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Related Experiment Video

Updated: Jul 4, 2025

MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
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Dynamic functional changes upon thalamotomy in essential tremor depend on baseline brain morphometry.

Thomas A W Bolton1,2, Dimitri Van De Ville3,4, Jean Régis5

  • 1Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland. thomas.bolton@epfl.ch.

Scientific Reports
|January 31, 2024
PubMed
Summary
This summary is machine-generated.

Gamma Knife thalamotomy for essential tremor (ET) improves functional connectivity in the brain. Dynamic functional connectivity and brain morphometry predict tremor reduction after stereotactic radiosurgery.

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Area of Science:

  • Neuroscience
  • Radiosurgery
  • Medical Imaging

Background:

  • Essential tremor (ET) is a neurological disorder often treated with Gamma Knife stereotactic radiosurgery targeting the ventro-intermediate nucleus (Vim).
  • Understanding the impact of this intervention on brain function and structure is crucial for optimizing treatment outcomes.

Purpose of the Study:

  • To investigate the effects of Gamma Knife thalamotomy (SRS-T) on dynamic functional connectivity (dFC) and surface-based morphometric features in patients with drug-resistant ET.
  • To explore the relationship between pre-intervention brain characteristics and post-treatment clinical improvement.

Main Methods:

  • Resting-state fMRI was used to analyze dFC in 23 ET patients before and 1 year after SRS-T, comparing them to healthy controls (HCs).
  • Surface-based morphometry was assessed in 34 ET patients.
  • Statistical analyses examined changes in dFC states, morphometric similarity to HCs, and their correlation with clinical tremor reduction.

Main Results:

  • SRS-T increased the spatial stability of a specific dFC state (state 1) in ET patients.
  • Pre-intervention expression of certain dFC states (state 3 over state 1) and lower spatial variability in state 3 predicted greater clinical recovery, with familial ET patients showing less improvement.
  • ET patients exhibited reduced morphometric similarity to HCs in 13 brain regions post-SRS-T, and pre-intervention morphometric similarity was inversely related to functional connectivity similarity, a relationship that normalized after treatment.

Conclusions:

  • Left Vim functional dynamics are directly associated with tremor reduction following SRS-T.
  • Brain morphometry plays a supportive role in modulating these functional dynamics after thalamotomy.
  • These findings highlight the interplay between functional connectivity and brain structure in the therapeutic effects of SRS-T for essential tremor.