Journal Article

DZNE-2026-00970

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Functional network reorganization after magnetic resonance-guided focused ultrasound thalamotomy in tremor-dominant Parkinson's disease patients.

Liu, J. ; Purrer, V.DZNE* ; Krauss, J.DZNE* ; Borger, V. ; Essler, M. ; Radbruch, A.DZNE* ; Wüllner, U.DZNE* ; Upadhyay, N.DZNE* ; Boecker, H. (Last author)DZNE*

2026
Elsevier [Amsterdam u.a.]

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Please use a persistent id in citations: doi:10.1016/j.nicl.2026.104058

Abstract: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy alleviates tremor in tremor-dominant Parkinson's disease (TD-PD). However, its effects on the functional network topology remain unclear.Twenty-one TD-PD patients underwent unilateral MRgFUS thalamotomy and clinical and MRI assessments. For the overall cohort, graph theory analysis was employed to examine differences in small-world properties and modular structure between baseline and 6 months after MRgFUS. Changes in topological properties were assessed using paired t-tests or Wilcoxon tests, and their associations with clinical improvement. Additionally, subgroup analyses were performed on responder (n = 10) and relapser (n = 9) data.Tremor scores decreased significantly after MRgFUS contralateral to the lesioned thalamus. Significant increases were observed in small-worldness and normalized clustering coefficient after MRgFUS. Inter-modular connectivity showed trend-level enhancement between cortical-basal ganglia and thalamic modules, and between cerebellar and temporal-hippocampal modules. In responder, significant increases were observed in small-worldness, normalized clustering coefficient, and global efficiency, whereas characteristic path length showed a significant decrease. Changes in global efficiency and characteristic path length were significantly correlated with clinical improvement.MRgFUS thalamotomy for TD-PD induced partial reorganization of small-world properties, indicating a shift toward a more integrated network topology, especially in responder. Changes correlated with tremor reduction and improved functional disability, highlighting that effective treatment impacts on global network integration.

Keyword(s): Brain networks ; Graph theory analysis ; MRgFUS ; Parkinson's disease ; Small-worldness

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Contributing Institute(s):

1. Positron Emissions Tomography (PET) (AG Boecker)
2. Clinical Research Coordination (Clinical Research (Bonn))
3. Clinical Neuroimaging (AG Radbruch)
4. Biomarker Parkinson's Disease (AG Wüllner)
5. Patient Studies (Bonn) (Patient Studies (Bonn))

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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