Sarica Alessia, Gramigna Vera, Arcuri Fulvia, Crasà Marianna, Calomino Camilla, Nisticò Rita, Bianco Maria Giovanna, Quattrone Andrea, Quattrone Aldo
Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, 88100, Catanzaro, Italy.
Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, 88100, Catanzaro, Italy; Institute of Neurology, Magna Graecia University, Catanzaro, Italy.
Neuroimage Clin. 2025;45:103734. doi: 10.1016/j.nicl.2025.103734. Epub 2025 Jan 11.
Essential Tremor (ET) is characterized by action tremor often associated with resting tremor (rET). Although previous studies have identified widespread brain white matter (WM) alterations in ET patients, differences between ET and rET have been less explored. In this study we employed differential tractography to investigate WM microstructural alterations in these tremor disorders. We conducted a Diffusion Tensor Imaging (DTI) study on age- and sex-matched cohorts: 25 healthy controls (HC), 30 ET, and 30 rET patients. Differential tractography using DSI Studio was employed to pairwise compare fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) among cohorts. ET and rET patients compared to HC exhibited similar widespread MD increase especially in basal ganglia and brainstem projections. WM changes were more pronounced in the left cerebral hemisphere and cerebellum (crus I and II) in ET, while in rET patients WM alterations were prevalent in right cerebral hemisphere and cerebellum crus I. Small FA decrease was found in rET but not in ET patients. ET patients showed changes in the left non-decussating dentato-rubro-thalamic tract (ndDRTT), whereas rET patients showed changes in both left ndDRTT and right decussating DRTT. In conclusion, our findings confirmed the DRTT involvement in essential tremor and demonstrated that ET and rET exhibited similar microstructural WM changes in the brain, with different hemispheric involvement-greater on the left side in ET and on the right side in rET-suggesting that these tremor disorders may be distinct subtypes of the same disease.
特发性震颤（ET）的特征是动作性震颤，常伴有静止性震颤（rET）。尽管先前的研究已经确定ET患者存在广泛的脑白质（WM）改变，但ET与rET之间的差异较少被探讨。在本研究中，我们采用差异纤维束成像来研究这些震颤疾病中的WM微观结构改变。我们对年龄和性别匹配的队列进行了扩散张量成像（DTI）研究：25名健康对照者（HC）、30名ET患者和30名rET患者。使用DSI Studio进行差异纤维束成像，以成对比较各队列之间的分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）。与HC相比，ET和rET患者表现出相似的广泛MD增加，尤其是在基底神经节和脑干投射区域。ET患者的左侧大脑半球和小脑（小脑脚I和II）的WM变化更为明显，而rET患者的右侧大脑半球和小脑脚I的WM改变更为普遍。在rET患者中发现了小的FA降低，而ET患者中未发现。ET患者左侧非交叉的齿状核-红核-丘脑束（ndDRTT）有变化，而rET患者左侧ndDRTT和右侧交叉的DRTT均有变化。总之，我们的研究结果证实了DRTT参与特发性震颤，并表明ET和rET在大脑中表现出相似的微观结构WM变化，但半球受累不同——ET中左侧更明显，rET中右侧更明显——这表明这些震颤疾病可能是同一种疾病的不同亚型。
