Filip Pavel, Burdová Kristína, Valenta Zdeněk, Jech Robert, Kokošová Viktória, Baláž Marek, Mangia Silvia, Michaeli Shalom, Bareš Martin, Vojtíšek Lubomír
Department of Neurology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic; Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, USA.
Department of Neurology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
Parkinsonism Relat Disord. 2022 Feb;95:28-34. doi: 10.1016/j.parkreldis.2021.12.014. Epub 2021 Dec 23.
Despite substantial clinical and pathophysiological differences, the characteristics of tremor in Parkinson's disease (PD) and essential tremor (ET) patients bear certain similarities. The presented study delineates tremor-related structural networks in these two disorders.
42 non-advanced PD patients (18 tremor-dominant, 24 without substantial tremor), 17 ET, and 45 healthy controls underwent high-angular resolution diffusion-weighted imaging acquisition to reconstruct their structural motor connectomes as a proxy of the anatomical interconnections between motor network regions, implementing state-of-the-art globally optimised probabilistic tractography.
When compared to healthy controls, ET patients exhibited higher structural connectivity in the cerebello-thalamo-cortical network. Interestingly, the comparison of tremor-dominant PD patients and PD patients without tremor yielded very similar results - higher structural connectivity in tremor-dominant PD sharing multiple nodes with the tremor network detected in ET, despite the generally lower structural connectivity between basal ganglia and frontal cortex in the whole PD group when compared to healthy controls.
The higher structural connectivity of the cerebello-thalamo-cortical network seems to be the dominant tremor driver in both PD and ET. While it appears to be the only tremor-related network in ET, its combination with large scale hypoconnectivity in the frontal cortico-subcortical network in PD may explain different clinical features of tremor in these two disorders.
尽管帕金森病（PD）和特发性震颤（ET）患者在临床和病理生理方面存在显著差异，但他们震颤的特征仍有一定相似之处。本研究描绘了这两种疾病中与震颤相关的结构网络。
42例非晚期PD患者（18例震颤为主型，24例无明显震颤）、17例ET患者和45名健康对照者接受了高角分辨率扩散加权成像采集，以重建其结构运动连接组，作为运动网络区域之间解剖学连接的替代指标，采用了最先进的全局优化概率纤维束成像技术。
与健康对照者相比，ET患者在小脑-丘脑-皮质网络中表现出更高的结构连接性。有趣的是，震颤为主型PD患者与无震颤的PD患者的比较产生了非常相似的结果——震颤为主型PD患者的结构连接性更高，与ET中检测到的震颤网络共享多个节点，尽管整个PD组中基底神经节与额叶皮质之间的结构连接性总体上低于健康对照者。
小脑-丘脑-皮质网络较高的结构连接性似乎是PD和ET中震颤的主要驱动因素。虽然它似乎是ET中唯一与震颤相关的网络，但它与PD中额叶皮质-皮质下网络的大规模低连接性相结合，可能解释了这两种疾病中震颤的不同临床特征。
