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Functional MRI for immediate monitoring stereotactic thalamotomy in a patient with essential tremor

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Abstract

The effect of stereotactic thalamotomy was assessed with pre- and postoperative functional magnetic resonance imaging (fMRI) under motor stimulation. A patient with unilateral essential tremor (ET) of the left arm underwent stereotactically guided thalamotomy of the right ventral intermediate thalamic nucleus (VIM). FMRI was done directly before and after surgery on a 1.5-Tesla scanner. The stimulation paradigm was maintainance of the affected arm in an extended position and hand clenching being performed in a block design manner. Statistical analysis was done with Brain Voyager 2000. After thalamotomy the tremor diminished completely. As a difference between the pre- and postoperative fMRI, a significant activation was found in the VIM contralateral to the activation site, adjacent to the inferior olivary nucleus contralateral to the activation site and in the dorsal cingulum. In conclusion, fMRI can detect the functional effect of thalamotomy for tremor treatment. Direct postoperative fMRI provides a sufficient method for estimating the effect of thalamotomy immediately after intervention. The importance of the intermediate thalamic nucleus and the olivary nucleus in tremor generation is supported by our findings.

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Acknowledgement

This work was supported by a grant from Koeln Fortune.

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Authors and Affiliations

  1. Department of Radiology, University of Cologne, Joseph-Stelzmann-Strasse 9, 50924, Cologne, Germany

    Volker Hesselmann, Maike Schaaf, Barbara Krug & Klaus Lackner

  2. Belegabteilung für Neurochirurgie, Klinikum Bamberg, Akademisches Lehrkrankenhaus der Universität Erlangen-Nürnberg, Buger Straße 80, 96049, Bamberg, Germany

    Christoph Wedekind

  3. Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Joseph-Stelzmann-Strasse 9, 50924, Cologne, Germany

    Mohammed Maarouf, Stefan Hunsche & Volker Sturm

  4. Universitätsklinikum Schleswig Holstein, Campus Lübeck, Klinik für Neurologie, Ratzeburger Allee 160, 23538, Lübeck, Germany

    Kathrin Lasek

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  1. Volker Hesselmann
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  2. Mohammed Maarouf
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  3. Stefan Hunsche
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  4. Kathrin Lasek
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  5. Maike Schaaf
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  6. Barbara Krug
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  7. Klaus Lackner
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  8. Volker Sturm
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  9. Christoph Wedekind
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Correspondence to Volker Hesselmann.

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Hesselmann, V., Maarouf, M., Hunsche, S. et al. Functional MRI for immediate monitoring stereotactic thalamotomy in a patient with essential tremor. Eur Radiol 16, 2229–2233 (2006). https://doi.org/10.1007/s00330-006-0211-8

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  • DOI: https://doi.org/10.1007/s00330-006-0211-8

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