Imagine the brain as a complex network of interconnected cities. In a study on essential tremor (ET) recovery after stereotactic radiosurgical thalamotomy, scientists used graph theoretical analysis to examine the structural covariance patterns in the brain. They looked at how cortical thickness, surface area, and mean curvature changed in ET patients before and after the procedure. Comparing this to healthy controls, they found significant differences in mean curvature, revealing brain plasticity in the targeted left thalamus and areas associated with visual processing and attention. By analyzing the correlation between different morphometric properties, they discovered readjustments in the dorsal visual stream. This research suggests that mean curvature is a key feature for understanding brain plasticity in ET patients. It emphasizes the importance of considering not only individual features but also their interactions to better understand recovery routes after intervention. For more details, check out the underlying research!

Essential tremor (ET) is the most common movement disorder. Its pathophysiology is only partially understood. Here, we leveraged graph theoretical analysis on structural covariance patterns quantified from morphometric estimates for cortical thickness, surface area, and mean curvature in patients with ET before and one year after (to account for delayed clinical effect) ventro-intermediate nucleus (Vim) stereotactic radiosurgical thalamotomy. We further contrasted the observed patterns with those from matched healthy controls (HCs). Significant group differences at the level of individual morphometric properties were specific to mean curvature and the post-/pre-thalamotomy contrast, evidencing brain plasticity at the level of the targeted left thalamus, and of low-level visual, high-level visuospatial and attentional areas implicated in the dorsal visual stream. The introduction of cross-correlational analysis across pairs of morphometric properties strengthened the presence of dorsal visual stream readjustments following thalamotomy, as cortical thickness in the right lingual gyrus, bilateral rostral middle frontal gyrus, and left pre-central gyrus was interrelated with mean curvature in the rest of the brain. Overall, our results position mean curvature as the most relevant morphometric feature to understand brain plasticity in drug-resistant ET patients following Vim thalamotomy. They also highlight the importance of examining not only individual features, but also their interactions, to gain insight into the routes of recovery following intervention.

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