Home > Publications Database > Longitudinal evolution of diffusion metrices within the Cerebello-Thalamo-cortical tract after MRgFUS thalamotomy for essential tremor. > print

001     280911
005     20250905102149.0
024 7 _ |a 10.1016/j.jns.2025.123604
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037 _ _ |a DZNE-2025-00994
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Upadhyay, Neeraj
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245 _ _ |a Longitudinal evolution of diffusion metrices within the Cerebello-Thalamo-cortical tract after MRgFUS thalamotomy for essential tremor.
260 _ _ |a Amsterdam [u.a.]
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520 _ _ |a 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.
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650 _ 7 |a Axial diffusivity
|2 Other
650 _ 7 |a Cerebello-thalamo-cortical tract
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650 _ 7 |a Essential tremor
|2 Other
650 _ 7 |a Fractional anisotropy
|2 Other
650 _ 7 |a MRgFUS
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650 _ 7 |a Mean diffusivity
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650 _ 7 |a Outcome
|2 Other
650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Essential Tremor: surgery
|2 MeSH
650 _ 2 |a Essential Tremor: diagnostic imaging
|2 MeSH
650 _ 2 |a Male
|2 MeSH
650 _ 2 |a Thalamus: surgery
|2 MeSH
650 _ 2 |a Thalamus: diagnostic imaging
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Aged
|2 MeSH
650 _ 2 |a Middle Aged
|2 MeSH
650 _ 2 |a Retrospective Studies
|2 MeSH
650 _ 2 |a Diffusion Tensor Imaging
|2 MeSH
650 _ 2 |a Cerebellum: diagnostic imaging
|2 MeSH
650 _ 2 |a Cerebellum: surgery
|2 MeSH
650 _ 2 |a Cerebral Cortex: diagnostic imaging
|2 MeSH
650 _ 2 |a Cerebral Cortex: surgery
|2 MeSH
650 _ 2 |a Longitudinal Studies
|2 MeSH
650 _ 2 |a Neural Pathways: diagnostic imaging
|2 MeSH
650 _ 2 |a Neural Pathways: surgery
|2 MeSH
650 _ 2 |a Diffusion Magnetic Resonance Imaging
|2 MeSH
700 1 _ |a Daamen, Marcel
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700 1 _ |a Purrer, Veronika
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700 1 _ |a Borger, Valeri
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700 1 _ |a Schmeel, Carsten
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700 1 _ |a Krauss, Jonas
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700 1 _ |a Maurer, Angelika
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700 1 _ |a Radbruch, Alexander
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700 1 _ |a Wüllner, Ullrich
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700 1 _ |a Boecker, Henning
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773 _ _ |a 10.1016/j.jns.2025.123604
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910 1 _ |a Deutsches Zentrum für Neurodegenerative Erkrankungen
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