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

Abstract

ABBREVIATIONS AC = anterior commissure; ADL = activities of daily living; BOLD = blood oxygenation level-dependent; DBS = deep brain stimulation; DMN = defaultmode network; DTI = diffusion tensor imaging; ET = essential tremor; FEW = family-wise error; IC = interconnectivity; ICA = independent component analysis; MNI = Montreal Neurological Institute; PC = posterior commissure; rs-fMRI = resting-state functional MRI; SMA = supplementary motor area; SRS = stereotactic radiosurgery; SRS-T = SRS thalamotomy; TSTH = tremor score on the treated hand; Vim = ventral intermediate nucleus.OBJECTIVE Essential 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. METHODS Seventeen 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. RESULTS Using 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) (p FWE = 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 (p FWE = 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, p FWE = 0.004, cluster size = 73), inter...

Partial‐volume modeling reveals reduced gray matter in specific thalamic nuclei early in the time course of psychosis and chronic schizophrenia

“…Finally, such assessment of GM integrity for the thalamus and its sub‐divisions can also be relevant for other psychiatric disorders and beyond, as there is an increasing interest in the study of the thalamus in other neurological pathologies such as frontotemporal dementia, multiple sclerosis, and Parkinson's disease (Bisecco et al, 2019; Bocchetta et al, 2018; Tuleasca et al, 2018).…”

Gama peilio talamotomija esencialiniam ir Parkinsono tremorui gydyti

“…Rea sons for this are poorly es ti mated VIM stereotactic coor di nates and, there fore, a wrongly planned shot, fail ure to tar get VIM due to im ag ing and stereotactic frame er rors, and phys i o log i cal re sis tance to Gamma-rays. 2-8% of patients ex pe ri ence an in suf fi cient or hy per-re sponse to gamma knife treat ment [5]. One 77-year-old fe male patient in cluded in our study ex pe ri enced no ef fect af ter thalamotomy.…”

“…Sec ondly, DBS implan ta tion re quires fre quent fol low-up vis its, pa ram e ter op ti mi sa tion, and re place ment of stimulator bat tery. Also, kin es thetic thalamic cells are sup pressed within 50% isodose vol ume even though apoptosis is not ob served; this may re sult in a safe and long-term antitremor ef fect [5]. Al though there is suf fi cient ev i dence that gamma knife thalamotomy is a safe and ef fec tive treat ment method for re duc ing tremor in med i ca tion-re sis tant PD and ET, there are doubts con cern ing the choice of treat ment method.…”

Altered brain connectivity in hyperkinetic movement disorders: A review of resting-state fMRI

“…The 51 included articles on tremor concerned tremor-dominant Parkinson’s disease (TDPD; n = 28), essential tremor (ET; n = 21), orthostatic tremor (n = 2), and primary writing tremor (n = 1). ( Bagarinao et al, 2022 , Basaia et al, 2022 , Benito-Leon et al, 2015 , Benito-Leon et al, 2016 , Benito-Leon et al, 2019 , Chen et al, 2015 , Chen et al, 2019 , Dirkx et al, 2017 , Dirkx et al, 2019 , Duan et al, 2021 , Fang et al, 2013 , Fang et al, 2015 , Fang et al, 2016 , Gallea et al, 2015 , Gallea et al, 2016 , Gu et al, 2017 , Helmich et al, 2011 , Hou et al, 2018 , Hu et al, 2015 , Hu et al, 2017 , Hu et al, 2019 , Jiang et al, 2016 , Karunanayaka et al, 2016 , Kato et al, 2022 , Lenka et al, 2017 , Lenka et al, 2017 , Li et al, 2018 , Li et al, 2020 , Li et al, 2021 , Li et al, 2021 , Ma et al, 2015 , Ma et al, 2017 , Mueller et al, 2017 , Nicoletti et al, 2020 , Nigro et al, 2019 , Popa et al, 2013 , Quarantelli et al, 2022 , Tikoo et al, 2020 , Tuleasca et al, 2018 , Tuleasca et al, 2020 , Vervoort et al, 2016 , Wang et al, 2016 , Wang et al, 2018 , Wang et al, 2021 , Wen et al, 2016 , Yin et al, 2016 , Zhang et al, 2015 , Zhang et al, 2015 , Zhang et al, 2015 , Zhang et al, 2016 , Zhu et al, 2021 ) The number of patients per study ranged from 10 to 99.…”