Tremor in multiple sclerosis is associated with cerebello-thalamic pathology

Area of Science:

• Neuroscience
• Neurology
• Radiology

Background:

• Tremor is a common and disabling symptom in multiple sclerosis (MS).
• The underlying pathophysiology of MS-related tremor is not fully understood.
• Structural brain changes may contribute to tremor severity.

Purpose of the Study:

• To investigate the relationship between clinical tremor severity and specific structural magnetic resonance imaging (MRI) parameters in MS patients.
• To identify brain regions associated with tremor in MS.

Main Methods:

• Eleven patients with definite MS and upper limb tremor were assessed.
• Tremor severity was measured using the Bain score.
• Thalamic volume and superior cerebellar peduncle (SCP) cross-sectional area were quantified using MRI.
• Lesion presence and volume were analyzed.

Main Results:

• Right thalamic volume negatively correlated with overall tremor severity.
• Left thalamic volume correlated negatively with general and writing tremor severity.
• Right SCP cross-sectional area negatively correlated with writing tremor severity.
• Patients with contralateral thalamic lesions had higher Archimedes spiral scores.

Conclusions:

• Degeneration in the cerebello-thalamic pathway is implicated in MS tremor.
• Thalamic volume and SCP integrity are associated with tremor severity.
• MRI parameters can help elucidate the mechanisms of MS tremor.