Department of Medical and Surgical Sciences, Neuroscience Research Center, Magna Graecia University, viale Europa, Germaneto, 88100, Catanzaro, Italy.
Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100, Catanzaro, Italy.
J Neurol. 2022 Nov;269(11):6029-6035. doi: 10.1007/s00415-022-11291-9. Epub 2022 Jul 19.
Imaging studies investigating cerebellar gray matter (GM) in essential tremor (ET) showed conflicting results. Moreover, no large study explored the cerebellum in ET patients with resting tremor (rET), a syndrome showing enhanced blink reflex recovery cycle (BRrc).
To investigate cerebellar GM in ET and rET patients using voxel-based morphometry (VBM) analysis.
Seventy ET patients with or without resting tremor and 39 healthy controls were enrolled. All subjects underwent brain 3 T-MRI and BRrc recording. We compared the cerebellar GM volumes between ET (n = 40) and rET (n = 30) patients and controls through a VBM analysis. Moreover, we investigated possible correlations between cerebellar GM volume and R2 component of BRrc.
rET and ET patients had similar disease duration. All rET patients and none of ET patients had enhanced BRrc. No differences in the cerebellar volume were found when ET and rET patients were compared to each other or with controls. By considering together the two tremor syndromes in a large patient group, the VBM analysis showed bilateral clusters of reduced GM volumes in Crus II in comparison with controls. The linear regression analysis in rET patients revealed a cluster in the left Crus II where the decrease in GM volume correlated with the R2BRrc increase.
Our study suggests that ET and rET are different tremor syndromes with similar mild cerebellar gray matter involvement. In rET patients, the left Crus II may play a role in modulating the brainstem excitability, encouraging further studies on the role of cerebellum in these patients.
研究小脑灰质（GM）的影像学研究在特发性震颤（ET）中显示出相互矛盾的结果。此外，没有大型研究探讨静止性震颤（rET）的 ET 患者的小脑，rET 是一种显示眨眼反射恢复周期（BRrc）增强的综合征。
使用基于体素的形态测量学（VBM）分析研究 ET 和 rET 患者的小脑 GM。
纳入 70 名 ET 患者（伴或不伴静止性震颤）和 39 名健康对照者。所有受试者均行脑 3T-MRI 和 BRrc 记录。我们通过 VBM 分析比较 ET（n=40）和 rET（n=30）患者与对照组之间小脑 GM 体积的差异。此外，我们还研究了小脑 GM 体积与 BRrc 的 R2 成分之间的可能相关性。
rET 和 ET 患者的疾病持续时间相似。所有 rET 患者和 ET 患者均无增强的 BRrc。与对照组相比，rET 和 ET 患者之间或与对照组相比，小脑体积无差异。通过将两种震颤综合征纳入大型患者组进行考虑，VBM 分析显示与对照组相比，Crus II 的双侧 GM 体积减少簇。在 rET 患者中，线性回归分析显示左侧 Crus II 中 GM 体积的减少与 R2BRrc 的增加相关。
我们的研究表明，ET 和 rET 是不同的震颤综合征，具有相似的轻度小脑灰质受累。在 rET 患者中，左侧 Crus II 可能在调节脑干兴奋性方面发挥作用，鼓励对这些患者的小脑作用进行进一步研究。
