Abstract #2191

Pre-operative diffusion metrics associated with long-term tremor outcome following MR-Guided Focused Ultrasound Thalamotomy

Conrad P Rockel^1,2, Darren L Clark^1,2, Arash Sereshki^1,2, Camila Aquino^1,2, Fady Girgis^2,3, Tejas Sankar⁴, Samuel Pichardo^1,2, Davide Martino^1,2, Zelma HT Kiss^1,2,3, and G Bruce Pike^1,2

¹Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, ²Radiology and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, ³Dept of Surgery, University of Calgary, Calgary, AB, Canada, ⁴University of Alberta, Edmonton, AB, Canada

Synopsis

Keywords: MR-Guided Focused Ultrasound, biomarkers, Tremor

Motivation: Fibre tract integrity may play a role in treatment-resistant Essential Tremor.

Goal(s): To determine if pre-operative DTI measurements of ET-related neuronal pathways had any association with long-term tremor improvement following MRgFUS-thalamotomy.

Approach: Pre-operative DTI metrics (FA & MD) of both DRTT were compared with clinical tremor outcomes 12-months following MRgFUS left thalomotomy in right-handed patients.

Results: Higher measures of pre-operative mean diffusivity in the DRTT contralateral to the surgically-targeted DRTT/Vim (particularly in cerebellar regions) showed greater reductions in tremor 12 months post-MRgFUS thalamotomy.

Impact: The DRTT contralateral to the surgical target plays an undetermined role in the long-term effectiveness of MRgFUS thalamotomy for Essential Tremor, particularly in cerebellar regions. Future research into tremor understanding and treatment should consider anatomy outside of direct pathways.

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