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特发性震颤患者皮质下容积异常的临床相关性。

Clinical correlates of abnormal subcortical volumes in Essential Tremor.

机构信息

Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, Karnataka, 560029, India.

Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, Karnataka, 560029, India.

出版信息

J Neural Transm (Vienna). 2019 May;126(5):569-576. doi: 10.1007/s00702-019-02004-0. Epub 2019 Apr 20.

Abstract

Essential tremor (ET) is considered to be a neurodegenerative disorder and it is plausible that the observed motor and non-motor symptoms may be attributable to functional alterations secondary to abnormalities of subcortical nuclei. This study aims to compare the volumes of subcortical nuclei in patients with ET to ascertain neuroimaging correlates of motor and non-motor features of ET. Forty patients of ET and 40 age- and gender-matched healthy controls (HC) were enrolled in this study. Tremor severity was quantified with the Fahn-Tolosa-Marin tremor rating scale. Patients of ET with and without a rest tremor were also compared. Structural imaging was performed on a 3T scanner, and volumes of subcortical structures were obtained using Freesurfer. There was no difference in total brain volume between ET and HC. However, compared to HC, significantly lower volumes of bilateral thalamus, hippocampus, and ventral diencephalon were observed in patients with ET. A significantly higher volume was observed in the right caudate nucleus, pallidum, amygdala, and bilateral putamen, and nucleus accumbens. No difference was observed between patients of ET with and without a rest tremor. Patients with ET have significant alterations in volumes of subcortical nuclei, which are not limited to the motor domain and include structures involved in cognitive and behavioral functions. These results add to the growing concept of a neurodegenerative pathophysiology of ET with abnormalities extending beyond the cerebellum.

摘要

特发性震颤(ET)被认为是一种神经退行性疾病,观察到的运动和非运动症状可能归因于皮质下核异常引起的功能改变。本研究旨在比较 ET 患者的皮质下核体积,以确定 ET 的运动和非运动特征的神经影像学相关性。本研究纳入了 40 名 ET 患者和 40 名年龄和性别匹配的健康对照者(HC)。震颤严重程度采用 Fahn-Tolosa-Marin 震颤评定量表进行量化。还比较了有无静止性震颤的 ET 患者。在 3T 扫描仪上进行结构成像,并使用 Freesurfer 获得皮质下结构的体积。ET 组和 HC 组的总脑容量无差异。然而,与 HC 相比,ET 患者双侧丘脑、海马和腹侧间脑的体积明显较小。右侧尾状核、苍白球、杏仁核和双侧壳核、伏隔核的体积明显较高。有无静止性震颤的 ET 患者之间无差异。ET 患者的皮质下核体积存在明显改变,不仅限于运动域,还包括涉及认知和行为功能的结构。这些结果增加了 ET 的神经退行性病理生理学概念,异常不仅局限于小脑。

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