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Characterizing Thalamo-Cortical Structural Connectivity in Essential Tremor with Diffusional Kurtosis Imaging
Gonzalo Revuelta1, Corinne McGill2, Jens H Jensen2
1Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Tremor and Other Hyperkinetic Movements (New York, N.Y.)
|September 20, 2019
Summary
Essential tremor (ET) patients show increased cerebello-thalamo-cortical connectivity, particularly in the Vim-SMA pathway. This enhanced Vim-SMA connectivity correlates with tremor severity, suggesting it as a therapeutic target for ET.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Thalamic stimulation is effective for essential tremor (ET) but requires understanding thalamo-cortical connections.
- Developing non-invasive neuromodulation for ET necessitates detailed mapping of these circuits.
Purpose of the Study:
- To investigate cerebello-thalamo-cortical (CTC) circuit connectivity in ET patients using diffusion kurtosis imaging (DKI).
- To elucidate specific thalamo-cortical pathways relevant to ET pathophysiology and tremor severity.
Main Methods:
- Twenty-eight subjects (18 ET patients, 10 controls) underwent DKI MRI.
- Fiber tracking initiated from the ventral intermediate nucleus (Vim) to motor cortical regions (M1, SMA, pre-SMA).
- Statistical comparisons and correlation analyses with tremor severity were performed, with Bonferroni correction for multiple comparisons.
Main Results:
- ET patients exhibited decreased mean diffusivity (MD) across Vim-M1, Vim-SMA, and Vim-pre-SMA tracts compared to controls.
- A significant positive correlation was found between tremor severity and both mean kurtosis (MK) and mean fractional anisotropy (FA) in the Vim-SMA tract.
Conclusions:
- Patients with ET show reinforced Vim-cortical connectivity, particularly in the Vim-SMA pathway.
- The Vim-SMA connection is implicated in ET pathophysiology, suggesting SMA inhibition as a potential therapeutic strategy.
