Pretherapeutic Motor Thalamus Resting-State Functional Connectivity with Visual Areas Predicts Tremor Arrest After Thalamotomy for Essential Tremor: Tracing the Cerebello-thalamo-visuo-motor Network
Résumé
BACKGROUND: Essential tremor (ET) is a common movement disorder. Resting-state functional magnetic resonance imaging is a noninvasive neuroimaging method acquired in absence of task. OBJECTIVE: Our study aimed to correlate pretherapeutic ventrolateral thalamus functional connectivity (FC) with clinical results 1 year after stereotactic radiosurgical thalamotomy (SRS-T) for drug-resistant ET. Data from 12 healthy control individuals were additionally included. METHODS: Resting state was acquired for 17 consecutive (right-handed) patients, before and 1 year after left unilateral SRS-T. Standard tremor scores were evaluated pretherapeutically and 1 year after SRS-T. Tremor network was investigated using region of interest, left ventrolateral ventral (VLV) cluster, obtained from pretherapeutic diffusion magnetic resonance imaging. Seed-based FC was obtained as correlations between the time courses of the VLV and that of every other voxel. The seed-connectivity maps were obtained pretherapeutically and correlated across all patients with clinical outcome 1 year after SRS-T. One-year magnetic resonance signature volume was always located inside VLV and did not correlate with reported seed-FC measures (P > 0.05). RESULTS: We report statistically significant correlations between pretherapeutic VLV FC with clinical outcome for 1) right visual association area (Brodmann area, BA19) predicting 1 year activities of daily living decrease (Punc~= 0.02); 2) left fusiform gyrus (BA37) predicting 1 year head tremor score improvement (Punc~= 0.04); and 3) posterior cingulate (left BA23, Puncor~= 0.009), lateral temporal cortex (right BA21, Punc~= 0.02) predicting time to tremor arrest. CONCLUSIONS: Our results suggest that pretherapeutic resting-state seed-FC of left VLV predicts tremor arrest after SRS-T for ET. Visual areas are identified as the main regions in this correlation.
Mots clés
essential tremor
Essential tremor
Essential Tremor
Female
fMRI
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Motor Cortex
Neuroimaging
Postoperative Care
Preoperative Care
radiosurgery
Radiosurgery
resting-state
Resting-state
seed-based approach
Seed-based approach
snc
thalamotomy
Thalamotomy
Treatment Outcome
Ventral Thalamic Nuclei
ventro-intermediate nucleus
Ventrointermediate nucleus
Visual Cortex
Activities of Daily Living
Aged
80 and over
Cerebellum
clin