title: Essential tremor is associated with disruption of functional connectivity in the ventral intermediate Nucleus--Motor Cortex--Cerebellum circuit.
abstract: The clinical benefits of targeting the ventral intermediate nucleus (VIM) for the treatment of tremors in essential tremor (ET) patients suggest that the VIM is a key hub in the network of tremor generation and propagation and that the VIM can be considered as a seed region to study the tremor network. However, little is known about the central tremor network in ET patients. Twenty-six ET patients and 26 matched healthy controls (HCs) were included in this study. After considering structural and head-motion factors and establishing the accuracy of our seed region, a VIM seed-based functional connectivity (FC) analysis of resting-state functional magnetic resonance imaging (RS-fMRI) data was performed to characterize the VIM FC network in ET patients. We found that ET patients and HCs shared a similar VIM FC network that was generally consistent with the VIM anatomical connectivity network inferred from normal nonhuman primates and healthy humans. Compared with HCs, ET patients displayed VIM-related FC changes, primarily within the VIM-motor cortex (MC)-cerebellum (CBLM) circuit, which included decreased FC in the CBLM and increased FC in the MC. Importantly, tremor severity correlated with these FC changes. These findings provide the first evidence that the pathological tremors observed in ET patients might be based on a physiologically pre-existing VIM - MC - CBLM network and that disruption of FC in this physiological network is associated with ET. Further, these findings demonstrate a potential approach for elucidating the neural network mechanisms underlying this disease.
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Huiyue
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Hansheng
authors.initials: H
authors.lastname: Wang
authors.affiliation: Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.
authors.forename: Han
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Munankami
authors.initials: M
authors.lastname: Puneet
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Mengqi
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Fajin
authors.initials: F
authors.lastname: Lv
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Tianyou
authors.initials: T
authors.lastname: Luo
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Oumei
authors.initials: O
authors.lastname: Cheng
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xiurong
authors.initials: X
authors.lastname: Lu
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001931:Brain Mapping; D016022:Case-Control Studies; D002531:Cerebellum / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology*; D020329:Essential Tremor / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D019416:Head Movements / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000098:blood supply / Q000503:physiopathology*; D009434:Neural Pathways / Q000098:blood supply / Q000473:pathology; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D012720:Severity of Illness Index; D020651:Ventral Thalamic Nuclei / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*
chemical_list: D010100:Oxygen
keywords: cerebellum; essential tremor; functional connectivity; functional magnetic resonance imaging; motor cortex; resting state; thalamus; ventral intermediate nucleus