title: Morphological differences in Parkinson's disease with and without rest tremor.
abstract: BACKGROUND
  Rest tremor is a hallmark of Parkinson's disease (PD), but its pathogenesis remains incompletely understood. Nigro-striatal dopamine deficiency correlates best with bradykinesia, but not with tremor. Oscillating neurons in one or multiple localizations within the basal gangliathalamo-cortical loop may cause rest tremor, and an active contribution of the cerebellum and the cerebello-thalamo-cortical projections has been postulated.
  
  
  OBJECTIVE
  To compare the pattern of grey matter volume in PD patients with and without tremor to identify structural correlates of rest tremor.
  
  
  METHODS
  Voxel-based morphometry (VBM) of a high-resolution 3 Tesla, T1-weighted MR images, pre-processed according to an optimized protocol using SPM2, was performed in 24 patients with mild to moderate PD comparing local grey matter volume in patients with (n = 14) and without rest tremor (n = 10).
  
  
  RESULTS
  Grey matter volume is decreased in the right quadrangular lobe and declive of the cerebellum in PD with tremor compared to those without (PFDR < 0.05).
  
  
  CONCLUSIONS
  These results demonstrate for the first time morphological changes in the cerebellum in PD patients with rest tremor and highlight the involvement of the cerebellum and cerebello- thalamo-cortical circuit in the pathogenesis of parkinsonian rest tremor.
authors.affiliation: Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10 Room 5N240 (MSC1428), Center Drive, Bethesda, MD 20892, USA. benningerd@ninds.nih.gov
authors.forename: David H
authors.initials: DH
authors.lastname: Benninger
authors.forename: Sebastian
authors.initials: S
authors.lastname: Thees
authors.forename: Spyros S
authors.initials: SS
authors.lastname: Kollias
authors.forename: Claudio L
authors.initials: CL
authors.lastname: Bassetti
authors.forename: Daniel
authors.initials: D
authors.lastname: Waldvogel
mesh_terms: D000368:Aged; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping; D002531:Cerebellum / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D010300:Parkinson Disease / Q000473:pathology* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology; D014202:Tremor / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*