Objective: To explore the brain network change after stereotactic functional surgery, we analyzed the functional connectivity using resting state fMRI (rs-fMRI) of the essential tremor patients treated with Focused Ultrasound Surgery (FUS).

Background: Stereotactic functional surgery, such as Deep brain stimulation and stereotactic ablation surgery, is known to dramatically ameliorate the involuntary movement of Parkinson’s disease, essential tremor, etc. Understanding the alteration in brain networks due to stereotactic functional surgery is indispensable to further improve therapeutic effects and to search new targets. The restrs-fMRI can analyze the entire brain network without requiring a specific task. VIM thalamotomy by FUS is an ideal model to analyze the brain network changes with rs-fMRI, because FUS can ameliorate patients’ tremor without the brain tissue damage other than the target, and without noisy electric devices.

Method: Seven patients with essential tremor and age matched seven healthy subjects were included in this study. We analyzed the changes in the brain network by FUS VIM thalamotomy using the rs-fMRI taken before and three months after surgery.

Results: FUS VIM-thalamotomy ameliorated patients’ tremor in all seven patients, and the functional connectivity between the left thalamus and the caudal part of the dorsal premotor cortex (PMDc) was strengthened after surgery. In addition, the essential tremor patients showed a tendency to have weaker functional connectivity between left thalamus and PMDc than healthy subjects.

Conclusion: PMDc is known to play an important role in reaching task. It is an issue that should be researched in the future whether the observed functional connectivity change after thalamotomy is a result of the reduction of tremor or one of the mechanisms to reduce tremor.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/analysis-of-brain-network-changes-due-to-focused-ultrasound-vim-thalamotomy/