Abstract:
Essential tremor (ET) is the most common movement disorder. Its neural underpinnings remain unclear. Here, we quantified structural covariance between cortical thickness (CT), surface area (SA), and mean curvature (MC) estimates in patients with ET before and 1 year after ventro-intermediate nucleus stereotactic radiosurgical thalamotomy, and contrasted the observed patterns with those from matched healthy controls. For SA, complex rearrangements within a network of motion-related brain areas characterized patients with ET. This was complemented by MC alterations revolving around the left middle temporal cortex and the disappearance of positive-valued covariance across both modalities in the right fusiform gyrus. Recovery following thalamotomy involved MC readjustments in frontal brain centers, the amygdala, and the insula, capturing nonmotor characteristics of the disease. The appearance of negative-valued CT covariance between the left parahippocampal gyrus and hippocampus was another recovery mechanism involving high-level visual areas. This was complemented by the appearance of negative-valued CT/MC covariance, and positive-valued SA/MC covariance, in the right inferior temporal cortex and bilateral fusiform gyrus. Our results demonstrate that different morphometric properties provide complementary information to understand ET, and that their statistical cross-dependences are also valuable. They pinpoint several anatomical features of the disease and highlight routes of recovery following thalamotomy.
摘要:
原发性震颤(ET)是最常见的运动障碍。其神经基础仍不清楚。这里,我们量化了皮质厚度(CT)之间的结构协方差,表面积(SA),在腹中核立体定向放射外科丘脑切开术之前和之后1年,ET患者的平均曲率(MC)估计,并将观察到的模式与匹配的健康对照进行了对比。对于SA,以ET患者为特征的运动相关大脑区域网络内的复杂重排。这得到了围绕左中颞叶皮层旋转的MC改变以及右梭状回两种形态的正值协方差的消失的补充。丘脑切开术后的恢复涉及额脑中心的MC重新调整,杏仁核,和脑岛,捕捉疾病的非运动特征。左侧海马旁回和海马之间出现负值CT协方差是另一种涉及高级视觉区域的恢复机制。这得到了负值CT/MC协方差的补充,和正值SA/MC协方差,右侧颞下皮质和双侧梭状回。我们的结果表明,不同的形态计量学特性为理解ET提供了补充信息,他们的统计交叉依赖性也很有价值。他们指出了该疾病的一些解剖学特征,并强调了丘脑切开术后的恢复途径。