Longitudinal brain functional connectivity changes induced by neurosurgical thalamotomy for tremor in Parkinson's disease: a preliminary study.

Autor: Albano L; Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy.; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy., Basaia S; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy., Emedoli D; Department of Rehabilitation and Functional Recovery, IRCCS Ospedale San Raffaele, Milan, Italy., Balestrino R; Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy.; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.; Neurology Unit, IRCCS Ospedale San Raffaele, Milan, Italy., Pompeo E; Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy.; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy., Barzaghi LR; Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy., Castellano A; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.; Neuroradiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy., Falini A; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.; Neuroradiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy., Iannaccone S; Department of Rehabilitation and Functional Recovery, IRCCS Ospedale San Raffaele, Milan, Italy., Mortini P; Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy.; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy., Filippi M; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.; Neurology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.; Neurorehabilitation Unit, IRCCS Ospedale San Raffaele, Milan, Italy.; Neurophysiology Service, IRCCS Ospedale San Raffaele, Milan, Italy., Agosta F; Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy. agosta.federica@hsr.it.; Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy. agosta.federica@hsr.it.; Neurology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. agosta.federica@hsr.it.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2023 Jul; Vol. 270 (7), pp. 3623-3629. Date of Electronic Publication: 2023 Apr 15.
DOI: 10.1007/s00415-023-11705-2
Abstrakt: The hypothesis that the effectiveness of neurosurgical procedures in Parkinson's disease (PD) would be related to connectivity dysfunctions between the site of the stimulation and other brain regions is growing. This study aimed to assess resting-state functional connectivity between thalamic ventral intermediate nucleus (Vim) and the rest of the brain before and after thalamotomy in PD. A 76-year-old right-handed woman with refractory tremor-dominant PD was selected as a candidate for left Vim radiosurgery thalamotomy. Clinical and motion sensor evaluation and brain resting-state functional MRI (rs-fMRI) were carried out before treatment and 3, 6, and 12 months later. Targeted Vim was selected as region of interest and a seed-based rs-fMRI analysis was performed in the patient and ten age- and sex-matched controls at baseline and over time. Furthermore, a correlation analysis between functional connectivity and tremor data was carried out. Both clinical and motion sensor measurements showed a progressive tremor improvement over time on right side after radiosurgery. In the patient, seed-based analysis showed a significantly increased functional connectivity between targeted Vim and ipsilateral visual areas relative to controls before treatment. Over 1 year, a normalization of aberrant pre-therapeutic functional connectivity between Vim and visual areas was obtained. At correlation analysis, the reduction of tremor metrics over time, assessed by clinical evaluation and wearable motion sensors, was related to the reduction of the left Vim-left visual cortex functional connectivity. Our findings support the evidence that fMRI was able to detect targeted Vim connectivity and its changes over time after thalamotomy.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE