Altered Thalamic Connectivity Due to Focused Ultrasound Thalamotomy in Patients with Essential Tremor
Altered Thalamic Connectivity Due to Focused Ultrasound Thalamotomy in Patients with Essential Tremor
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特发性震颤患者因聚焦超声丘脑切除术而改变丘脑连接
DOI：
10.1016/j.wneu.2022.05.113
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发表时间：
2022
影响因子：
2
通讯作者：
Kishima Haruhiko
中科院分区：
文献类型：
--
作者：
Tani Naoki;Oshino Satoru;Hosomi Koichi;Hattori Noriaki;Mihara Masahito;Yanagisawa Takufumi;Khoo Hui Ming;Kanemoto Manabu;Watanabe Yoshiyuki;Mochizuki Hideki;Kishima Haruhiko
背景尽管立体定向消融术可以显著改善不自主运动，但由于脑深部核团的破坏而引起的全脑网络的改变却知之甚少。为了探讨丘脑切开术后全脑网络的变化，我们分析了结构和功能连接的改变，使用静息态功能磁共振成像和扩散张量成像在原发性震颤患者谁经历了聚焦超声（FUS）thalamotomy.MethodsSeven顽固性原发性震颤和7个年龄匹配的健康对照组的患者参加了这项研究。特发性震颤患者的震颤评分进行了评估，并进行静息态功能磁共振成像和扩散张量成像前和3个月后左腹中间核丘脑切开术使用FUS.ResultsThere是一个显着的改善后FUS丘脑切开术的右手震颤。基于种子的功能连接分析显示，FUS丘脑切开术后，左侧丘脑和背侧运动前皮质尾部之间的功能连接显著增加。结构连接性分析未发现FUS前后的统计学显著变化。功能连接和震颤scores.ConclusionsAlthough的数量是小的，我们的研究结果表明，功能连接之间的丘脑和前运动皮层的FUS丘脑切开术改善震颤后增加的变化之间没有相关性。增加的功能连接和临床震颤评分之间缺乏相关性表明，所观察到的功能连接的增加可能是丘脑切开术后发生的继发感觉运动变化的代偿性变化。
BackgroundAlthough stereotactic ablation surgery is known to ameliorate involuntary movement dramatically, little is known regarding alterations in whole-brain networks due to disruption of the deep brain nucleus. To explore changes in the whole-brain network after thalamotomy, we analyzed structural and functional connectivity alterations using resting-state functional magnetic resonance imaging and diffusion tensor imaging in patients with essential tremor who had undergone focused ultrasound (FUS) thalamotomy.MethodsSeven patients with intractable essential tremors and 7 age-matched healthy controls were enrolled in the study. The tremor score in essential tremor patients was assessed, and resting-state functional magnetic resonance imaging and diffusion tensor imaging were performed before and 3 months after left ventral intermediate nucleus thalamotomy using FUS.ResultsThere was a significant improvement in the tremor of the right hand after FUS thalamotomy. Seed-based functional connectivity analysis revealed a significant increase in functional connectivity between the left thalamus and the caudal part of the dorsal premotor cortex after FUS thalamotomy. Structural connectivity analysis did not detect statistically significant changes between before and after FUS. There was no correlation between the changes in functional connectivity and tremor score.ConclusionsAlthough the number of cases is small, our results show that functional connectivity between the thalamus and the premotor cortex increases after the amelioration of tremors by FUS thalamotomy. The lack of correlation between increased functional connectivity and clinical tremor scores suggests that the observed increase in functional connectivity may be a compensatory change in the secondary sensorimotor changes that occur after thalamotomy.