Department of Neurology, National Institute of Clinical Neurosciences, Amerikai út 57, Budapest, 1145, Hungary.
János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Üllői út 26., Budapest, 1085, Hungary.
Cerebellum. 2019 Aug;18(4):705-720. doi: 10.1007/s12311-019-01027-3.
It is a clinical experience that acute lesions of the cerebellum induce pathological tremor, which tends to improve. However, quantitative characteristics, imaging correlates, and recovery of cerebellar tremor have not been systematically investigated. We studied the prevalence, quantitative parameters measured with biaxial accelerometry, and recovery of pathological tremor in 68 patients with lesions affecting the cerebellum. We also investigated the correlation between the occurrence and characteristics of tremor and lesion localization using 3D T1-weighted MRI images which were normalized and segmented according to a spatially unbiased atlas template for the cerebellum. Visual assessment detected pathological tremor in 19% while accelerometry in 47% of the patients. Tremor was present both in postural and intentional positions, but never at rest. Two types of pathological tremor were distinguished: (1) low-frequency tremor in 36.76% of patients (center frequency 2.66 ± 1.17 Hz) and (2) normal frequency-high-intensity tremor in 10.29% (center frequency 8.79 ± 1.43 Hz). The size of the lesion did not correlate with the presence or severity of tremor. Involvement of the anterior lobe and lobule VI was related to high tremor intensity. In all followed up patients with acute cerebellar ischemia, the tremor completely recovered within 8 weeks. Our results indicate that cerebellar lesions might induce pathological postural and intentional tremor of 2-3 Hz frequency. Due to its low frequency and low amplitude, quantitative tremorometry is neccessary to properly identify it. There is no tight correlation between lesion localization and quantitative characteristics of cerebellar tremor.
这是一种临床经验，即小脑的急性病变会引起病理性震颤，且这种震颤往往会有所改善。然而，小脑震颤的定量特征、影像学相关性和恢复情况尚未得到系统研究。我们研究了影响小脑的病变患者中病理性震颤的患病率、双轴加速计测量的定量参数以及恢复情况。我们还使用根据小脑的空间无偏图谱模板进行归一化和分割的 3D T1 加权 MRI 图像，研究了震颤的发生和特征与病变定位之间的相关性。视觉评估发现 19%的患者存在病理性震颤，而加速计则发现 47%的患者存在病理性震颤。震颤既存在于姿势位，也存在于意向位，但从不静止出现。区分出两种类型的病理性震颤：（1）低频震颤，占 36.76%的患者（中心频率 2.66±1.17 Hz）；（2）正常频率-高强度震颤，占 10.29%（中心频率 8.79±1.43 Hz）。病变的大小与震颤的存在或严重程度无关。前叶和 VI 小叶的受累与高震颤强度有关。在所有随访的急性小脑缺血患者中，震颤在 8 周内完全恢复。我们的结果表明，小脑病变可能引起 2-3 Hz 频率的病理性姿势性和意向性震颤。由于其频率低、幅度小，需要定量震颤计才能正确识别。病变定位与小脑震颤的定量特征之间没有紧密的相关性。
