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Role of altered cerebello-thalamo-cortical network in the neurobiology of essential tremor

  • Functional Neuroradiology
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Abstract

Introduction

Essential tremor (ET) is the most common movement disorder among adults. Although ET has been recognized as a mono-symptomatic benign illness, reports of non-motor symptoms and non-tremor motor symptoms have increased its clinical heterogeneity. The neural correlates of ET are not clearly understood. The aim of this study was to understand the neurobiology of ET using resting state fMRI.

Methods

Resting state functional MR images of 30 patients with ET and 30 age- and gender-matched healthy controls were obtained. The functional connectivity of the two groups was compared using whole-brain seed-to-voxel-based analysis.

Results

The ET group had decreased connectivity of several cortical regions especially of the primary motor cortex and the primary somatosensory cortex with several right cerebellar lobules compared to the controls. The thalamus on both hemispheres had increased connectivity with multiple posterior cerebellar lobules and vermis. Connectivity of several right cerebellar seeds with the cortical and thalamic seeds had significant correlation with an overall score of Fahn-Tolosa-Marin tremor rating scale (FTM-TRS) as well as the subscores for head tremor and limb tremor.

Conclusion

Seed-to-voxel resting state connectivity analysis revealed significant alterations in the cerebello-thalamo-cortical network in patients with ET. These alterations correlated with the overall FTM scores as well as the subscores for limb tremor and head tremor in patients with ET. These results further support the previous evidence of cerebellar pathology in ET.

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Authors and Affiliations

  1. Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India

    Abhishek Lenka, Ketaki Swapnil Bhalsing, Ketan Jhunjhunwala, Rajini M Naduthota, Ravi Yadav & Pramod Kumar Pal

  2. Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India

    Abhishek Lenka, Ketaki Swapnil Bhalsing & Ketan Jhunjhunwala

  3. Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India

    Rajanikant Panda, Jitender Saini & Rose Dawn Bharath

Authors
  1. Abhishek Lenka
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  2. Ketaki Swapnil Bhalsing
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  3. Rajanikant Panda
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  4. Ketan Jhunjhunwala
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  5. Rajini M Naduthota
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  6. Jitender Saini
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  7. Rose Dawn Bharath
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  8. Ravi Yadav
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  9. Pramod Kumar Pal
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Corresponding authors

Correspondence to Rose Dawn Bharath or Pramod Kumar Pal.

Ethics declarations

We declare that all human and animal studies have been approved by the ethics committee of the National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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We declare that we have no conflict of interest.

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Lenka, A., Bhalsing, K.S., Panda, R. et al. Role of altered cerebello-thalamo-cortical network in the neurobiology of essential tremor. Neuroradiology 59, 157–168 (2017). https://doi.org/10.1007/s00234-016-1771-1

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  • DOI: https://doi.org/10.1007/s00234-016-1771-1

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