PDF(Pubmed)
Abstract：
Essential tremor (ET) is the most common movement disorder. Its pathophysiology is only partially understood. Here, we leveraged graph theoretical analysis on structural covariance patterns quantified from morphometric estimates for cortical thickness, surface area, and mean curvature in patients with ET before and one year after (to account for delayed clinical effect) ventro-intermediate nucleus (Vim) stereotactic radiosurgical thalamotomy. We further contrasted the observed patterns with those from matched healthy controls (HCs). Significant group differences at the level of individual morphometric properties were specific to mean curvature and the post-/pre-thalamotomy contrast, evidencing brain plasticity at the level of the targeted left thalamus, and of low-level visual, high-level visuospatial and attentional areas implicated in the dorsal visual stream. The introduction of cross-correlational analysis across pairs of morphometric properties strengthened the presence of dorsal visual stream readjustments following thalamotomy, as cortical thickness in the right lingual gyrus, bilateral rostral middle frontal gyrus, and left pre-central gyrus was interrelated with mean curvature in the rest of the brain. Overall, our results position mean curvature as the most relevant morphometric feature to understand brain plasticity in drug-resistant ET patients following Vim thalamotomy. They also highlight the importance of examining not only individual features, but also their interactions, to gain insight into the routes of recovery following intervention.
摘要：
原发性震颤（ET）是最常见的运动障碍。其病理生理学仅被部分理解。这里,我们利用图论分析从皮质厚度的形态估计量化的结构协方差模式，表面积,ET患者在腹中核（Vim）立体定向放射手术丘脑切开术之前和之后一年（考虑到延迟的临床效果）的平均曲率。我们进一步将观察到的模式与来自匹配的健康对照(HC)的模式进行了对比。在个体形态测量特性水平上的显著组间差异特定于平均曲率和丘脑切开术后/前对比，在目标左丘脑水平证明大脑可塑性，和低级视觉，涉及背侧视觉流中的高级视觉空间和注意区域。在成对的形态计量学特性之间引入交叉相关分析，增强了丘脑切开术后背侧视觉流重新调整的存在，右舌回的皮质厚度，双侧延髓中额回，左中央前回与大脑其余部分的平均曲率相关。总的来说,我们的结果将平均曲率定位为了解Vim丘脑切开术后耐药ET患者的脑可塑性的最相关形态计量学特征.他们还强调了不仅检查个体特征，还有它们的相互作用，深入了解干预后的康复途径。
