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Structural connectivity differences in essential tremor with and without resting tremor.

Maria Eugenia Caligiuri1, Gennarina Arabia2, Gaetano Barbagallo2

  • 1Institute of Molecular Bioimaging and Physiology (IBFM-CNR), National Research Council, Catanzaro, Italy.

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|July 22, 2017
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Summary

Essential tremor (ET) and resting tremor (rET) share altered cerebello-thalamo-precentral cortex connectivity. Resting tremor patients exhibit additional motor network damage, suggesting subtypes of a single neurodegenerative disorder.

Keywords:
Cerebello–thalamo–cortical damageDWIGlobus pallidusMRITremor

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Area of Science:

  • Neuroscience
  • Neurology
  • Neuroimaging

Background:

  • Essential tremor (ET) is a common movement disorder.
  • ET can present with or without resting tremor (rET).
  • The underlying structural changes in ET subtypes are not fully understood.

Purpose of the Study:

  • To investigate motor network structural differences between ET and rET patients.
  • To compare motor network connectivity in ET and rET patients versus healthy controls.
  • To elucidate the neuroanatomical basis of differing ET clinical presentations.

Main Methods:

  • Probabilistic tractography of the cerebello-thalamo-basal ganglia-cortical loop.
  • Diffusion-weighted MRI and DAT-SPECT in 25 ET, 22 rET, and 25 healthy controls.
  • Network mode tractography to reconstruct neural pathways.

Main Results:

  • All ET patients showed reduced cerebello-thalamo-precentral cortex connectivity compared to controls.
  • rET patients exhibited further reduced connectivity in the globus pallidus-caudate-supplementary motor area pathway.
  • This pathway damage in rET was contralateral to the most affected resting tremor side.

Conclusions:

  • ET and rET share common alterations in the cerebello-thalamo-precentral cortex circuit.
  • rET involves specific damage to additional motor network structures (globus pallidus, caudate, SMA).
  • Findings suggest ET and rET are distinct subtypes of the same neurodegenerative disorder.