Abstract #0675

Contralesional motor-related functional networks following MR-guided focused ultrasound thalamotomy for essential tremor.

Darren L. Clark^1,2, Conrad Rockel^2,3, Samuel Pichardo^2,3, Davide Martino^1,2, Camila Aquino^1,2, Tejas Sankar⁴, Fady Girgis^2,5, Zelma H.T. Kiss^1,2, and G. Bruce Pike^2,3

¹Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada, ²Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada, ³Department of Radiology, University of Calgary, Calgary, AB, Canada, ⁴Department of Surgery, University of Alberta, Edmonton, AB, Canada, ⁵Department of Surgery, University of Calgary, Calgary, AB, Canada

Synopsis

Keywords: MR-Guided Focused Ultrasound, fMRI (resting state), focused ultrasound, essential tremor, plasticity

Motivation: To understanding how MR-guided focused ultrasound (MRgFUS)-thalamotomy affects motor network connectivity over time in essential tremor.

Goal(s): To explore if long-term motor network reorganization, outside of the targeted nucleus, occurs after MRgFUS thalamotomy in essential tremor.

Approach: Dentate nucleus connectivity changes in 25 essential tremor patients were tracked via fMRI at three intervals: pre-operation, one day post-operation, and twelve months post-MRgFUS.

Results: Initially, the right DN showed diminished local connectivity. By one year, both DNs showed enhanced connectivity with right sensorimotor cortex (contralateral to the targeted motor network), compared to pre-MRgFUS thalamotomy.

Impact: MRgFUS thalamotomy for essential tremor induces lasting motor network reorganization, suggesting that long-term tremor relief may arise from adaptive connectivity changes. These findings could inform strategies to enhance neuromodulatory treatments for essential tremor or movement disorders.

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