1. Lateral cerebellothalamic tract activation underlies DBS therapy for Essential Tremor
- Author
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AnneMarie Brinda, Julia P. Slopsema, Rebecca D. Butler, Salman Ikramuddin, Thomas Beall, William Guo, Cong Chu, Remi Patriat, Henry Braun, Mojgan Goftari, Tara Palnitkar, Joshua Aman, Lauren Schrock, Scott E. Cooper, Joseph Matsumoto, Jerrold L. Vitek, Noam Harel, and Matthew D. Johnson
- Subjects
Essential Tremor ,Deep brain stimulation ,Pathway activation models ,Cerebellothalamic tract ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background: While deep brain stimulation (DBS) therapy can be effective at suppressing tremor in individuals with medication-refractory Essential Tremor, patient outcome variability remains a significant challenge across centers. Proximity of active electrodes to the cerebellothalamic tract (CTT) is likely important in suppressing tremor, but how tremor control and side effects relate to targeting parcellations within the CTT and other pathways in and around the ventral intermediate (VIM) nucleus of thalamus remain unclear. Methods: Using ultra-high field (7T) MRI, we developed high-dimensional, subject-specific pathway activation models for 23 directional DBS leads. Modeled pathway activations were compared with post-hoc analysis of clinician-optimized DBS settings, paresthesia thresholds, and dysarthria thresholds. Mixed-effect models were utilized to determine how the six parcellated regions of the CTT and how six other pathways in and around the VIM contributed to tremor suppression and induction of side effects. Results: The lateral portion of the CTT had the highest activation at clinical settings (p
- Published
- 2023
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