Article Text

Download PDFPDF
Increased number of heterotopic Purkinje cells in essential tremor
  1. Sheng-Han Kuo1,
  2. Cordelia Erickson-Davis2,
  3. Arthur Gillman2,
  4. Phyllis L Faust3,
  5. Jean-Paul G Vonsattel3,4,
  6. Elan D Louis1,2,4,5
  1. 1Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA
  2. 2GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, USA
  3. 3Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, USA
  4. 4Taub Institute for Research on Alzheimer's Disease and the Ageing Brain, College of Physicians and Surgeons, Columbia University, New York, USA
  5. 5Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
  1. Correspondence to Dr E D Louis, Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032, USA; edl2{at}


Objective Recent postmortem studies reveal degenerative changes, including Purkinje cell (PC) loss, in most brains from individuals with essential tremor (ET). Heterotopic PCs (HPCs) (ie, PC bodies displaced into the molecular layer) may be found in neurodegenerative diseases with PC loss. HPCs have been observed in ET but no quantitative case control analysis has been performed.

Methods HPCs were counted in 35 ET brains and 32 control brains (including 21 non-diseased controls and 11 diseased controls with progressive supranuclear palsy (PSP)) using a standard 20×25 mm cerebellar cortical section stained with a modified Bielscholwsky method.

Results The median number of HPCs per section was three times higher in 35 ET cases (median 3, mean±SD 3.8±3.6, range 0–14) versus 32 controls (median 1, mean±SD 1.6±1.7, range 0–5) (p=0.007). The number of HPCs was similarly low in the 21 non-diseased controls and 12 PSP brains (median 1 in each group) (p=0.04 and p=0.01 compared with ET). In ET, the number of HPCs was inversely related to the number of PCs (Spearman's rho −0.36, p=0.038) (ie, cases with more HPCs had fewer PCs).

Conclusion PC heterotopia, which occurs in cerebellar degenerative disorders, is also a feature of ET. These findings further contribute to our understanding of the postmortem changes in this common neurological disease.


Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding R01 NS42859 from the National Institutes of Health (Bethesda, Maryland), the Arlene Bronstein Essential Tremor Research Fund (Columbia University) and the Claire O'Neil Essential Tremor Research Fund (Columbia University).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of Columbia University.

  • Provenance and peer review Not commissioned; externally peer reviewed.