tremor, the brain needs to perform additional mechanisms of control and so the results of this study might represent adaptive reorganization and compensation through increased demands on the visuospatial control of skilled movements in patients with essential tremor. This view is supported by the findings of the study by Tuleasca et al that included a one-year follow-up of ventral intermediate nucleus (VIM) radiosurgery for essential tremor with voxel-based morphometry before and after treatment, which showed a significant change in gray matter volume in the left temporal pole and occipital cortex of the brain before and after treatment, resulting in the conclusion that visual areas might be linked with tremor arrest and be involved in the tremor loop [ 29 ].…”

Section: Discussionmentioning

confidence: 77%

A Voxel-Based Magnetic Resonance Imaging Morphometric Study of Cerebral and Cerebellar Gray Matter in Patients Under 65 Years with Essential Tremor

et al. 2018

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BackgroundThe aim of this study was to compare the morphological changes in cerebral and cerebellar gray matter in patients with essential tremor under 60-years-of-age, with age-matched and gender-matched normal healthy volunteer control subjects, using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM) analysis.Material/MethodsA retrospective, controlled, comparative clinical study included 17 patients with essential tremor, <60 years-of-age, and 17 age-matched and gender-matched healthy volunteer control subjects, recruited between June 2010–July 2012. MRI and VBM analysis were used to compare cerebral and cerebellar gray matter density between groups. The Washington Heights–Inwood Genetic Study of Essential Tremor (WHIGET) rating scale was used to assess tremor severity in the patient group. Clinical and demographic characteristics were recorded for all study participants.ResultsMRI and VBM analysis showed significant bilateral expansion of the cerebellum, occipital fusiform cortices, right inferior temporal gyrus, and precentral lobes in patients with essential tremor (P<0.005); reduction in gray matter was found in the left parietal lobe. The region of interest (ROI) analysis showed volume enlargement in the thalamus, midbrain, and the precuneus (P<0.005). No significant correlation between changes in gray matter and changes in clinical variables, including age, gender, tremor duration, the activity of daily living (ADL) scale, the mini-mental state examination (MMSE) scale, family history, and tremor severity were found.ConclusionsPredominantly cerebellar gray matter expansion in patients less than 60 years-of-age with essential tremor might be the result of compensation for the decline in cerebellar function.

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Section: Discussionmentioning

confidence: 77%

A Voxel-Based Magnetic Resonance Imaging Morphometric Study of Cerebral and Cerebellar Gray Matter in Patients Under 65 Years with Essential Tremor

et al. 2018

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“…Here, we constructed a general linear model allowing predicting if an eventual pretherapeutic GMD in a specific anatomical area would relate to TSTH improvement. Of particular importance, we used TSTH as a continuous variable, without splitting of any group, as in the previous study [38]. We found that higher pretherapeutic GMD within right BA 18 predicted better TSTH improvement.…”

Section: Discussionmentioning

confidence: 92%

“…In a recently published paper [38], we have evaluated longitudinal GMD changes in time, between pretherapeutic state and 1 year after Vim RS. We assessed whether these structural MR changes would relate to TSTH improvement, by conventionally separating two different groups, clinically responders (<50% improvement) and non-responders (>=50% improvement).…”

Section: Discussionmentioning

confidence: 99%

Right Brodmann area 18 predicts tremor arrest after Vim radiosurgery: a voxel-based morphometry study

et al. 2017

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“…The importance of brain visual areas in tremor pathogenesis has been recently investigated by using a visual task of increasing difficulty to illustrate the impact of visuospatial network in tremor augmentation (Archer et al, 2018). Furthermore, recent series of investigations suggested that structural and functional changes of the visual cortex could be a preoperative predictor of optimum tremor outcome after ablative radiosurgery (Tuleasca et al, 2017(Tuleasca et al, , 2018b(Tuleasca et al, , 2018c.…”

Section: The Tremor Network and Pattern Of Beneficial Dbs Connectivitymentioning

confidence: 99%

Connectivity profile of thalamic deep brain stimulation to effectively treat essential tremor

Al‐Fatly

Ewert

Kübler

et al. 2019

Preprint

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Essential tremor is the most prevalent movement disorder and is often refractory to medical treatment. Deep brain stimulation offers a therapeutic approach that can efficiently control tremor symptoms. Several deep brain stimulation targets (ventral intermediate nucleus, zona incerta, posterior subthalamic area) have been discussed for tremor treatment. Effective deep brain stimulation therapy for tremor critically involves optimal targeting to modulate the tremor network. This could potentially become more robust and precise by using state-of-the-art brain connectivity measurements. In the current study, we utilized two normative brain connectomes (structural and functional) to show the pattern of effective deep brain stimulation electrode connectivity in 36 essential tremor patients. Our structural and functional connectivity models were significantly predictive of post-operative tremor improvement in out-of-sample data (p < 0.001 for both structural and functional leave-one-out cross-validation). Additionally, we segregated the somatotopic brain network based on head and hand tremor scores. These resulted in segregations that mapped onto the well-known somatotopic maps of both motor cortex and cerebellum. Crucially, this shows that slightly distinct networks need to be modulated to ameliorate head vs. hand tremor and that those networks could be identified based on somatotopic zones in motor cortex and cerebellum.Finally, we propose a multi-modal connectomic deep brain stimulation sweet spot that may serve as a reference to enhance clinical care, in the future. This spot resided in the posterior subthalamic area, encroaching on the inferior borders of ventral intermediate nucleus and sensory thalamus.Our results underscore the importance of integrating brain connectivity in optimizing deep brain stimulation targeting for essential tremor.

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Assessing the clinical outcome of Vim radiosurgery with voxel-based morphometry: visual areas are linked with tremor arrest!

Cited by 42 publications

References 30 publications

A Voxel-Based Magnetic Resonance Imaging Morphometric Study of Cerebral and Cerebellar Gray Matter in Patients Under 65 Years with Essential Tremor

A Voxel-Based Magnetic Resonance Imaging Morphometric Study of Cerebral and Cerebellar Gray Matter in Patients Under 65 Years with Essential Tremor

Right Brodmann area 18 predicts tremor arrest after Vim radiosurgery: a voxel-based morphometry study

Connectivity profile of thalamic deep brain stimulation to effectively treat essential tremor

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