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000280911 0247_ $$2doi$$a10.1016/j.jns.2025.123604
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000280911 1001_ $$0P:(DE-2719)2812558$$aUpadhyay, Neeraj$$b0$$eFirst author$$udzne
000280911 245__ $$aLongitudinal evolution of diffusion metrices within the Cerebello-Thalamo-cortical tract after MRgFUS thalamotomy for essential tremor.
000280911 260__ $$aAmsterdam [u.a.]$$bElsevier Science$$c2025
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000280911 520__ $$aMagnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy in essential tremor (ET) targets ventral intermediate nucleus hub region within cerebello-thalamo-cortical tract (CTCT). Understanding the microstructural changes in CTCT over time and their link to tremor improvement is crucial from a tremor-network perspective. We retrospectively analyzed tremor scores, lesion characteristics, and diffusion MRI-derived CTCT microstructural measures in 27 ET patient's pre-treatment (T0), at 1 month (T2), and 6 months (T3) post-MRgFUS. Using probabilistic tractography, we created an average CTCT mask at T0 for assessing fractional anisotropy (FA), axial (AD), mean (MD), and radial diffusivity (RD) measures across time points. Significant tremor reduction was observed at T2 and T3. The Linear mixed effect analyses showed significant time effects for FA, MD, and AD. Relative to baseline, post-hoc comparisons showed a significant decrease of FA and AD at lesion site only for T2. Instead, there was a significant increase in AD and MD at T3 compared to T2 at lesion site, and remotely near the motor cortex. Lesion size and FA changes in the CTCT at T2 showed only trend-level correlations with tremor outcome. Stronger associations were observed for the thalamic lesion-tract overlap at T2, which were even more robust at T3. Dynamic microstructural changes suggest early axonal disruption at the lesion site and subsequent reorganization, with remote CTCT changes potentially indicating chronic degeneration. Meanwhile, microstructural measures show limited predictive value for tremor outcome at 6 months compared with macroanatomical lesion-CTCT overlap. Yet, advanced diffusion imaging protocol could increase the sensitivity to predict MRgFUS clinical outcome.
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000280911 650_7 $$2Other$$aAxial diffusivity
000280911 650_7 $$2Other$$aCerebello-thalamo-cortical tract
000280911 650_7 $$2Other$$aEssential tremor
000280911 650_7 $$2Other$$aFractional anisotropy
000280911 650_7 $$2Other$$aMRgFUS
000280911 650_7 $$2Other$$aMean diffusivity
000280911 650_7 $$2Other$$aOutcome
000280911 650_2 $$2MeSH$$aHumans
000280911 650_2 $$2MeSH$$aEssential Tremor: surgery
000280911 650_2 $$2MeSH$$aEssential Tremor: diagnostic imaging
000280911 650_2 $$2MeSH$$aMale
000280911 650_2 $$2MeSH$$aThalamus: surgery
000280911 650_2 $$2MeSH$$aThalamus: diagnostic imaging
000280911 650_2 $$2MeSH$$aFemale
000280911 650_2 $$2MeSH$$aAged
000280911 650_2 $$2MeSH$$aMiddle Aged
000280911 650_2 $$2MeSH$$aRetrospective Studies
000280911 650_2 $$2MeSH$$aDiffusion Tensor Imaging
000280911 650_2 $$2MeSH$$aCerebellum: diagnostic imaging
000280911 650_2 $$2MeSH$$aCerebellum: surgery
000280911 650_2 $$2MeSH$$aCerebral Cortex: diagnostic imaging
000280911 650_2 $$2MeSH$$aCerebral Cortex: surgery
000280911 650_2 $$2MeSH$$aLongitudinal Studies
000280911 650_2 $$2MeSH$$aNeural Pathways: diagnostic imaging
000280911 650_2 $$2MeSH$$aNeural Pathways: surgery
000280911 650_2 $$2MeSH$$aDiffusion Magnetic Resonance Imaging
000280911 7001_ $$0P:(DE-2719)2811028$$aDaamen, Marcel$$b1$$udzne
000280911 7001_ $$0P:(DE-2719)9000867$$aPurrer, Veronika$$b2$$udzne
000280911 7001_ $$0P:(DE-HGF)0$$aBorger, Valeri$$b3
000280911 7001_ $$0P:(DE-2719)9001551$$aSchmeel, Carsten$$b4
000280911 7001_ $$0P:(DE-HGF)0$$aKrauss, Jonas$$b5
000280911 7001_ $$0P:(DE-HGF)0$$aMaurer, Angelika$$b6
000280911 7001_ $$0P:(DE-2719)9001861$$aRadbruch, Alexander$$b7$$udzne
000280911 7001_ $$0P:(DE-2719)2000056$$aWüllner, Ullrich$$b8$$udzne
000280911 7001_ $$0P:(DE-2719)2810726$$aBoecker, Henning$$b9$$eLast author$$udzne
000280911 773__ $$0PERI:(DE-600)1500645-1$$a10.1016/j.jns.2025.123604$$gVol. 476, p. 123604 -$$p123604$$tJournal of the neurological sciences$$v476$$x0022-510X$$y2025
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