Constantin Tuleasca1,2,3, Tatiana Witjas4,5, Dimitri Van de Ville6,7, Elena Najdenovska8, Antoine Verger5,9,10, Nadine Girard11, Jerome Champoudry12, Jean-Philippe Thiran13,14,15, Meritxell Bach Cuadra8, Marc Levivier16,14, Eric Guedj5,9,10, Jean Régis12. 1. Department of Clinical Neuroscience, Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 44-46, BH-08, 1011, Lausanne, Switzerland. constantin.tuleasca@gmail.com. 2. Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland. constantin.tuleasca@gmail.com. 3. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. constantin.tuleasca@gmail.com. 4. Department of Neurology and Movement Disorders, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital, Marseille, France. 5. Institut de Neurosciences de la Timone, UMR 7289, CNRS Aix-Marseille Université, Marseille, France. 6. Faculty of Medicine, University of Geneva, Geneva, Switzerland. 7. Stereotactic and Functional Neurosurgery Service and Gamma Knife Unit, CHU Timone, Marseille, France. 8. Medical Image Processing Laboratory, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland. 9. Radiology Department, Center for Biomedical Imaging (CIBM), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland. 10. Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Timone University Hospital, Marseille, France. 11. CERIMED, Aix-Marseille Université, Marseille, France. 12. AMU, CRMBM UMR CNRS 7339, Faculté de Médecine et APHM, Department of Diagnostic and Interventionnal Neuroradiology, Hopital Timone, Marseille, France. 13. Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland. 14. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. 15. Radiology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. 16. Department of Clinical Neuroscience, Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 44-46, BH-08, 1011, Lausanne, Switzerland.
Abstract
INTRODUCTION: Drug-resistant essential tremor (ET) can benefit from open standard stereotactic procedures, such as deep-brain stimulation or radiofrequency thalamotomy. Non-surgical candidates can be offered either high-focused ultrasound (HIFU) or radiosurgery (RS). All procedures aim to target the same thalamic site, the ventro-intermediate nucleus (e.g., Vim). The mechanisms by which tremor stops after Vim RS or HIFU remain unknown. We used voxel-based morphometry (VBM) on pretherapeutic neuroimaging data and assessed which anatomical site would best correlate with tremor arrest 1 year after Vim RS. METHODS: Fifty-two patients (30 male, 22 female; mean age 71.6 years, range 49-82) with right-sided ET benefited from left unilateral Vim RS in Marseille, France. Targeting was performed in a uniform manner, using 130 Gy and a single 4-mm collimator. Neurological (pretherapeutic and 1 year after) and neuroimaging (baseline) assessments were completed. Tremor score on the treated hand (TSTH) at 1 year after Vim RS was included in a statistical parametric mapping analysis of variance (ANOVA) model as a continuous variable with pretherapeutic neuroimaging data. Pretherapeutic gray matter density (GMD) was further correlated with TSTH improvement. No a priori hypothesis was used in the statistical model. RESULTS: The only statistically significant region was right Brodmann area (BA) 18 (visual association area V2, p = 0.05, cluster size Kc = 71). Higher baseline GMD correlated with better TSTH improvement at 1 year after Vim RS (Spearman's rank correlation coefficient = 0.002). CONCLUSIONS: Routine baseline structural neuroimaging predicts TSTH improvement 1 year after Vim RS. The relevant anatomical area is the right visual association cortex (BA 18, V2). The question whether visual areas should be included in the targeting remains open.
INTRODUCTION: Drug-resistant essential tremor (ET) can benefit from open standard stereotactic procedures, such as deep-brain stimulation or radiofrequency thalamotomy. Non-surgical candidates can be offered either high-focused ultrasound (HIFU) or radiosurgery (RS). All procedures aim to target the same thalamic site, the ventro-intermediate nucleus (e.g., Vim). The mechanisms by which tremor stops after Vim RS or HIFU remain unknown. We used voxel-based morphometry (VBM) on pretherapeutic neuroimaging data and assessed which anatomical site would best correlate with tremor arrest 1 year after Vim RS. METHODS: Fifty-two patients (30 male, 22 female; mean age 71.6 years, range 49-82) with right-sided ET benefited from left unilateral Vim RS in Marseille, France. Targeting was performed in a uniform manner, using 130 Gy and a single 4-mm collimator. Neurological (pretherapeutic and 1 year after) and neuroimaging (baseline) assessments were completed. Tremor score on the treated hand (TSTH) at 1 year after Vim RS was included in a statistical parametric mapping analysis of variance (ANOVA) model as a continuous variable with pretherapeutic neuroimaging data. Pretherapeutic gray matter density (GMD) was further correlated with TSTH improvement. No a priori hypothesis was used in the statistical model. RESULTS: The only statistically significant region was right Brodmann area (BA) 18 (visual association area V2, p = 0.05, cluster size Kc = 71). Higher baseline GMD correlated with better TSTH improvement at 1 year after Vim RS (Spearman's rank correlation coefficient = 0.002). CONCLUSIONS: Routine baseline structural neuroimaging predicts TSTH improvement 1 year after Vim RS. The relevant anatomical area is the right visual association cortex (BA 18, V2). The question whether visual areas should be included in the targeting remains open.
Authors: Derek B Archer; Stephen A Coombes; Winston T Chu; Jae Woo Chung; Roxana G Burciu; Michael S Okun; Aparna Wagle Shukla; David E Vaillancourt Journal: Brain Date: 2018-06-01 Impact factor: 13.501
Authors: Constantin Tuleasca; Thomas Bolton; Jean Régis; Tatiana Witjas; Nadine Girard; Marc Levivier; Dimitri Van De Ville Journal: Hum Brain Mapp Date: 2019-12-15 Impact factor: 5.038
Authors: Mario Stanziano; Nico Golfrè Andreasi; Giuseppe Messina; Sara Rinaldo; Sara Palermo; Mattia Verri; Greta Demichelis; Jean Paul Medina; Francesco Ghielmetti; Salvatore Bonvegna; Anna Nigri; Giulia Frazzetta; Ludovico D'Incerti; Giovanni Tringali; Francesco DiMeco; Roberto Eleopra; Maria Grazia Bruzzone Journal: Front Neurol Date: 2022-01-12 Impact factor: 4.003