AJNR. American journal of neuroradiology · 2026
Brain Plasticity Induced by MR-Guided Focused Ultrasound Correlates with Tremor Improvement in Essential Tremor: A Prospective Cohort Study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Lu Haoxuan, Xiong Yongqin, Hu Jianxing, Wang Xiaoyu, Wang Xinyu, Huang Jiayu, Li Yan, Li Zhixuan, Pan Longsheng, Lou Xin
Аннотация
BACKGROUND AND PURPOSE: MR-guided focused ultrasound (MRgFUS) is a promising and noninvasive treatment for medication-refractory essential tremor (ET). However, the mechanism of long-term postoperative brain structural remodeling remains unclear. This study aimed to investigate the changes in gray matter volume (GMV) before and after MRgFUS, as well as to explore the relationship between GMV changes and tremor control.
MATERIALS AND METHODS: Twenty-six patients with ET who underwent MRgFUS successfully were included in this study. They underwent structural MR imaging and clinical assessment before and one year after treatment. The Computational Anatomy Toolbox and spatially unbiased infratentorial template were used to estimate changes in GMV. Then, voxel- and region of interest-wise GMV analyses were conducted. Additionally, longitudinal changes were assessed by using one-way repeated measures ANOVA. Finally, the Pearson correlation was used to assess the relationship between GMV changes and tremor improvement.
RESULTS: Patients with ET showed significantly decreased GMV in the left postcentral gyrus, left thalamus, and right superior temporal gyrus from baseline to one year postoperation (clusters 1 through 3, respectively, voxel-level P < .001, cluster-level P family-wise error (FWE) < .05). Increased GMV was found in the left crus I, left crus II (cluster 4), and left lobule V (cluster 5) of the cerebellum (voxel-level P < .001, cluster-level P FWE < .05). Region of interest-wise analysis revealed that GMV reduction mainly occurred in the left external and internal globus pallidus (Pfalse discovery rate ( FDR) = .04). Additionally, ROI-wise analysis using the Automatic Anatomic Labeling 3 (AAL3) Brain or Oxford Thalamic Connectivity Atlases identified significant GMV reductions in the lateral posterior or temporal region of the left thalamus (lateral posterior: P FDR = .01; temporal region: P FDR = .001). GMV changes in clusters 2 through 4 from baseline to 1 year postoperatively were significantly correlated with symptom improvement (P < .05).
CONCLUSIONS: Our findings suggest that MRgFUS may induce brain plasticity, affecting regions adjacent to the ablation lesion as well as remote brain areas. The reduction in GMV in the thalamic nuclei, which are located in nonablated regions, may reflect neuroplastic changes and functional deafferentation induced by the MRgFUS.
MATERIALS AND METHODS: Twenty-six patients with ET who underwent MRgFUS successfully were included in this study. They underwent structural MR imaging and clinical assessment before and one year after treatment. The Computational Anatomy Toolbox and spatially unbiased infratentorial template were used to estimate changes in GMV. Then, voxel- and region of interest-wise GMV analyses were conducted. Additionally, longitudinal changes were assessed by using one-way repeated measures ANOVA. Finally, the Pearson correlation was used to assess the relationship between GMV changes and tremor improvement.
RESULTS: Patients with ET showed significantly decreased GMV in the left postcentral gyrus, left thalamus, and right superior temporal gyrus from baseline to one year postoperation (clusters 1 through 3, respectively, voxel-level P < .001, cluster-level P family-wise error (FWE) < .05). Increased GMV was found in the left crus I, left crus II (cluster 4), and left lobule V (cluster 5) of the cerebellum (voxel-level P < .001, cluster-level P FWE < .05). Region of interest-wise analysis revealed that GMV reduction mainly occurred in the left external and internal globus pallidus (Pfalse discovery rate ( FDR) = .04). Additionally, ROI-wise analysis using the Automatic Anatomic Labeling 3 (AAL3) Brain or Oxford Thalamic Connectivity Atlases identified significant GMV reductions in the lateral posterior or temporal region of the left thalamus (lateral posterior: P FDR = .01; temporal region: P FDR = .001). GMV changes in clusters 2 through 4 from baseline to 1 year postoperatively were significantly correlated with symptom improvement (P < .05).
CONCLUSIONS: Our findings suggest that MRgFUS may induce brain plasticity, affecting regions adjacent to the ablation lesion as well as remote brain areas. The reduction in GMV in the thalamic nuclei, which are located in nonablated regions, may reflect neuroplastic changes and functional deafferentation induced by the MRgFUS.