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@ARTICLE{Krauss:276825,
author = {Krauss, Jonas and Upadhyay, Neeraj and Purrer, Veronika and
Borger, Valeri and Daamen, Marcel and Schmitt, Angelika and
Schmeel, Carsten and Radbruch, Alexander and Wüllner,
Ullrich and Boecker, Henning},
title = {{B}eyond the cerebello-thalamo-cortical tract: {R}emote
structural changes after {VIM}-{MR}g{FUS} in essential
tremor.},
journal = {Parkinsonism $\&$ related disorders},
volume = {132},
issn = {1353-8020},
address = {Amsterdam [u.a.]},
publisher = {Elsevier Science},
reportid = {DZNE-2025-00338},
pages = {107318},
year = {2025},
abstract = {Essential tremor (ET) is a progressive disorder
characterized by altered network connectivity between the
cerebellum, thalamus, and cortical regions. Magnetic
Resonance-guided Focused Ultrasound (MRgFUS) of the ventral
intermediate nucleus (VIM) is an effective, minimally
invasive treatment for ET. The impact of MRgFUS
interventions on regional Gray Matter Volume (GMV) are as
yet not well understood.Forty-six patients with
medication-resistant ET underwent unilateral VIM-MRgFUS.
Voxel-based morphometry was applied to investigate GMV
changes over a time span of 6 months in the whole brain and
the thalamus in particular to investigate local and distant
effects.Clinically, contralateral tremor significantly
decreased by 68 $\%$ at 6 months following MRgFUS. In
addition to local GMV decreases in thalamic nuclei (VIM,
ventral lateral posterior, centromedian thalamus and
pulvinar), VBM revealed remote GMV decreases in the
ipsilesional insula and the anterior cingulate cortex as
well as the contralesional middle occipital gyrus. Increased
GMV was found in the right superior and middle temporal
gyrus, as well as in the left inferior temporal gyrus. There
was no significant correlation between regional GMV declines
and tremor improvement. However, temporal volume increases
were associated with improved motor-related functional
abilities and quality of life outcomes.Our findings
implicate distributed structural changes following
unilateral VIM-MRgFUS. Structural losses could reflect
Wallerian degeneration of VIM output neurons or plasticity
due to decreased sensory input following tremor
improvement.},
keywords = {Humans / Essential Tremor: therapy / Essential Tremor:
diagnostic imaging / Essential Tremor: pathology / Female /
Male / Aged / Ventral Thalamic Nuclei: diagnostic imaging /
Middle Aged / Magnetic Resonance Imaging / Cerebral Cortex:
diagnostic imaging / Cerebral Cortex: pathology / Gray
Matter: diagnostic imaging / Gray Matter: pathology / Neural
Pathways: diagnostic imaging / Neural Pathways: pathology /
Cerebellum: diagnostic imaging / Cerebellum: pathology /
High-Intensity Focused Ultrasound Ablation: methods /
Thalamus: diagnostic imaging / Thalamus: pathology /
Essential tremor (Other) / MRgFUS (Other) / Structural
changes (Other) / VBM (Other) / VIM (Other)},
cin = {AG Boecker / Clinical Research (Bonn) / AG Radbruch / AG
Wüllner},
ddc = {610},
cid = {I:(DE-2719)1011202 / I:(DE-2719)1011001 /
I:(DE-2719)5000075 / I:(DE-2719)1011302},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39913957},
doi = {10.1016/j.parkreldis.2025.107318},
url = {https://pub.dzne.de/record/276825},
}