Chang M H, Chang T W, Lai P H, Sy C G
Section of Neurology, Veterans General Hospital-Kaohsiung, Taiwan.
J Neurol Sci. 1995 Jun;130(2):215-9. doi: 10.1016/0022-510x(95)00033-x.
Resting tremor is one of the characteristic features of Parkinson's disease. However, there are a number of patients who typically have resting tremor alone for at least 5 years without development of other parkinsonian signs or symptoms. The etiology of an isolated resting tremor is still obscure. Recently, positron emission tomography was used to study these patients with isolated resting tremor, and demonstrated a markedly decreased striatal uptake of fluoro-dopa to the range of Parkinson's disease. These findings suggested the existence of a separate subtype, namely, tremulous Parkinson's disease with a manifestation of resting tremor alone. In order to confirm the existence of this subgroup of tremulous Parkinson's disease and further investigate its morphological changes and the usefulness of magnetic resonance imaging, we collected 5 patients who typically have resting tremor for at least 8 years in the absence of other features of Parkinson's disease. MRI was performed and the results of the images showed typical findings of Parkinson's disease with smudging or decreased distance between substantia nigra and red nucleus. Quantitative analysis also demonstrated a significant decrease of the above-noted distance when the resting tremor group was compared to the essential tremor group. Therefore, patients with an isolated resting tremor can have morphological abnormalities in addition to functional disturbances shown by positron emission tomography. To our knowledge, this is the first paper to report that resting tremor is a variant of Parkinson's disease rather than essential tremor, by using a double-blind method, with magnetic resonance imaging to support.
静止性震颤是帕金森病的特征性表现之一。然而，有许多患者通常仅出现静止性震颤至少5年，而未出现其他帕金森病体征或症状。孤立性静止性震颤的病因仍不清楚。最近，正电子发射断层扫描被用于研究这些孤立性静止性震颤患者，结果显示纹状体对氟多巴的摄取明显降低，降至帕金森病的水平。这些发现提示存在一种单独的亚型，即仅表现为静止性震颤的震颤型帕金森病。为了证实这种震颤型帕金森病亚组的存在，并进一步研究其形态学变化以及磁共振成像的作用，我们收集了5例通常有静止性震颤至少8年且无帕金森病其他特征的患者。进行了磁共振成像检查，图像结果显示出帕金森病的典型表现，即黑质与红核之间有模糊或距离减小。定量分析还表明，与特发性震颤组相比，静止性震颤组上述距离显著减小。因此，孤立性静止性震颤患者除了有正电子发射断层扫描显示的功能障碍外，还可能存在形态学异常。据我们所知，本文是第一篇通过双盲方法并借助磁共振成像支持来报道静止性震颤是帕金森病的一种变异型而非特发性震颤的论文。
