Cortico-thalamic tremor circuits and their associations with deep brain stimulation effects in essential tremor

作者：Shenghong He, Timothy O. West, Fernando Rodriguez Plazas, Laura Wehmeyer, Alek Pogosyan, Alceste Deli, Christoph Wiest, Damian M. Herz, Thomas G Simpson, Pablo Andrade, Fahd Baig, Michael G. Hart, Francesca Morgante, James J. FitzGerald, Michael T. Barbe, Veerle Visser‐Vandewalle, Alexander L. Green, Erlick Pereira, Hayriye Cagnan, Huiling Tan · 发表于：Brain · 年份：2024 · DOI：10.1093/brain/awae387 · 被引用次数：15 · 研究领域：Neurological disorders and treatments、Neuroscience and Neural Engineering、Parkinson's Disease Mechanisms and Treatments

Essential tremor is one of the most common movement disorders in adults. Deep brain stimulation (DBS) of the ventralis intermediate nucleus of the thalamus and/or the posterior subthalamic area has been shown to provide significant tremor suppression in patients with essential tremor, but with significant inter-patient variability and habituation to the stimulation. Several non-invasive neuromodulation techniques targeting other parts of the CNS, including cerebellar, motor cortex or peripheral nerves, have also been developed for treating essential tremor, but the clinical outcomes remain inconsistent. Existing studies suggest that pathology in essential tremor might emerge from multiple cortical and subcortical areas, but its exact mechanisms remain unclear. By simultaneously capturing neural activities from motor cortices and thalami and recording hand tremor signals via accelerometers in 15 human subjects who had undergone lead implantations for DBS, we systematically characterized the efferent and afferent cortico-thalamic tremor networks. Through the comparisons of these network characteristics and tremor amplitude between DBS off and on conditions, we also investigated the associations between different tremor network characteristics and the magnitude of the DBS effect. Our findings implicate the thalamus, specifically the contralateral hemisphere, as the primary generator of tremor in essential tremor, also with a significant contribution of the ipsilateral hemisphere...