• Naoki Tani, Satoru Oshino, Koichi Hosomi, Noriaki Hattori, Masahito Mihara, Takufumi Yanagisawa, Hui Ming Khoo, Manabu Kanemoto, Yoshiyuki Watanabe, Hideki Mochizuki, and Haruhiko Kishima.
• Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: n-tani@nsurg.med.osaka-u.ac.jp.
• World Neurosurg. 2022 Aug 1; 164: e1103-e1110.

BackgroundAlthough stereotactic ablation surgery is known to ameliorate involuntary movement dramatically, little is known regarding alterations in whole-brain networks due to disruption of the deep brain nucleus. To explore changes in the whole-brain network after thalamotomy, we analyzed structural and functional connectivity alterations using resting-state functional magnetic resonance imaging and diffusion tensor imaging in patients with essential tremor who had undergone focused ultrasound (FUS) thalamotomy.MethodsSeven patients with intractable essential tremors and 7 age-matched healthy controls were enrolled in the study. The tremor score in essential tremor patients was assessed, and resting-state functional magnetic resonance imaging and diffusion tensor imaging were performed before and 3 months after left ventral intermediate nucleus thalamotomy using FUS.ResultsThere was a significant improvement in the tremor of the right hand after FUS thalamotomy. Seed-based functional connectivity analysis revealed a significant increase in functional connectivity between the left thalamus and the caudal part of the dorsal premotor cortex after FUS thalamotomy. Structural connectivity analysis did not detect statistically significant changes between before and after FUS. There was no correlation between the changes in functional connectivity and tremor score.ConclusionsAlthough the number of cases is small, our results show that functional connectivity between the thalamus and the premotor cortex increases after the amelioration of tremors by FUS thalamotomy. The lack of correlation between increased functional connectivity and clinical tremor scores suggests that the observed increase in functional connectivity may be a compensatory change in the secondary sensorimotor changes that occur after thalamotomy.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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