Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Cerebellum. 2024 Oct;23(5):2060-2081. doi: 10.1007/s12311-024-01699-6. Epub 2024 May 18.
Substantial evidence highlights the role of the cerebellum in the pathophysiology of tremor in essential tremor (ET), although its potential involvement in altered movement execution in this condition remains unclear. This study aims to explore potential correlations between the cerebellum and basal ganglia functional connectivity and voluntary movement execution abnormalities in ET, objectively assessed with kinematic techniques. A total of 20 patients diagnosed with ET and 18 healthy subjects were enrolled in this study. Tremor and repetitive finger tapping were recorded using an optoelectronic kinematic system. All participants underwent comprehensive 3T-MRI examinations, including 3D-T1 and blood-oxygen-level dependent (BOLD) sequences during resting state. Morphometric analysis was conducted on the 3D-T1 images, while a seed-based analysis was performed to investigate the resting-state functional connectivity (rsFC) of dorsal and ventral portions of the dentate nucleus and the external and internal segments of the globus pallidus. Finally, potential correlations between rsFC alterations in patients and clinical as well as kinematic scores were assessed. Finger tapping movements were slower in ET than in healthy subjects. Compared to healthy subjects, patients with ET exhibited altered FC of both dentate and globus pallidus with cerebellar, basal ganglia, and cortical areas. Interestingly, both dentate and pallidal FC exhibited positive correlations with movement velocity in patients, differently from that we observed in healthy subjects, indicating the higher the FC, the faster the finger tapping. The findings of this study indicate the possible role of both cerebellum and basal ganglia in the pathophysiology of altered voluntary movement execution in patients with ET.
大量证据强调了小脑在原发性震颤（ET）震颤病理生理学中的作用，尽管其在这种情况下改变运动执行中的潜在作用仍不清楚。本研究旨在探索 ET 中小脑和基底节功能连接与自愿运动执行异常之间的潜在相关性，这些异常通过运动技术客观评估。共纳入 20 名 ET 患者和 18 名健康对照者。使用光电运动系统记录震颤和重复手指敲击。所有参与者均接受了全面的 3T-MRI 检查，包括静息状态下的 3D-T1 和血氧水平依赖（BOLD）序列。对 3D-T1 图像进行形态计量分析，并进行基于种子的分析，以研究齿状核背侧和腹侧以及苍白球外和内节的静息状态功能连接（rsFC）。最后，评估了 rsFC 改变与患者临床和运动学评分之间的潜在相关性。与健康对照组相比，ET 患者的手指敲击运动速度较慢。与健康对照组相比，ET 患者的齿状核和苍白球的 FC 发生改变，与小脑、基底节和皮质区域相关。有趣的是，齿状核和苍白球的 FC 与患者的运动速度呈正相关，这与我们在健康对照组中观察到的不同，表明 FC 越高，手指敲击速度越快。这项研究的结果表明，小脑和基底节可能在 ET 患者自愿运动执行异常的病理生理学中发挥作用。
