title: Atrophy of the Cerebellar Vermis in Essential Tremor: Segmental Volumetric MRI Analysis.
abstract: Postmortem studies of essential tremor (ET) have demonstrated the presence of degenerative changes in the cerebellum, and imaging studies have examined related structural changes in the brain. However, their results have not been completely consistent and the number of imaging studies has been limited. We aimed to study cerebellar involvement in ET using MRI segmental volumetric analysis. In addition, a unique feature of this study was that we stratified ET patients into subtypes based on the clinical presence of cerebellar signs and compared their MRI findings. Thirty-nine ET patients and 36 normal healthy controls, matched for age and sex, were enrolled. Cerebellar signs in ET patients were assessed using the clinical tremor rating scale and International Cooperative Ataxia Rating Scale. ET patients were divided into two groups: patients with cerebellar signs (cerebellar-ET) and those without (classic-ET). MRI volumetry was performed using CIVET pipeline software. Data on whole and segmented cerebellar volumes were analyzed using SPSS. While there was a trend for whole cerebellar volume to decrease from controls to classic-ET to cerebellar-ET, this trend was not significant. The volume of several contiguous segments of the cerebellar vermis was reduced in ET patients versus controls. Furthermore, these vermis volumes were reduced in the cerebellar-ET group versus the classic-ET group. The volume of several adjacent segments of the cerebellar vermis was reduced in ET. This effect was more evident in ET patients with clinical signs of cerebellar dysfunction. The presence of tissue atrophy suggests that ET might be a neurodegenerative disease.
authors.affiliation: Department of Neurology, Anyang Sam Hospital, Gyeunggi-do, Republic of Korea.
authors.forename: Hyeeun
authors.initials: H
authors.lastname: Shin
authors.affiliation: Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea.
authors.forename: Dong-Kyun
authors.initials: DK
authors.lastname: Lee
authors.affiliation: Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Irwon dong 50, Gangnam-gu, Seoul, 135-710, Republic of Korea.|Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Huh
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Irwon dong 50, Gangnam-gu, Seoul, 135-710, Republic of Korea.|Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Youn
authors.affiliation: Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, 06520, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Irwon dong 50, Gangnam-gu, Seoul, 135-710, Republic of Korea. jinwhan.cho@samsung.com.|Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea. jinwhan.cho@samsung.com.
authors.forename: Jin Whan
authors.initials: JW
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000378:metabolism; D002524:Cerebellar Ataxia / Q000503:physiopathology; D065814:Cerebellar Vermis / Q000503:physiopathology*; D020329:Essential Tremor / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged
keywords: Atrophy; Cerebellum; Essential tremor; Vermis