Evaluation of Cerebral Volume Changes in Patients with Tremor Treated by MRgFUS Thalamotomy
, Emanuele Tommasino 3, Alessia Catalucci 4, Cristina Pastorelli 3, Francesco Borea 3, Giulia Caldarelli 3, Mattia Bellini 3, Pierfrancesco Badini 3, Sara Mancini 3, Chiara Santobuono 3, Saverio Martino 3, Valeria Pagliei 3, Guglielmo Manco 5, Davide Cerone 6, Francesca Pistoia 3, Pierpaolo Palumbo 2,7, Francesco Arrigoni 1, Ernesto Di Cesare 8, Carmine Marini 3, Antonio Barile 3, Alessandra Splendiani 3 and add
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Round 1
Reviewer 1 Report
Dear Authors,
the topic is very interesting. However, I recommend a careful analysis of the latest literature. Please consider comparing your results with other studies. Please clearly state the purpose of the study and present prospects for the future. Please add clear conclusions as a separate paragraph. The figures are illegible. Please improve their quality.
Author Response
R: thank you for your valuable comments and suggestion. We have added some details about the research background and the study hypotheses. We have added discussion of clinical findings and references to comparisons with current literature. We separated and expanded the conclusions paragraph by adding the limitations of the study. Regarding the image quality, we did not intend to show the content of the image results but only the graphical interface with the software usage features. However, we have replaced the image with a higher quality one.
Reviewer 2 Report
1. The authors should have clear description about the image analysis, especially the validation or references.
2. The authors did not provide a scientific interpretation about the results and the lack of the conclusion.
3. The authors should provide clear legend for figure and tables.
4. Considering the reduction of cerebellar cortex, is there any change of cerebellar function after treatment (balance, coordination and cognition)?
5. It would be interesting to know if the author separates the cerebellar cortex to ipislateral/contralateral side of lesion.
Author Response
- The authors should have clear description about the image analysis, especially the validation or references.
R: thank you for the suggestion, we added the details of the algorithm on wich the software is based and validated
- The authors did not provide a scientific interpretation about the results and the lack of the conclusion.
R: thank you for your valuable comment. As suggested also by R1, We have added some details about the research background and the study hypotheses. We have added discussion of clinical findings and references to comparisons with current literature. We separated and expanded the conclusions paragraph by adding the limitations of the study.
- The authors should provide clear legend for figure and tables.
R: thank you for the suggestion, figure and table legends are provided in the revised manuscript
- Considering the reduction of cerebellar cortex, is there any change of cerebellar function after treatment (balance, coordination and cognition)?
R: thank you for pointing this very interesting issue. We actualy haven’t described in the original manuscript that also motor complications, including those regarding balance and coordination, are evaluated and recorded during the follow-up. In the present study population, we did not observed any motor complication that could explain clinically the changes in cerebellar volumes
- It would be interesting to know if the author separates the cerebellar cortex to ipislateral/contralateral side of lesion.
R: thank you for your comment. This is an absolutely right observation. Unfortunately, the software we used in the present study only makes separate laterality analysis for supratentorial structures, while the cerebellar volumes are calculated in toto, without segmenting left and right hemispheres. However we know that most cerebellar neural pathways are bilateral and decussating, and this concept could partially address this limitation.
Round 2
Reviewer 1 Report
The authors responded to my recommendations.
Author Response
We sincerely thank the reviewers for their constructive comments
Reviewer 2 Report
Thanks for the responses from the authors. I would suggest the authors to add a paragraph about the limitations of the present study, especially regarding the lack of some crucial information I address, and the authors cannot provide.
Author Response
Thank you for your suggestion, we added a paragraph including the limitations previous highlighted.
