Goede Lukas L, Al-Fatly Bassam, Li Ningfei, Sobesky Leon K, Bahners Bahne H, Zvarova Patricia, Neudorfer Clemens, Reich Martin, Volkmann Jens, Zhang Chencheng, Odekerken Vincent J J, de Bie Rob M A, Younger Ellen F P, Corp Daniel T, Middlebrooks Erik H, Joutsa Juho, Dirkx Michiel, Deuschl Günther, Helmich Rick C, Kühn Andrea A, Fox Michael D, Horn Andreas
Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
Nat Commun. 2025 May 22;16(1):4772. doi: 10.1038/s41467-025-60089-6.
Tremor occurs in various forms across diverse neurological disorders, including Parkinson's disease and essential tremor. While clinically heterogeneous, converging evidence suggests a shared brain network may underlie tremor across conditions. Here, we empirically define such a network using four modalities: lesion locations, atrophy patterns, EMG-fMRI, and deep brain stimulation outcomes. We show that network connectivity robustly explains clinical outcomes in independent cohorts undergoing deep brain stimulation of the subthalamic nucleus for Parkinson's disease and the ventral intermediate nucleus for essential tremor. Maps from each cohort accounted for outcomes in the respective other, supporting a disorder-independent tremor network. A multimodal agreement map revealed consistent substrates in the primary motor cortex and motor cerebellum. To validate the network, we test its predictive power in a third, independent cohort treated with pallidal stimulation for Parkinson's disease. Our findings define a robust, cross-condition tremor network that may guide both invasive and noninvasive neuromodulation strategies.
震颤在多种神经系统疾病中以不同形式出现,包括帕金森病和特发性震颤。虽然临床上存在异质性,但越来越多的证据表明,不同疾病状态下的震颤可能有一个共同的脑网络作为基础。在这里,我们通过四种方式实证性地定义了这样一个网络:病变位置、萎缩模式、肌电图-功能磁共振成像以及脑深部电刺激结果。我们表明,网络连接性有力地解释了在接受丘脑底核脑深部电刺激治疗帕金森病和腹中间核脑深部电刺激治疗特发性震颤的独立队列中的临床结果。每个队列的图谱都能解释另一个队列的结果,支持了一个与疾病无关的震颤网络。一个多模态一致性图谱揭示了初级运动皮层和运动小脑存在一致的基质。为了验证该网络,我们在接受苍白球刺激治疗帕金森病的第三个独立队列中测试了其预测能力。我们的研究结果定义了一个强大的、跨疾病状态的震颤网络,这可能会指导侵入性和非侵入性神经调节策略。