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AJNR - American Journal of Neuroradiology

Published ahead of print on July 24, 2008
doi: 10.3174/ajnr.A1190

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American Journal of Neuroradiology 29:1692-1697, October 2008
© 2008 American Society of Neuroradiology

BRAIN

Essential Head Tremor Is Associated with Cerebellar Vermis Atrophy: A Volumetric and Voxel-Based Morphometry MR Imaging Study

A. Quattrone^a,b, A. Cerasa^a, D. Messina^a,b, G. Nicoletti^a,b, G.E. Hagberg^c, L. Lemieux^d, F. Novellino^b, P. Lanza^a, G. Arabia^a and M. Salsone^b

^a Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy
^b Institute of Neurology, University "Magna Graecia," Catanzaro, Italy
^c IRCCS Fondazione Santa Lucia, Rome, Italy
^d Department of Clinical and Experimental Epilepsy, University College London, Institute of Neurology, Queen Square, London, UK

Please address correspondence to Aldo Quattrone, MD, Institute of Neurology, Department of Medical Sciences, University Magna Graecia Catanzaro, Italy; e-mail: a.quattrone{at}isn.cnr.it

BACKGROUND AND PURPOSE: Our aim was to investigate the presence of brain gray matter (GM) abnormalities in patients with different forms of essential tremor (ET).

MATERIALS AND METHODS: We used optimized voxel-based morphometry (VBM) and manually traced single region-of-interest analysis in 50 patients with familial ET and in 32 healthy subjects. Thirty patients with ET had tremor of the arms (a-ET), whereas the remaining 20 patients had both arm and head tremor (h-ET).

RESULTS: VBM showed marked atrophy of the cerebellar vermis in the patients with h-ET with respect to healthy subjects (P_corrected < .001). Patients with a-ET showed a trend toward a vermal GM volume loss that did not reach a significant difference with respect to healthy controls (P_uncorrected < .01). The region-of-interest analysis showed a reduction of the cerebellar volume (CV) in the h-ET group (98.2 ± 13.6 mm³) compared with healthy controls (110.5 ± 15.5 mm³, P < .012) as well as in the entire vermal area (790.3 ± 94.5 mm², 898.6 ± 170.6 mm², P < .04 in h-ET and control groups, respectively).

CONCLUSIONS: Atrophy of the cerebellar vermis detected in patients with h-ET strongly supports the evidence for the involvement of the cerebellum in the pathophysiology of ET. The lack of a significant CV loss observed in patients with a-ET suggests that a-ET and h-ET might represent distinct subtypes of the same disease.

This article has been cited by other articles:

				A. Cerasa, D. Messina, G. Nicoletti, F. Novellino, P. Lanza, F. Condino, G. Arabia, M. Salsone, and A. Quattrone Cerebellar Atrophy in Essential Tremor Using an Automated Segmentation Method AJNR Am. J. Neuroradiol., June 1, 2009; 30(6): 1240 - 1243. [Abstract] [Full Text] [PDF]