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Cerebellar Atrophy in Cortical Myoclonic Tremor and Not in Hereditary Essential Tremor-a Voxel-Based Morphometry Study.

Authors
  • Buijink, A W G1, 2
  • Broersma, M3, 4
  • van der Stouwe, A M M3, 4
  • Sharifi, S1, 2
  • Tijssen, M A J3
  • Speelman, J D1
  • Maurits, N M3, 4
  • van Rootselaar, A F5, 6
  • 1 Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Room D2-113, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. , (Netherlands)
  • 2 Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. , (Netherlands)
  • 3 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. , (Netherlands)
  • 4 Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. , (Netherlands)
  • 5 Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Room D2-113, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. [email protected] , (Netherlands)
  • 6 Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. [email protected] , (Netherlands)
Type
Published Article
Journal
Cerebellum (London, England)
Publication Date
December 2016
Volume
15
Issue
6
Pages
696–704
Identifiers
PMID: 26519379
Source
Medline
Keywords
License
Unknown

Abstract

Essential tremor (ET) presumably has a cerebellar origin. Imaging studies showed various cerebellar and also cortical structural changes. A number of pathology studies indicated cerebellar Purkinje cell pathology. ET is a heterogeneous disorder, possibly indicating different underlying disease mechanisms. Familial cortical myoclonic tremor with epilepsy (FCMTE), with evident Purkinje cell degeneration, can be an ET mimic. Here, we investigate whole brain and, more specifically, cerebellar morphological changes in hereditary ET, FCMTE, and healthy controls. Anatomical magnetic resonance images were preprocessed using voxel-based morphometry. Study 1 included voxel-wise comparisons of 36 familial, propranolol-sensitive ET patients, with subgroup analysis on age at onset and head tremor, and 30 healthy controls. Study 2 included voxel-wise comparisons in another nine ET patients, eight FCMTE patients, and nine healthy controls. Study 3 compared total cerebellar volume between 45 ET patients, 8 FCTME patients, and 39 controls. In our large sample of selected hereditary ET patients and ET subgroups, no local atrophy was observed compared to healthy controls or FCMTE. In ET patients with head tremor, a volume increase in cortical motor regions was observed. In FCMTE, a decrease in total cerebellar volume and in local cerebellar gray matter was observed compared to healthy controls and ET patients. The current study did not find local atrophy, specifically not in the cerebellum in hereditary ET, contrary to FCMTE. Volume increase of cortical motor areas in ET patients with head tremor might suggest cortical plasticity changes due to continuous involuntary head movements.

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