背景:磁共振引导聚焦超声(MRgFUS)丘脑切开术已被实施为治疗药物难治性特发性震颤(ET)的替代治疗方法。然而,其对大脑结构网络的影响尚不清楚。
目的:研究MRgFUS丘脑切开术后ET中白质(WM)连接网络的整体和局部改变。
方法:回顾性。
方法:27例ET患者(61±11岁,19名男性)进行MRgFUS丘脑切开术和28名健康对照(HC)(61±11岁,招募20名男性)进行比较。
■通过使用基于自旋回波的回波平面成像进行的3T/单壳扩散张量成像,利用基于梯度回波序列的三维T1加权成像。
结果:患者正在接受MRgFUS丘脑切开术,他们的临床数据从术前到术后6个月收集。网络拓扑指标,包括富人俱乐部组织,小世界,并计算了效率特性。还计算了ET组中拓扑指标与震颤评分之间的相关性,以评估神经重塑在大脑中的作用。
方法:两样本独立t检验,卡方检验,方差分析,Bonferroni测试,和斯皮尔曼的相关性。P<0.05时具有统计学意义。
结果:对于ET患者,丰富的俱乐部联系强度和聚类系数显着增加。与手术前相比,手术后6个月的特征路径长度减少。ET组的富俱乐部区分布格局不同。具体来说,根据MRgFUS丘脑切开术后的网络度值改变了丰富俱乐部区域的顺序。此外,颞上回右侧颞极(R=0.434-0.596)和右侧壳核(R=0.413-0.436)的淋巴结效率改变与不同的震颤改善呈正相关。
结论:这些发现可能从网络的角度提高对治疗诱导的调节的理解,并且可能作为MRgFUS丘脑切开术评估ET震颤控制的客观标志物。
方法:3技术效果:第4阶段。
BACKGROUND: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy has been implemented as a therapeutic alternative for the treatment of drug-refractory essential tremor (ET). However, its impact on the brain structural network is still unclear.
OBJECTIVE: To investigate both global and local alterations of the white matter (WM) connectivity network in ET after MRgFUS thalamotomy.
METHODS: Retrospective.
METHODS: Twenty-seven ET patients (61 ± 11 years, 19 males) with MRgFUS thalamotomy and 28 healthy controls (HC) (61 ± 11 years, 20 males) were recruited for comparison.
UNASSIGNED: A 3 T/single shell diffusion tensor imaging by using spin-echo-based echo-planar imaging, three-dimensional T1 weighted imaging by using gradient-echo-based sequence.
RESULTS: Patients were undergoing MRgFUS thalamotomy and their clinical data were collected from pre-operation to 6-month post-operation. Network topological metrics, including rich-club organization, small-world, and efficiency properties were calculated. Correlation between the topological metrics and tremor scores in ET groups was also calculated to assess the role of neural remodeling in the brain.
METHODS: Two-sample independent t-tests, chi-squared test, ANOVA, Bonferroni test, and Spearman\'s correlation. Statistical significance was set at P < 0.05.
RESULTS: For ET patients, the strength of rich-club connection and clustering coefficient significantly increased vs. characteristic path length decreased at 6-month post-operation compared with pre-operation. The distribution pattern of rich-club regions was different in ET groups. Specifically, the order of the rich-club regions was changed according to the network degree value after MRgFUS thalamotomy. Moreover, the altered nodal efficiency in the right temporal pole of the superior temporal gyrus (R = 0.434-0.596) and right putamen (R = 0.413-0.436) was positively correlated with different tremor improvement.
CONCLUSIONS: These findings might improve understanding of treatment-induced modulation from a network perspective and may work as an objective marker in the assessment of ET tremor control with MRgFUS thalamotomy.
METHODS: 3 TECHNICAL EFFICACY: Stage 4.