Published ahead of print on July 24, 2008
doi: 10.3174/ajnr.A1190
Essential Head Tremor Is Associated with Cerebellar Vermis Atrophy: A Volumetric and Voxel-Based Morphometry MR Imaging Study
A. Quattronea,b,
A. Cerasaa,
D. Messinaa,b,
G. Nicolettia,b,
G.E. Hagbergc,
L. Lemieuxd,
F. Novellinob,
P. Lanzaa,
G. Arabiaa and
M. Salsoneb
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

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Fig 1. Sample manual region-of-interest tracings assessing planimetric measurements of the vermal-functional areas by using the MRreg software.14 Data are shown for a control subject with no atrophy. A, The anterior lobule. B, The posterior superior lobule. C, The posterior inferior lobule. A + B + C = midsagittal vermal area.
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Fig 2. Results from an optimized VBM analysis showing significant cerebellar atrophy at the level of the anterior lobe, above that occurring globally, selectively in patients with both a-ET and h-ET (Pcorrected < .001). Data analyses have been further corrected for age and sex. The maps are superimposed on the T1-weighted image averaged across all participants. The bar graphs give the mean and SD GM volume of voxels showing peak differences in the vermis. Patients with only a-ET display a tendency toward a CV loss.
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