Lenka Abhishek, Bhalsing Ketaki Swapnil, Panda Rajanikant, Jhunjhunwala Ketan, Naduthota Rajini M, Saini Jitender, Bharath Rose Dawn, Yadav Ravi, Pal Pramod Kumar
Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India.
Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India.
Neuroradiology. 2017 Feb;59(2):157-168. doi: 10.1007/s00234-016-1771-1. Epub 2017 Jan 6.
Essential tremor (ET) is the most common movement disorder among adults. Although ET has been recognized as a mono-symptomatic benign illness, reports of non-motor symptoms and non-tremor motor symptoms have increased its clinical heterogeneity. The neural correlates of ET are not clearly understood. The aim of this study was to understand the neurobiology of ET using resting state fMRI.
Resting state functional MR images of 30 patients with ET and 30 age- and gender-matched healthy controls were obtained. The functional connectivity of the two groups was compared using whole-brain seed-to-voxel-based analysis.
The ET group had decreased connectivity of several cortical regions especially of the primary motor cortex and the primary somatosensory cortex with several right cerebellar lobules compared to the controls. The thalamus on both hemispheres had increased connectivity with multiple posterior cerebellar lobules and vermis. Connectivity of several right cerebellar seeds with the cortical and thalamic seeds had significant correlation with an overall score of Fahn-Tolosa-Marin tremor rating scale (FTM-TRS) as well as the subscores for head tremor and limb tremor.
Seed-to-voxel resting state connectivity analysis revealed significant alterations in the cerebello-thalamo-cortical network in patients with ET. These alterations correlated with the overall FTM scores as well as the subscores for limb tremor and head tremor in patients with ET. These results further support the previous evidence of cerebellar pathology in ET.
特发性震颤（ET）是成年人中最常见的运动障碍。尽管ET一直被认为是一种单症状良性疾病，但关于非运动症状和非震颤性运动症状的报道增加了其临床异质性。ET的神经关联尚不清楚。本研究的目的是利用静息态功能磁共振成像（fMRI）了解ET的神经生物学。
获取了30例ET患者和30例年龄及性别匹配的健康对照者的静息态功能磁共振图像。使用基于全脑种子点到体素的分析方法比较两组的功能连接性。
与对照组相比，ET组的几个皮质区域，特别是初级运动皮质和初级体感皮质与右侧几个小脑小叶的连接性降低。双侧丘脑与多个后小脑小叶和小脑蚓部的连接性增加。右侧几个小脑种子点与皮质和丘脑种子点的连接性与法恩-托洛萨-马林震颤评分量表（FTM-TRS）的总分以及头部震颤和肢体震颤的子评分显著相关。
基于种子点到体素的静息态连接性分析显示，ET患者的小脑-丘脑-皮质网络存在显著改变。这些改变与ET患者的FTM总分以及肢体震颤和头部震颤的子评分相关。这些结果进一步支持了先前关于ET中小脑病理学的证据。
