title: Cerebellar Atrophy in Cortical Myoclonic Tremor and Not in Hereditary Essential Tremor-a Voxel-Based Morphometry Study.
abstract: Essential tremor (ET) presumably has a cerebellar origin. Imaging studies showed various cerebellar and also cortical structural changes. A number of pathology studies indicated cerebellar Purkinje cell pathology. ET is a heterogeneous disorder, possibly indicating different underlying disease mechanisms. Familial cortical myoclonic tremor with epilepsy (FCMTE), with evident Purkinje cell degeneration, can be an ET mimic. Here, we investigate whole brain and, more specifically, cerebellar morphological changes in hereditary ET, FCMTE, and healthy controls. Anatomical magnetic resonance images were preprocessed using voxel-based morphometry. Study 1 included voxel-wise comparisons of 36 familial, propranolol-sensitive ET patients, with subgroup analysis on age at onset and head tremor, and 30 healthy controls. Study 2 included voxel-wise comparisons in another nine ET patients, eight FCMTE patients, and nine healthy controls. Study 3 compared total cerebellar volume between 45 ET patients, 8 FCTME patients, and 39 controls. In our large sample of selected hereditary ET patients and ET subgroups, no local atrophy was observed compared to healthy controls or FCMTE. In ET patients with head tremor, a volume increase in cortical motor regions was observed. In FCMTE, a decrease in total cerebellar volume and in local cerebellar gray matter was observed compared to healthy controls and ET patients. The current study did not find local atrophy, specifically not in the cerebellum in hereditary ET, contrary to FCMTE. Volume increase of cortical motor areas in ET patients with head tremor might suggest cortical plasticity changes due to continuous involuntary head movements.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Room D2-113, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: A W G
authors.initials: AW
authors.lastname: Buijink
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Broersma
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: A M M
authors.initials: AM
authors.lastname: van der Stouwe
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Room D2-113, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Sharifi
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: M A J
authors.initials: MA
authors.lastname: Tijssen
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Room D2-113, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: J D
authors.initials: JD
authors.lastname: Speelman
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: N M
authors.initials: NM
authors.lastname: Maurits
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, Room D2-113, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. a.f.vanrootselaar@amc.uva.nl.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. a.f.vanrootselaar@amc.uva.nl.
authors.forename: A F
authors.initials: AF
authors.lastname: van Rootselaar
mesh_terms: D000328:Adult; D017668:Age of Onset; D001284:Atrophy / Q000000981:diagnostic imaging; D002531:Cerebellum / Q000000981:diagnostic imaging*; D004831:Epilepsies, Myoclonic / Q000000981:diagnostic imaging*; D020329:Essential Tremor / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000494:pharmacology; D009929:Organ Size; D011433:Propranolol / Q000494:pharmacology
chemical_list: D009465:Neuromuscular Agents; D011433:Propranolol
keywords: Cerebellum; Essential tremor; FCMTE; MRI; VBM; Volumetry