Fig. 1: Lesion-derived tremor-relief map connectivity correlates with clinical improvement in deep brain stimulation (DBS) cohorts.
A The panel illustrates 11 published cases of patients who experienced tremor alleviation following beneficial lesions due to stroke19. Using lesion network mapping, a tremor-relief network was identified (bottom). Colors represent the probability (p) of voxels associated with tremor relief. B Electrode localizations from subjects in the current study, with blue representing VIM patients and orange representing STN patients. The bottom plot shows a positive Spearman correlation (two-sided) between relative clinical improvement (measured as ratios of the maximum achievable score for UPDRS-III tremor scores or FTM) following DBS and each DBS electrode’s connectivity to the lesion network map. A cohort regressor was applied to control for potential confounding effects related to differences between patient groups. No adjustment for multiple comparisons was applied. The shaded area indicates the 95% confidence interval. The red circle highlights an example of a volume of activated tissue (VTA) with low connectivity, shown alongside an example with high connectivity (green circle) to the lesion network map in (C). Transversal and coronal slices from the BigBrain atlas were used61. Cerebellar flatmaps were created using the SUIT toolbox62. DBS Deep Brain Stimulation, FTM Fahn-Tolosa-Marin Tremor Rating Scale, GPi Globus pallidus internus, STN Subthalamic nucleus, UPDRS-III Unified Parkinson’s Disease Rating Scale, part III, VIM Ventral intermediate nucleus of the thalamus.
