Correlation of visual area with tremor improvement after MRgFUS thalamotomy in Parkinson’s disease

Xiong, Yongqin; Han, Dongshan; He, Jianfeng; Zong, Rui; Bian, Xiaowei; Duan, Caohui; Zhang, Dekang; Zhou, Xin; Pan, Longsheng; Lou, Xin

doi:10.3171/2021.3.jns204329

Cited by 23 publications

(32 citation statements)

References 45 publications

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“…These FC changes were correlated with clinical improvement of tremor. In line with Xiong et al ( 42 ) we observed the involvement of the second-order, functionally highly-specialized, visual area in the pathogenesis of tremor in PD. Also, such contribution was already evidenced in ET ( 37 , 40 , 41 , 89 ).…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

“…There is only one report investigating the impact of MRgFUS Vim thalamotomy on the neuronal activity in a whole-brain level ( 42 ). In particular, the authors measured fractional amplitude of low-frequency fluctuations (fALFF) on nine medication-refractory of patients with TD-PD, finding significant changes in visual areas at 12 months after the treatment compared to baseline ( 42 ). On a different note, in our study, we assessed the effect on the brain FC of unilateral MRgFUS thalamotomy according to the commonly accepted pathogenic structure functional hypothesis of tremor, which is based on the cerebello-thalamo-cortical circuitries converging on the Vim.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, there are only a few studies describing functional correlates of Vim ablation, and the potential mechanisms of connectivity reorganization over time after lesional procedures on Vim (mainly based on stereotactic radiosurgical thalamotomy) are yet to be recognized. To date, the literature on PD only includes at most 10 patients (34)(35)(36)(37)(38)(39)(40)(41)(42).…”

Section: Introductionmentioning

confidence: 99%

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Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study

et al. 2022

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Magnetic Resonance-guided high-intensity Focused Ultrasound (MRgFUS) of the thalamic ventral intermediate nucleus (Vim) for tremor has increasingly gained interest as a new non-invasive alternative to standard neurosurgery. Resting state functional connectivity (rs-FC) correlates of MRgFUS have not been extensively investigated yet. A region of interest (ROI)-to-ROI rs-FC MRI “connectomic” analysis focusing on brain regions relevant for tremor was conducted on 15 tremor-dominant patients with Parkinson's disease who underwent MRgFUS. We tested whether rs-FC between tremor-related areas was modulated by MRgFUS at 1 and 3 months post-operatively, and whether such changes correlated with individual clinical outcomes assessed by the MDS-UPDRS-III sub items for tremor. Significant increase in FC was detected within bilateral primary motor (M1) cortices, as well as between bilateral M1 and crossed primary somatosensory cortices, and also between pallidum and the dentate nucleus of the untreated hemisphere. Correlation between disease duration and FC increase at 3 months was found between the putamen of both cerebral hemispheres and the Lobe VI of both cerebellar hemispheres, as well as between the Lobe VI of untreated cerebellar hemisphere with bilateral supplementary motor area (SMA). Drop-points value of MDS-UPDRS at 3 months correlated with post-treatment decrease in FC, between the anterior cingulate cortex and bilateral SMA, as well as between the Lobe VI of treated cerebellar hemisphere and the interpositus nucleus of untreated cerebellum. Tremor improvement at 3 months, expressed as percentage of intra-subject MDS-UPDRS changes, correlated with FC decrease between bilateral occipital fusiform gyrus and crossed Lobe VI and Vermis VI. Good responders (≥50% of baseline tremor improvement) showed reduced FC between bilateral SMA, between the interpositus nucleus of untreated cerebellum and the Lobe VI of treated cerebellum, as well as between the untreated SMA and the contralateral putamen. Good responders were characterized at baseline by crossed hypoconnectivity between bilateral putamen and M1, as well as between the putamen of the treated hemisphere and the contralateral SMA. We conclude that MRgFUS can effectively modulate brain FC within the tremor network. Such changes are associated with clinical outcome. The shifting mode of integration among the constituents of this network is, therefore, susceptible to external redirection despite the chronic nature of PD.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study

et al. 2022

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“…The trajectory of some of these changes not only corresponds to increasing motor deficits, in line with dopaminergic neuron loss ( 2 ), but also non-axial symptoms ( 5 ) that highlights their heterogeneous nature. Interestingly, a recent study found that therapy-resistant patients with PD who underwent thalamotomy exhibit changes of low-frequency fluctuations in the primary visual cortex that correspond to improving hand tremor symptoms ( 6 ). In addition, patients with PD who report visual hallucinations were shown to have abnormal activation patterns in the occipital and temporal extrastriate cortices ( 7 ), where structural changes also manifest ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Modulation of cortical resting state functional connectivity during a visuospatial attention task in Parkinson's disease

et al. 2022

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Visual dysfunction is a recognized early symptom of Parkinson's disease (PD) that partly scales motor symptoms, yet its background is heterogeneous. With additional deficits in visuospatial attention, the two systems are hard to disentangle and it is not known whether impaired functional connectivity in the visual cortex is translative in nature or disrupted attentional modulation also contributes. In this study, we investigate functional connectivity modulation during a visuospatial attention task in patients with PD. In total, 15 PD and 16 age-matched healthy controls performed a visuospatial attention task while undergoing fMRI, in addition to a resting-state fMRI scan. Tensorial independent component analysis was used to investigate task-related network activity patterns. Independently, an atlas-based connectivity modulation analysis was performed using the task potency method. Spearman's rank correlation was calculated between task-related network expression, connectivity modulation, and clinical characteristics. Task-related networks including mostly visual, parietal, and prefrontal cortices were expressed to a significantly lesser degree in patients with PD (p < 0.027). Resting-state functional connectivity did not differ between the healthy and diseased cohorts. Connectivity between the precuneus and ventromedial prefrontal cortex was modulated to a higher degree in patients with PD (p < 0.004), while connections between the posterior parietal cortex and primary visual cortex, and also the superior frontal gyrus and opercular cortex were modulated to a lesser degree (p < 0.001 and p < 0.011). Task-related network expression and superior frontal gyrus–opercular cortex connectivity modulation were significantly associated with UPDRSIII motor scores and the Hoehn–Yahr stages (R = −0.72, p < 0.006 and R = −0.90, p < 0.001; R = −0.68, p < 0.01 and R = −0.71, p < 0.007). Task-related networks function differently in patients with PD in association with motor symptoms, whereas impaired modulation of visual and default-mode network connectivity was not correlated with motor function.

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Regional white matter hyperintensity volume in Parkinson's disease and associations with the motor signs

Hong

et al. 2023

Ann Clin Transl Neurol

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ObjectiveTo determine whether white matter hyperintensity (WMH) volumes in specific regions are associated with Parkinson's disease (PD) compared to non‐PD controls, and to assess their impact on motor signs through cross‐sectional and longitudinal analyses.MethodsA total of 50 PD participants and 47 age‐ and gender‐matched controls were enrolled. All PD participants were followed up for at least 2 years. To detect regions of greater WMH in the PD, the WMH volume of each region was compared with the corresponding region in the control group. Linear regression and linear mixed effects models were respectively used for cross‐sectional and longitudinal analyses of the impact of increases in WMH volume on motor signs.ResultsThe PD group had greater WMH volume in the occipital region compared with the control group. Cross‐sectional analyses only detected a significant correlation between occipital WMH volume and motor function in PD. Occipital WMH volume positively correlated with the severity of tremor, and gait and posture impairments, in the PD group. During the follow‐up period, the participants' motor signs progressed and the WMH volumes remained stable, no longitudinal association was detected between them. The baseline occipital WMH volume cannot predict the progression of signs after adjustment for baseline disease duration and the presence of vascular risk factors.InterpretationPD participants in this study were characterized by greater WMH at the occipital region, and greater occipital WMH volume had cross‐sectional associations with worse motor signs, while its longitudinal impact on motor signs progression was limited.

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Correlation of visual area with tremor improvement after MRgFUS thalamotomy in Parkinson’s disease

Cited by 23 publications

References 45 publications

Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study

Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study

Modulation of cortical resting state functional connectivity during a visuospatial attention task in Parkinson's disease

Regional white matter hyperintensity volume in Parkinson's disease and associations with the motor signs

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