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Clinical Article
Regional homogeneity changes after MR-guided focused ultrasound thalamotomy in essential tremor: A rs-fMRI study
DENG Linlin  LIN Jiaji  WANG Xiaoyu  LU Haoxuan  XIONG Yongqin  BIAN Xingbing  ZHOU Jiayou  PAN Longsheng  LOU Xin 

Cite this article as: Deng LL, Lin JJ, Wang XY, et al. Regional homogeneity changes after MR-guided focused ultrasound thalamotomy in essential tremor: A rs-fMRI study[J]. Chin J Magn Reson Imaging, 2022, 13(9): 1-6, 12. DOI:10.12015/issn.1674-8034.2022.09.001.


[Abstract] Objective To explore long-term longitudinal changes in local spontaneous brain activity and correlation with clinical tremor scores after MR-guided focused ultrasound (MRgFUS) in essential tremor (ET) patients.Materials and Methods In this study, we included 9 patients with essential tremor who underwent MRgFUS thalamotomy in the Chinese PLA General Hospital from January 2019 to May 2019 and 9 healthy controls with no statistical difference in age and sex, and 9 healthy volunteers with matched age and sex. We collected resting-state functional MRI (rs-fMRI) data and Clinical Rating Scale for Tremor (CRST) at baseline, 6 months and 2 years after MRgFUS thalamotomy in ET patients and rs-fMRI data in healthy volunteers. We used a regional homogeneity (ReHo) approach in the REST plus v1.2 toolkit based on the MATLAB platform, based on whole-brain voxel paired-sample t-tests to identify difference in brain areas in ET patients at baseline and 2 years after MRgFUS thalamotomy, The ReHo values of this significantly different brain region in the HC and ET groups were extracted using the DPABI v5.1 toolkit, a two independent sample t-test was used to compare spontaneous and synchronous brain activity in this significantly different brain region between the HC and ET groups, and one-way repeated measures ANOVA was used to compare spontaneous and synchronous brain activity in this significantly different brain region between the ET group at baseline, 6 months after MRgFUS, and 2 years after MRgFUS. We used Spearman correlation analysis to correlate the trend between clinical tremor improvement in the ET group after surgery and the change in ReHo values in the ET group; and Pearson correlation analysis to correlate the rate of tremor improvement in the ET group 2 years after MRgFUS with the baseline ReHo values in the ET group.Results Findings showed that the significantly different brain regions in the ET group at baseline and 2 years after MRgFUS were located in the right postcentral gyrus. Compared with the HC group, the ReHo value of the right postcentral gyrus at baseline was significantly lower in the ET group (P<0.01). There was no statistically significant difference in the right postcentral gyrus two years after MRgFUS in the ET group (P>0.05). The ReHo value of the right postcentral gyrus increased in the ET group at baseline, 6 months after MRgFUS, and 2 years after MRgFUS (F=3.95, P<0.05). There was a positive correlation between the improvement of clinical tremor and the change of ReHo value after operation; the improvement rate of CRST-A 2 years after MRgFUS in the ET group was negatively correlated with the baseline ReHo value in the ET group (r=-0.709, P=0.032).Conclusions MRgFUS thalamotomy helps relieve tremor symptoms in ET patients, MRgFUS thalamotomy affects the spontaneous and synchronous brain function of ET patients, and there is a correlation between ReHo and clinical score, which provide neuroimaging basis for the evaluation of nerve remodeling after MRgFUS.
[Keywords] magnetic resonance-guided focus ultrasound;regional homogeneity;essential tremor;resting-state functional magnetic resonance imaging;clinical rating scale for tremor

DENG Linlin1   LIN Jiaji2   WANG Xiaoyu2   LU Haoxuan2   XIONG Yongqin2   BIAN Xingbing2   ZHOU Jiayou3   PAN Longsheng3   LOU Xin1, 2*  

1 School of Medical Imaging, Guizhou Medical University, Guiyang 550004, China

2 Department of Radiology, Chinese PLA General Hospital/Chinese PLA Medical School, Beijing 100853, China

3 Department of Neurosurgery, Chinese PLA General Hospital/Chinese PLA Medical School, Beijing 100853, China

*Lou X, E-mail: louxin@301hospital.com.cn

Conflicts of interest   None.

Received  2022-04-15
Accepted  2022-08-25
DOI: 10.12015/issn.1674-8034.2022.09.001
Cite this article as: Deng LL, Lin JJ, Wang XY, et al. Regional homogeneity changes after MR-guided focused ultrasound thalamotomy in essential tremor: A rs-fMRI study[J]. Chin J Magn Reson Imaging, 2022, 13(9): 1-6, 12.DOI:10.12015/issn.1674-8034.2022.09.001

[1]
Welton T, Cardoso F, Carr JA, et al. Essential tremor[J]. Nat Rev Dis Primers, 2021, 7(1): 83. DOI: 10.1038/s41572-021-00314-w.
[2]
Reich SG. Essential tremor[J]. Med Clin N Am, 2019, 103(2): 351-356. DOI: 10.1016/j.mcna.2018.10.016.
[3]
Louis ED, Rios E, Henchcliffe C. How are we doing with the treatment of essential tremor (ET)?: persistence of patients with ET on medication: data from 528 patients in three settings[J]. Eur J Neurol, 2010, 17(6): 882-884. DOI: 10.1111/j.1468-1331.2009.02926.x.
[4]
Wang XY, Xiong YQ, Lin JJ, et al. Target selection for magnetic resonance-guided focused ultrasound in the treatment of Parkinson's disease[J]. J Magn Reson Imaging, 2022, 56(1): 35-44. DOI: 10.1002/jmri.28080.
[5]
Elias WJ, Lipsman N, Ondo WG, et al. A randomized trial of focused ultrasound thalamotomy for essential tremor[J]. N Engl J Med, 2016, 375(8): 730-739. DOI: 10.1056/NEJMoa1600159.
[6]
Xiong YQ, He JF, Lou X. The clinical applications of MR-guided focused ultrasound in the treatment of tremor-related disorders[J]. Chin J Radiol, 2020, 54(8): 804-807. DOI: 10.3760/cma.j.cn112149-20191120-00920.
[7]
Lin JJ, Kang XP, Xiong YQ, et al. Convergent structural network and gene signatures for MRgFUS thalamotomy in patients with Parkinson's disease[J/OL]. NeuroImage, 2021 [2022-04-03]. https://doi.org/10.1016/j.neuroimage.2021.118550. DOI: 10.1016/j.neuroimage.2021.118550.
[8]
Xiong Y, Lin J, Pan L, et al. Pretherapeutic functional connectivity of tractography-based targeting of the ventral intermediate nucleus for predicting tremor response in patients with Parkinson's disease after thalamotomy with MRI-guided focused ultrasound[J/OL]. J Neurosurg, 2022 [2022-04-03]. https://thejns.org/view/journals/j-neurosurg/aop/article-10.3171-2022.1.JNS212449/article-10.3171-2022.1.JNS212449.xml. DOI: 10.3171/2022.1.JNS212449.
[9]
Xiong YQ, Han DS, He JF, et al. Correlation of visual area with tremor improvement after MRgFUS thalamotomy in Parkinson's disease[J]. J Neurosurg, 2022, 136(3): 681-688. DOI: 10.3171/2021.3.JNS204329.
[10]
Lang S, Duncan N, Northoff G. Resting-state functional magnetic resonance imaging: review of neurosurgical applications[J]. Neurosurgery, 2014, 74(5): 453-464. DOI: 10.1227/NEU.0000000000000307.
[11]
Kim SG, Ogawa S. Biophysical and physiological origins of blood oxygenation level-dependent fMRI signals[J]. J Cereb Blood Flow Metab, 2012, 32(7): 1188-1206. DOI: 10.1038/jcbfm.2012.23.
[12]
Jiang LL, Zuo XN. Regional homogeneity: a multimodal, multiscale neuroimaging marker of the human connectome[J]. Neuroscientist, 2016, 22(5): 486-505. DOI: 10.1177/1073858415595004.
[13]
Zhang JP, Cai XW, Wang YJ, et al. Different brain activation after acupuncture at combined acupoints and single acupoint in hypertension patients: an rs-fMRI study based on ReHo analysis[J/OL]. Evid Based Complement Alternat Med, 2019 [2022-04-03]. https://www.hindawi.com/journals/ecam/2019/5262896/. DOI: 10.1155/2019/5262896.
[14]
Geng JT, Yan R, Shi JB, et al. Altered regional homogeneity in patients with somatic depression: a resting-state fMRI study[J]. J Affect Disord, 2019, 246: 498-505. DOI: 10.1016/j.jad.2018.12.066.
[15]
Zhang XY, Chen HY, Tao L, et al. Combined multivariate pattern analysis with frequency-dependent intrinsic brain activity to identify essential tremor[J/OL]. Neurosci Lett, 2022 [2022-4-12]. https://doi.org/10.1016/j.neulet.2022.136566. DOI: 10.1016/j.neulet.2022.136566.
[16]
Fang W, Lv F, Luo T, et al. Abnormal regional homogeneity in patients with essential tremor revealed by resting-state functional MRI[J/OL]. PLoS One, 2013 [2022-04-15]. https://doi.org/10.1371/journal.pone.0069199. DOI: 10.1371/journal.pone.0069199.
[17]
Bhatia KP, Bain P, Bajaj N, et al. Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society[J]. Mov Disord, 2018, 33(1): 75-87. DOI: 10.1002/mds.27121.
[18]
Haubenberger D, Hallett M. Essential tremor[J]. N Engl J Med, 2018, 378(19): 1802-1810. DOI: 10.1056/nejmcp1707928.
[19]
Zang Y, Jiang T, Lu Y, et al. Regional homogeneity approach to fMRI data analysis[J]. Neuroimage, 2004, 22(1): 394-400. DOI: 10.1016/j.neuroimage.2003.12.030.
[20]
Duan XY, Fang Z, Tao L, et al. Altered local and matrix functional connectivity in depressed essential tremor patients[J/OL]. BMC Neurol, 2021, 21(1) [2022-04-14]. https://doi.org/10.1186/s12883-021-02100-3. DOI: 10.1186/s12883-021-02100-3.
[21]
Li JY, Lu ZJ, Suo XL, et al. Patterns of intrinsic brain activity in essential tremor with resting tremor and tremor-dominant Parkinson's disease[J]. Brain Imaging Behav, 2020, 14(6): 2606-2617. DOI: 10.1007/s11682-019-00214-4.
[22]
Wang P, Luo XD, Zhong CQ, et al. Resting state fMRI reveals the altered synchronization of BOLD signals in essential tremor[J]. J Neurol Sci, 2018, 392: 69-76. DOI: 10.1016/j.jns.2018.07.008.
[23]
Wen Z, Zhang J, Li JL, et al. Altered activation in cerebellum contralateral to unilateral thalamotomy may mediate tremor suppression in Parkinson's disease: a short-term regional homogeneity fMRI study[J/OL]. PLoS One, 2016 [2022-04-12]. https://doi.org/10.1371/journal.pone.0157562. DOI: 10.1371/journal.pone.0157562.
[24]
Schellekens W, Thio M, Badde S, et al. A touch of hierarchy: population receptive fields reveal fingertip integration in Brodmann areas in human primary somatosensory cortex[J]. Brain Struct Funct, 2021, 226(7): 2099-2112. DOI: 10.1007/s00429-021-02309-5.
[25]
Sun FQ, Zhang GJ, Ren LK, et al. Functional organization of the human primary somatosensory cortex: a stereo-electroencephalography study[J]. Clin Neurophysiol, 2021, 132(2): 487-497. DOI: 10.1016/j.clinph.2020.11.032.
[26]
Härtner J, Strauss S, Pfannmöller J, et al. Tactile acuity of fingertips and hand representation size in human Area 3b and Area 1 of the primary somatosensory cortex[J/OL]. Neuroimage, 2021 [2022-04-12]. https://doi.org/10.1016/j.neuroimage.2021.117912. DOI: 10.1016/j.neuroimage.2021.117912.
[27]
Novaes NP, Balardin JB, Hirata FC, et al. Global efficiency of the motor network is decreased in Parkinson's disease in comparison with essential tremor and healthy controls[J]. Brain Behav, 2021 [2022-04-12]. https://doi.org/10.1002/brb3.2178. DOI: 10.1002/brb3.2178.
[28]
Lan H, Suo XL, Li WB, et al. Abnormalities of intrinsic brain activity in essential tremor: a meta-analysis of resting-state functional imaging[J]. Hum Brain Mapp, 2021, 42(10): 3156-3167. DOI: 10.1002/hbm.25425.
[29]
Benito-León J, Sanz-Morales E, Melero H, et al. Graph theory analysis of resting-state functional magnetic resonance imaging in essential tremor[J]. Hum Brain Mapp, 2019, 40(16): 4686-4702. DOI: 10.1002/hbm.24730.
[30]
Duval C, Daneault JF, Hutchison WD, et al. A brain network model explaining tremor in Parkinson's disease[J]. Neurobiol Dis, 2016, 85: 49-59. DOI: 10.1016/j.nbd.2015.10.009.
[31]
Jang C, Park HJ, Chang WS, et al. Immediate and longitudinal alterations of functional networks after thalamotomy in essential tremor[J/OL]. Front Neurol, 2016, 7 [2022-04-14]. https://doi.org/10.3389/fneur.2016.00184.
[32]
Miyagishima T, Takahashi A, Kikuchi S, et al. Effect of ventralis intermedius thalamotomy on the area in the sensorimotor cortex activated by passive hand movements: fMR imaging study[J]. Stereotact Funct Neurosurg, 2007, 85(5): 225-234. DOI: 10.1159/000103261.
[33]
Tsolaki E, Downes A, Speier W, et al. The potential value of probabilistic tractography-based for MR-guided focused ultrasound thalamotomy for essential tremor[J]. Neuroimage Clin, 2017, 17: 1019-1027. DOI: 10.1016/j.nicl.2017.12.018.

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