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<p>Emerging evidence indicates that movement disorders arise from symptom-specific rather than disease-specific brain network dysfunctions that can be influenced through targeted neuromodulation. Such networks are widely mapped using normative connectome analyses from lesion and stimulation sites. Here, we used [<sup>18</sup>F]-fluorodeoxyglucose (FDG)-PET in 14 essential tremor patients undergoing thalamic deep brain stimulation (DBS) to identify stimulation-induced and tremor related regional metabolic changes in a within-subject design and combined this with normative connectome results. Stimulation increased metabolism in motor cortical and cerebellar regions - key hubs of the previously proposed tremor treatment network as derived from normative functional connectivity. Importantly, individual alignment with this network predicted clinical tremor improvement (<i>R</i><sup><i>2</i></sup> = 0.593, <i>p</i> = 0.007). These same regions showed higher metabolism during tremor expression in the untreated condition, suggesting overlap between the circuits involved in symptom generation and therapeutic response. These findings support indirect connectome-based models by linking them to brain glucose metabolism changes and suggest that DBS relieves tremor by modulating the same circuit that underlies symptom expression.</p>

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Converging metabolic and functional networks for tremor expression and deep brain stimulation-mediated control

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Benedikt Weigl,
  • Regina Pistorius,
  • Joachim Brumberg,
  • Nicoló G. Pozzi,
  • Andreas Buck,
  • Muthuraman Muthuraman,
  • Ioannis U. Isaias,
  • Jens Volkmann,
  • Juho Joutsa,
  • Martin M. Reich

摘要

Emerging evidence indicates that movement disorders arise from symptom-specific rather than disease-specific brain network dysfunctions that can be influenced through targeted neuromodulation. Such networks are widely mapped using normative connectome analyses from lesion and stimulation sites. Here, we used [18F]-fluorodeoxyglucose (FDG)-PET in 14 essential tremor patients undergoing thalamic deep brain stimulation (DBS) to identify stimulation-induced and tremor related regional metabolic changes in a within-subject design and combined this with normative connectome results. Stimulation increased metabolism in motor cortical and cerebellar regions - key hubs of the previously proposed tremor treatment network as derived from normative functional connectivity. Importantly, individual alignment with this network predicted clinical tremor improvement (R2 = 0.593, p = 0.007). These same regions showed higher metabolism during tremor expression in the untreated condition, suggesting overlap between the circuits involved in symptom generation and therapeutic response. These findings support indirect connectome-based models by linking them to brain glucose metabolism changes and suggest that DBS relieves tremor by modulating the same circuit that underlies symptom expression.