Effects of Cerebellothalamic Tractotomy on Cognitive and Emotional Functioning in Essential Tremor: A Preliminary Study in 5 Essential Tremor Patients

Abstract

Background: Subthalamic stereotactic interventions have recently caught renewed interest as a treatment for essential tremor (ET). However, it is not clear whether these interventions are associated with neurocognitive, mood or personality changes. Objective: To investigate neurocognition, neuropsychiatric functions and personality variables in patients with ET and to explore the neurocognitive and neuropsychiatric effects of cerebellothalamic tractotomy (CTT), a form of subthalamotomy. Methods: In our study, we investigated cognitive functions, frontal functions, mood and personality variables in 5 patients with intractable ET. Patients were tested before and 3 months after surgery using neuropsychological tests, clinical scales for depression, anxiety, anger regulation and a personality test. Results: Before surgery, ET patients showed normal neurocognitive function, a slightly elevated frontal lobe score in the dimensions mental control and memory, without being indicative of a frontal lesion, and no elevated depression or anxiety scores compared to norm values. After surgery, there was no change in neurocognitive function and no increase in depression or anxiety scores. Conclusion: In this exploratory study on 5 ET patients, CTT was not associated with alterations of mood or neurocognitive functions.

Incisionless transcranial MR-guided focused ultrasound in essential tremor: cerebellothalamic tractotomy

“…This case series is the first to include patients operated for chronic therapy-refractory ET with MRgFUS CTT. A technical report of the CTT performed with radiofrequency ablation was published by Magnin et al [ 57 ], and Ledermann et al [ 58 ] addressed the neuropsychological outcome of this specific procedure.…”

Comment on the Article by Ledermann et al. Entitled ‘Effects of Cerebellothalamic Tractotomy on Cognitive and Emotional Functioning in Essential Tremor: A Preliminary Study in 5 Essential Tremor Patients'

“…We read the paper of Ledermann et al [1] with interest and congratulate the authors for focussing on neuropsychiatric, cognitive and personality outcomes following surgery to the cerebellothalamic tract. As indicated by Ledermann et al, the cerebellothalamic tract is one of the major ascending fibre bundles running through the posterior subthalamic area (PSA) which is the area below and behind the subthalamic nucleus and lateral to the red nucleus.…”