% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Upadhyay:280911,
      author       = {Upadhyay, Neeraj and Daamen, Marcel and Purrer, Veronika
                      and Borger, Valeri and Schmeel, Carsten and Krauss, Jonas
                      and Maurer, Angelika and Radbruch, Alexander and Wüllner,
                      Ullrich and Boecker, Henning},
      title        = {{L}ongitudinal evolution of diffusion metrices within the
                      {C}erebello-{T}halamo-cortical tract after {MR}g{FUS}
                      thalamotomy for essential tremor.},
      journal      = {Journal of the neurological sciences},
      volume       = {476},
      issn         = {0022-510X},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DZNE-2025-00994},
      pages        = {123604},
      year         = {2025},
      abstract     = {Magnetic 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.},
      keywords     = {Humans / Essential Tremor: surgery / Essential Tremor:
                      diagnostic imaging / Male / Thalamus: surgery / Thalamus:
                      diagnostic imaging / Female / Aged / Middle Aged /
                      Retrospective Studies / Diffusion Tensor Imaging /
                      Cerebellum: diagnostic imaging / Cerebellum: surgery /
                      Cerebral Cortex: diagnostic imaging / Cerebral Cortex:
                      surgery / Longitudinal Studies / Neural Pathways: diagnostic
                      imaging / Neural Pathways: surgery / Diffusion Magnetic
                      Resonance Imaging / Axial diffusivity (Other) /
                      Cerebello-thalamo-cortical tract (Other) / Essential tremor
                      (Other) / Fractional anisotropy (Other) / MRgFUS (Other) /
                      Mean diffusivity (Other) / Outcome (Other)},
      cin          = {AG Boecker / Patient Studies (Bonn) / Clinical Research
                      (Bonn) / AG Radbruch},
      ddc          = {610},
      cid          = {I:(DE-2719)1011202 / I:(DE-2719)1011101 /
                      I:(DE-2719)1011001 / I:(DE-2719)5000075},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40651055},
      doi          = {10.1016/j.jns.2025.123604},
      url          = {https://pub.dzne.de/record/280911},
}