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Tremor associated with similar structural networks in Parkinson's disease and essential tremor

P. Filip, K. Burdová, Z. Valenta, R. Jech, V. Kokošová, M. Baláž, S. Mangia, S. Michaeli, M. Bareš, L. Vojtíšek

. 2022 ; 95 (-) : 28-34. [pub] 20211223

Language English Country Great Britain

Document type Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc22019448

INTRODUCTION: Despite substantial clinical and pathophysiological differences, the characteristics of tremor in Parkinson's disease (PD) and essential tremor (ET) patients bear certain similarities. The presented study delineates tremor-related structural networks in these two disorders. METHODS: 42 non-advanced PD patients (18 tremor-dominant, 24 without substantial tremor), 17 ET, and 45 healthy controls underwent high-angular resolution diffusion-weighted imaging acquisition to reconstruct their structural motor connectomes as a proxy of the anatomical interconnections between motor network regions, implementing state-of-the-art globally optimised probabilistic tractography. RESULTS: When compared to healthy controls, ET patients exhibited higher structural connectivity in the cerebello-thalamo-cortical network. Interestingly, the comparison of tremor-dominant PD patients and PD patients without tremor yielded very similar results - higher structural connectivity in tremor-dominant PD sharing multiple nodes with the tremor network detected in ET, despite the generally lower structural connectivity between basal ganglia and frontal cortex in the whole PD group when compared to healthy controls. CONCLUSION: The higher structural connectivity of the cerebello-thalamo-cortical network seems to be the dominant tremor driver in both PD and ET. While it appears to be the only tremor-related network in ET, its combination with large scale hypoconnectivity in the frontal cortico-subcortical network in PD may explain different clinical features of tremor in these two disorders.

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$a Filip, Pavel $u Department of Neurology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic; Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, USA. Electronic address: pvlfilip@gmail.com
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$a INTRODUCTION: Despite substantial clinical and pathophysiological differences, the characteristics of tremor in Parkinson's disease (PD) and essential tremor (ET) patients bear certain similarities. The presented study delineates tremor-related structural networks in these two disorders. METHODS: 42 non-advanced PD patients (18 tremor-dominant, 24 without substantial tremor), 17 ET, and 45 healthy controls underwent high-angular resolution diffusion-weighted imaging acquisition to reconstruct their structural motor connectomes as a proxy of the anatomical interconnections between motor network regions, implementing state-of-the-art globally optimised probabilistic tractography. RESULTS: When compared to healthy controls, ET patients exhibited higher structural connectivity in the cerebello-thalamo-cortical network. Interestingly, the comparison of tremor-dominant PD patients and PD patients without tremor yielded very similar results - higher structural connectivity in tremor-dominant PD sharing multiple nodes with the tremor network detected in ET, despite the generally lower structural connectivity between basal ganglia and frontal cortex in the whole PD group when compared to healthy controls. CONCLUSION: The higher structural connectivity of the cerebello-thalamo-cortical network seems to be the dominant tremor driver in both PD and ET. While it appears to be the only tremor-related network in ET, its combination with large scale hypoconnectivity in the frontal cortico-subcortical network in PD may explain different clinical features of tremor in these two disorders.
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$a Burdová, Kristína $u Department of Neurology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
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$a Valenta, Zdeněk $u Department of Statistical Modelling, Institute of Computer Science of the Czech Academy of Sciences, Prague, Czech Republic
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$a Jech, Robert $u Department of Neurology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
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$a Baláž, Marek $u First Department of Neurology, Faculty of Medicine, Masaryk University and University Hospital of St. Anne, Brno, Czech Republic
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$a Mangia, Silvia $u Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, USA
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$a Bareš, Martin $u First Department of Neurology, Faculty of Medicine, Masaryk University and University Hospital of St. Anne, Brno, Czech Republic; Department of Neurology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
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