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000888240 1001_ $$00000-0003-0749-3840$$aPetry‐Schmelzer, Jan Niklas$$b0$$eCorresponding author
000888240 245__ $$aNetwork fingerprint of stimulation‐induced speech impairment in essential tremor
000888240 260__ $$aHoboken, NJ$$bWiley-Blackwell$$c2021
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000888240 520__ $$aObjectiveThis study was undertaken to gain insights into structural networks associated with stimulation‐induced dysarthria (SID) and to predict stimulation‐induced worsening of intelligibility in essential tremor patients with bilateral thalamic deep brain stimulation (DBS).MethodsMonopolar reviews were conducted in 14 essential tremor patients. Testing included determination of SID thresholds, intelligibility ratings, and a fast syllable repetition task. Volumes of tissue activated (VTAs) were calculated to identify discriminative fibers for stimulation‐induced worsening of intelligibility in a structural connectome. The resulting fiber‐based atlas structure was then validated in a leave‐one‐out design.ResultsFibers determined as discriminative for stimulation‐induced worsening of intelligibility were mainly connected to the ipsilateral precentral gyrus as well as to both cerebellar hemispheres and the ipsilateral brain stem. In the thalamic area, they ran laterally to the thalamus and posteromedially to the subthalamic nucleus, in close proximity, mainly anterolaterally, to fibers beneficial for tremor control as published by Al‐Fatly et al in 2019. The overlap of the respective clinical stimulation setting's VTAs with these fibers explained 62.4% (p < 0.001) of the variance of stimulation‐induced change in intelligibility in a leave‐one‐out analysis.InterpretationThis study demonstrates that SID in essential tremor patients is associated with both motor cortex and cerebellar connectivity. Furthermore, the identified fiber‐based atlas structure might contribute to future postoperative programming strategies to achieve optimal tremor control without speech impairment in essential tremor patients with thalamic DBS. ANN NEUROL 2021;89:315–326
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000888240 7001_ $$0P:(DE-HGF)0$$aJergas, Hannah$$b1
000888240 7001_ $$0P:(DE-HGF)0$$aThies, Tabea$$b2
000888240 7001_ $$0P:(DE-HGF)0$$aSteffen, Julia K.$$b3
000888240 7001_ $$0P:(DE-HGF)0$$aReker, Paul$$b4
000888240 7001_ $$0P:(DE-HGF)0$$aDafsari, Haidar S.$$b5
000888240 7001_ $$0P:(DE-HGF)0$$aMücke, Doris$$b6
000888240 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon R.$$b7$$ufzj
000888240 7001_ $$0P:(DE-HGF)0$$aVisser‐Vandewalle, Veerle$$b8
000888240 7001_ $$00000-0001-7023-146X$$aDembek, Till A.$$b9
000888240 7001_ $$0P:(DE-Juel1)131613$$aBarbe, Michael T.$$b10
000888240 773__ $$0PERI:(DE-600)2037912-2$$a10.1002/ana.25958$$gp. ana.25958$$n2$$p315-326$$tAnnals of neurology$$v89$$x1531-8249$$y2021
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