Pretherapeutic Motor Thalamus Resting-State Functional Connectivity with Visual Areas Predicts Tremor Arrest After Thalamotomy for Essential Tremor: Tracing the Cerebello-thalamo-visuo-motor Network

Constantin Tuleasca; Elena Najdenovska; Jean Régis; Tatiana Witjas; Nadine Girard; Jérôme Champoudry; Mohamed Faouzi; Jean-Philippe Thiran; Meritxell Bach Cuadra; Marc Levivier; Dimitri Van De Ville

doi:10.1016/j.wneu.2018.06.049

Pretherapeutic Motor Thalamus Resting-State Functional Connectivity with Visual Areas Predicts Tremor Arrest After Thalamotomy for Essential Tremor: Tracing the Cerebello-thalamo-visuo-motor Network

World Neurosurg. 2018 Sep:117:e438-e449. doi: 10.1016/j.wneu.2018.06.049. Epub 2018 Jun 18.

Affiliations

¹ Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Medical Image Analysis Laboratory (MIAL) and Department of Radiology-Center of Biomedical Imaging (CIBM), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland. Electronic address: constantin.tuleasca@gmail.com.
² Medical Image Analysis Laboratory (MIAL) and Department of Radiology-Center of Biomedical Imaging (CIBM), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
³ Stereotactic and Functional Neurosurgery Service and Gamma Knife Unit, CHU Timone, Marseille, France.
⁴ Neurology Department, CHU Timone, Marseille, France.
⁵ AMU, CRMBM UMR CNRS 7339, Department of Diagnostic and Interventional Neuroradiology, Faculté de Médecine and APHM, Hôpital Timone, Marseille, France.
⁶ Centre for Clinical Epidemiology, Institute of Social and Preventive Medicine, Lausanne, Switzerland.
⁷ Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland; Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
⁸ Medical Image Analysis Laboratory (MIAL) and Department of Radiology-Center of Biomedical Imaging (CIBM), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
⁹ Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland.
¹⁰ Faculty of Medicine, University of Geneva, Geneva, Switzerland; Medical Image Processing Laboratory, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.

PMID: 29920392
DOI: 10.1016/j.wneu.2018.06.049

Abstract

Background: Essential tremor (ET) is a common movement disorder. Resting-state functional magnetic resonance imaging is a noninvasive neuroimaging method acquired in absence of task.

Objective: Our study aimed to correlate pretherapeutic ventrolateral thalamus functional connectivity (FC) with clinical results 1 year after stereotactic radiosurgical thalamotomy (SRS-T) for drug-resistant ET. Data from 12 healthy control individuals were additionally included.

Methods: Resting state was acquired for 17 consecutive (right-handed) patients, before and 1 year after left unilateral SRS-T. Standard tremor scores were evaluated pretherapeutically and 1 year after SRS-T. Tremor network was investigated using region of interest, left ventrolateral ventral (VLV) cluster, obtained from pretherapeutic diffusion magnetic resonance imaging. Seed-based FC was obtained as correlations between the time courses of the VLV and that of every other voxel. The seed-connectivity maps were obtained pretherapeutically and correlated across all patients with clinical outcome 1 year after SRS-T. One-year magnetic resonance signature volume was always located inside VLV and did not correlate with reported seed-FC measures (P > 0.05).

Results: We report statistically significant correlations between pretherapeutic VLV FC with clinical outcome for 1) right visual association area (Brodmann area, BA19) predicting 1 year activities of daily living decrease (P_unc = 0.02); 2) left fusiform gyrus (BA37) predicting 1 year head tremor score improvement (P_unc = 0.04); and 3) posterior cingulate (left BA23, P_uncor = 0.009), lateral temporal cortex (right BA21, P_unc = 0.02) predicting time to tremor arrest.

Conclusions: Our results suggest that pretherapeutic resting-state seed-FC of left VLV predicts tremor arrest after SRS-T for ET. Visual areas are identified as the main regions in this correlation.

Keywords: Essential tremor; Radiosurgery; Resting-state; Seed-based approach; Thalamotomy; Ventrointermediate nucleus; fMRI.

MeSH terms

Activities of Daily Living
Aged
Aged, 80 and over
Cerebellum / physiology
Essential Tremor / radiotherapy*
Female
Humans
Magnetic Resonance Imaging / methods
Male
Middle Aged
Motor Cortex / physiology
Neuroimaging / methods
Postoperative Care
Preoperative Care
Radiosurgery / methods
Treatment Outcome
Ventral Thalamic Nuclei / physiopathology*
Ventral Thalamic Nuclei / surgery
Visual Cortex / physiology