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Exploring White Matter Microstructure with Symptom Severity and Outcomes Following Deep Brain Stimulation in Tremor
Luke Andrews1, Simon Keller1, Corey Ratcliffe1
1Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.
Tremor and Other Hyperkinetic Movements (New York, N.Y.)
|September 2, 2024
Summary
White matter changes in the cerebellum correlate with upper limb tremor severity in essential tremor (ET) and dystonic tremor (DT) patients. These diffusion changes are similar across both movement disorders, offering potential biomarkers for tremor assessment.
Area of Science:
- Neuroscience
- Neurology
- Biomarkers
Background:
- Essential tremor (ET) and dystonic tremor (DT) are debilitating movement disorders with poorly understood pathophysiology.
- Current treatment outcomes, particularly following deep brain stimulation (DBS), require better biomarkers for patient characterization and optimal treatment.
Purpose of the Study:
- To investigate white matter microstructure in pathways relevant to ET and DT pathophysiology and DBS.
- To identify associations between white matter integrity, tremor severity, and DBS response in ET and DT patients.
Main Methods:
- A retrospective cohort study involving 17 DT and 19 ET patients.
- Fixel-based analysis of diffusion MRI data to assess white matter microstructural metrics.
- Analysis of associations between white matter metrics, tremor severity (pre- and post-DBS), and stimulation site.
Main Results:
- Deep brain stimulation (DBS) significantly improved tremor in both ET and DT groups.
- Increased fiber density and combined fiber density/cross-section in the left cerebellum correlated with greater upper limb tremor severity across both disorders.
- No significant associations were found between white matter microstructure in cerebello-thalamic pathways or stimulation-connected tracts and tremor improvement.
Conclusions:
- Cerebellar white matter diffusion changes are linked to upper limb tremor severity in both essential tremor and dystonic tremor.
- These findings suggest overlapping cerebellar involvement in the pathophysiology of ET and DT, highlighting potential biomarkers for tremor severity.
