Photo Credit: Nur Ceren Demir

The following is a summary of “MR-guided focused ultrasound thalamotomy modulates cerebello-thalamo-cortical tremor network in essential tremor patients,” published in the April 2025 issue of Frontiers in Neurology by Jiang et al. 

Researchers conducted a retrospective study to explore changes in brain connectivity following MR-guided Focused Ultrasound ventral intermediate nucleus (VIM) thalamotomy for essential tremor (ET).  

They included 15 right-handed patients with essential tremor (ET) who underwent successful unilateral VIM ablation surgery and experienced improved hand tremor on their dominant hand. Resting-state fMRI scans were conducted before and 1-year post-treatment. A seed-based whole brain resting-state functional connectivity (FC) analysis was performed, focusing on tremor-related regions in the cerebello-thalamo-cortical (CTC) network, including the left and right VIM, primary motor cortex (M1H), and dentate nucleus (DN). Changes in functional connectivity and their correlation with clinical outcomes, evaluated using the Clinical Rating Scale for Tremor (CRST) at 1-year post-treatment, were examined. 

The results showed significant tremor improvement in the treated hand over 1 year. Functional connectivity of both left and right VIM decreased in the precentral and postcentral gyri; left M1H increased in the premotor cortex and SMA; left DN increased in the premotor cortex, SMA, M1, and anterior cingulate cortex (ACC). Negative correlation was found between changes in left VIM connectivity and contralateral tremor scores in bilateral precentral gyrus, superior parietal lobule, precuneus, occipital cortex, and middle prefrontal cortex. Positive correlation was observed in the frontal orbital cortex, right insular cortex, temporal pole, hippocampus, left lingual gyrus, right cerebellar lobules IV/V, left cerebellar lobule VI, and vermis IV/V. 

Investigators found altered functional connectivity within the cerebello-thalamo-cortical network involving motor, sensory, attention, visual, and visuospatial regions. They also observed its association with hand tremor improvement, suggesting a potential approach for alleviating tremor symptoms in patients with ET. 

Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1526501/full