Modulations of thalamo-cortical coupling during voluntary movement in patients with essential tremor

The ventral intermediate nucleus of the thalamus (VIM) is the main thalamic hub for cerebellar inputs and the primary deep brain stimulation target in essential tremor (ET). As such, it presumably plays a critical role in motor control. However, this structure is rarely studied in humans, and existing studies mostly focus on tremor. Here, we studied neural oscillations in the VIM and their coupling to cortical oscillations during voluntary movement. We investigated thalamo-cortical coupling, combining recordings of thalamic local field potentials and magnetoencephalography, in 10 ET patients with externalized deep brain stimulation electrodes. During the recording, patients repeatedly pressed a button in response to a visual cue. In a whole-brain analysis of VIM-cortex coherence, we contrasted activity during pre-movement baseline and button pressing. Button pressing was associated with a bilateral decrease of thalamic alpha (8-12 Hz) and beta (13-21 Hz) power and a contralateral gamma (35-90 Hz) power increase. Alpha/low-beta (8-20 Hz) coherence decreased during movement. This effect localized to the supplementary motor area and premotor cortex. A high-beta (21-35 Hz) coherence increase occurred in the same region but was more focal than the suppression. Pre-movement levels of thalamo-cortex low-beta coherence correlated with reaction time. Our results demonstrate that voluntary movement is associated with modulations of behaviourally relevant thalamic coupling, primarily to premotor areas. We observed a clear distinction between low- and high-beta frequencies and our results suggest that the concept of "antikinetic" beta oscillations, originating from research on Parkinson's disease, is transferable to ET.