Department of Neurology, Bezmialem Foundation University School of Medicine, Bezmialem Foundation University, Istanbul, Turkey.
Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.
Int J Neurosci. 2022 Feb;132(2):154-164. doi: 10.1080/00207454.2020.1803859. Epub 2020 Aug 6.
Essential tremor (ET) is disease with both motor and non-motor features. Notable among the non-motor features is cognitive impairment. While this impairment has been attributed to cortico-thalamo-cerebellar pathway pathology, it is likely that a more complicated involvement of brain structures underlies cognitive function in ET.
To evaluate the brain microstructural changes of both white matter and grey matter in ET using region of interest based diffusion tensor imaging (DTI), and to correlate these changes with cognitive function assessed during detailed neuropsychological testing.
Thirty-five non-demented ET patients with a range of cognitive function (Clinical Dementia Rating = 0-0.5, mean age = 57.5 ± 16.7 years, age range = 23-76 years) underwent a comprehensive neuropsychological evaluation and brain magnetic resonance imaging, including DTI. DTI findings were reported as fractional anisotropy, average diffusion coefficient, these values were evaluated for 32 ROIs. Cognitive domains included attention, visuospatial functions, executive function, verbal memory, visual memory, and language. Domain Z-scores were calculated each cognitive domain and compared for each brain region.
Microstructural changes in prefrontal cortical areas (dorsolateral, ventrolateral), paralimbic and limbic structures (posterior cingulate cortex, precuneus, hippocampus), basal ganglia (substantia nigra, putamen, caudate nucleus) and white matter bundles (corpus callosum, anterior thalamic radiation, longitudinal fasciculus, frontooccipital fasciculus, etc.) correlated with specific domains of cognitive function in ET patients.
These data suggest that not only the cerebello thalamocortical pathway, but numerous other brain structures are related to level of cognitive performance and possibly underlie cognitive dysfunction in ET.
特发性震颤（ET）是一种既有运动症状又有非运动症状的疾病。在非运动症状中，认知障碍较为突出。虽然这种损害归因于皮质-丘脑-小脑通路的病理学，但更复杂的脑结构参与可能是 ET 认知功能的基础。
使用基于感兴趣区的弥散张量成像（DTI）评估 ET 患者的白质和灰质的脑微观结构变化，并将这些变化与详细神经心理学测试评估的认知功能相关联。
35 名非痴呆 ET 患者，认知功能范围广泛（临床痴呆评定=0-0.5，平均年龄=57.5±16.7 岁，年龄范围 23-76 岁），接受了全面的神经心理学评估和脑部磁共振成像，包括 DTI。DTI 结果报告为各向异性分数、平均扩散系数，这些值评估了 32 个 ROI。认知领域包括注意力、视空间功能、执行功能、言语记忆、视觉记忆和语言。为每个认知域计算了域 Z 分数，并比较了每个脑区的分数。
前额皮质区域（背外侧、腹外侧）、边缘和边缘结构（后扣带回、楔前叶、海马）、基底节（黑质、壳核、尾状核）和白质束（胼胝体、前丘脑辐射、纵束、额枕束等）的微观结构变化与 ET 患者特定的认知功能域相关。
这些数据表明，不仅是小脑-丘脑-皮质通路，而且许多其他脑结构与认知表现水平相关，可能是 ET 认知功能障碍的基础。
