Department of Radiology, Chinese PLA General Hospital/Medical School of Chinese PLA, No.28 Fuxing Road, Beijing, 100853, China; Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 710038, China.
School of Artificial Intelligence, University of Chinese Academy of Sciences, No.19A Yuquan Road, Beijing, 100876, China.
Neuroimage Clin. 2024;42:103605. doi: 10.1016/j.nicl.2024.103605. Epub 2024 Apr 15.
MR-guided focused ultrasound (MRgFUS) thalamotomy is a novel and effective treatment for medication-refractory tremor in essential tremor (ET), but how the brain responds to this deliberate lesion is not clear.
The current study aimed to evaluate the immediate and longitudinal alterations of functional networks after MRgFUS thalamotomy.
We retrospectively obtained preoperative and postoperative 30-day, 90-day, and 180-day data of 31 ET patients subjected with MRgFUS thalamotomy from 2018 to 2020. Their archived resting-state functional MRI data were used for functional network comparison as well as graph-theory metrics analysis. Both partial least squares (PLS) regression and linear regression were conducted to associate functional features to tremor symptoms.
MRgFUS thalamotomy dramatically abolished tremors, while global functional network only sustained immediate fluctuation within one week after the surgery. Network-based statistics have identified a long-term enhanced corticostriatal subnetwork by comparison between 180-day and preoperative data (P = 0.019). Within this subnetwork, network degree, global efficiency and transitivity were significantly recovered in ET patients right after MRgFUS thalamotomy compared to the pre-operative timepoint (P < 0.05), as well as hemisphere lateralization (P < 0.001). The PLS main component significantly accounted for 33.68 % and 34.16 % of the total variances of hand tremor score and clinical rating scale for tremor (CRST)-total score (P = 0.037 and 0.027). Network transitivity of this subnetwork could serve as a reliable biomarker for hand tremor score control prediction at 180-day after the surgery (β = 2.94, P = 0.03).
MRgFUS thalamotomy promoted corticostriatal connectivity activation correlated with tremor improvement in ET patient after MRgFUS thalamotomy.
MR 引导聚焦超声（MRgFUS）丘脑切开术是治疗原发性震颤（ET）药物难治性震颤的一种新的有效方法，但大脑对这种蓄意损伤的反应尚不清楚。
本研究旨在评估 MRgFUS 丘脑切开术后功能网络的即刻和纵向变化。
我们回顾性地获得了 2018 年至 2020 年间 31 例 ET 患者接受 MRgFUS 丘脑切开术的术前和术后 30 天、90 天和 180 天的数据。他们的存档静息态功能磁共振成像数据用于功能网络比较和图论度量分析。我们进行了偏最小二乘（PLS）回归和线性回归，将功能特征与震颤症状相关联。
MRgFUS 丘脑切开术显著消除了震颤，而全局功能网络仅在手术后一周内保持了即刻波动。与术前数据相比，基于网络的统计学方法发现，术后 180 天与术前相比，皮质纹状体子网长期增强（P=0.019）。在这个子网中，与术前相比，ET 患者在接受 MRgFUS 丘脑切开术后，网络度、全局效率和传递性显著恢复（P<0.05），以及半球侧化（P<0.001）。PLS 主成分显著解释了手部震颤评分和震颤临床评定量表（CRST）总评分总方差的 33.68%和 34.16%（P=0.037 和 0.027）。该子网的网络传递性可作为术后 180 天手部震颤评分控制预测的可靠生物标志物（β=2.94，P=0.03）。
MRgFUS 丘脑切开术促进了 ET 患者接受 MRgFUS 丘脑切开术后皮质纹状体连接的激活，与震颤改善相关。
