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Voxel-based morphometry after Gamma Knife thalamotomy of the Vim for tremor could help discriminating clinical responders from non-responders the Vim nucleus for tremor.

Authors :
Tuleasca, Constantin
Witjas, Tatiana
Najdenovska, Elena
Verger, Antoine
Girard, Nadine
Champoudry, Jerome
Thiran, Jean-Philippe
Cuadra, Meritxell Bach
Levivier, Marc
Guedj, Eric
Régis, Jean
Source :
Stereotactic & Functional Neurosurgery; 2017 Supplement, Vol. 95, p68-68, 1p
Publication Year :
2017

Abstract

Objective: To assess for the first time structural brain changes, by voxel-based morphometry (VBM), before and after unilateral Gamma Knife thalamotomy (GKT) for drug-resistant tremor. To identify differences between clinical responders and nonresponders to GKT. Methods: Thirty-eight patients (mean age 71.8 years) with severe refractory right essential tremor (ET) were treated with unilateral left GKT. Targeting of ventro-intermediate nucleus (Vim) was performed with Leksell Gamma Knife using a single 4- mm collimator and 130 Gy. Neurological, neuropsychological and neuroimaging (3 Tesla, including 3D T1 weighted) assessment had been done at baseline and 1 year after GKT. Clinical responders were considered those improved in tremor score (Fahn-Tolosa-Marin) with at least 45%. Results: Thirty-one (81.6%) patients were responders (R) and 7 (18.4%) non-responders (NR). With regard to GM changes after GKT, independently of clinical answer, atrophy was present in extensive areas (right globus pallidus, left putamen, left thalamus, right anterior and medio-dorsal thalamus, cerebellar, right premotor and supplementary motor area, left and right visual association cortex, right ventral temporal, left parahippocampal and posterior cingulate gyrus). The interaction between R - NR with time showed brain plasticity in R remote areas, within left temporal pole (BA 38) and cluster including left occipital cortex (BA 19), visual areas V4 and V5, parahippocampal place area (p<subscript>unc</subscript><0.005, k>120). Conclusions: Our results show brain plasticity after unilateral left GKT. Responders present changes in areas involved in motion, mainly locomotor monitoring towards the local and distant environment, suggesting the requirement to recruit in the targeting specific visuomotor networks. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10116125
Volume :
95
Database :
Complementary Index
Journal :
Stereotactic & Functional Neurosurgery
Publication Type :
Academic Journal
Accession number :
124148785