Quattrone A, Cerasa A, Messina D, Nicoletti G, Hagberg G E, Lemieux L, Novellino F, Lanza P, Arabia G, Salsone M
Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy.
AJNR Am J Neuroradiol. 2008 Oct;29(9):1692-7. doi: 10.3174/ajnr.A1190. Epub 2008 Jul 24.
Our aim was to investigate the presence of brain gray matter (GM) abnormalities in patients with different forms of essential tremor (ET).
We used optimized voxel-based morphometry (VBM) and manually traced single region-of-interest analysis in 50 patients with familial ET and in 32 healthy subjects. Thirty patients with ET had tremor of the arms (a-ET), whereas the remaining 20 patients had both arm and head tremor (h-ET).
VBM showed marked atrophy of the cerebellar vermis in the patients with h-ET with respect to healthy subjects (P(corrected) < .001). Patients with a-ET showed a trend toward a vermal GM volume loss that did not reach a significant difference with respect to healthy controls (P(uncorrected) < .01). The region-of-interest analysis showed a reduction of the cerebellar volume (CV) in the h-ET group (98.2 +/- 13.6 mm(3)) compared with healthy controls (110.5 +/- 15.5 mm(3), P < .012) as well as in the entire vermal area (790.3 +/- 94.5 mm(2), 898.6 +/- 170.6 mm(2), P < .04 in h-ET and control groups, respectively).
Atrophy of the cerebellar vermis detected in patients with h-ET strongly supports the evidence for the involvement of the cerebellum in the pathophysiology of ET. The lack of a significant CV loss observed in patients with a-ET suggests that a-ET and h-ET might represent distinct subtypes of the same disease.
我们的目的是研究不同形式特发性震颤（ET）患者脑灰质（GM）异常情况。
我们对50例家族性ET患者和32名健康受试者采用优化的基于体素的形态学测量（VBM）及手动追踪单个感兴趣区域分析。30例ET患者有手臂震颤（a-ET），其余20例患者既有手臂震颤又有头部震颤（h-ET）。
VBM显示，与健康受试者相比，h-ET患者的小脑蚓部明显萎缩（校正P值<.001）。a-ET患者显示出小脑蚓部GM体积减少的趋势，但与健康对照相比未达到显著差异（未校正P值<.01）。感兴趣区域分析显示，与健康对照（110.5±15.5mm³）相比，h-ET组小脑体积（CV）减小（98.2±13.6mm³，P<.012），整个蚓部区域也减小（分别为790.3±94.5mm²和898.6±170.6mm²，h-ET组和对照组P<.04）。
h-ET患者中检测到的小脑蚓部萎缩有力地支持了小脑参与ET病理生理学的证据。a-ET患者未观察到明显的CV损失，这表明a-ET和h-ET可能代表同一疾病的不同亚型。
