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Morphological differences in Parkinson’s disease with and without rest tremor

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Abstract

Background

Rest tremor is a hallmark of Parkinson’s disease (PD), but its pathogenesis remains incompletely understood. Nigro-striatal dopamine deficiency correlates best with bradykinesia, but not with tremor. Oscillating neurons in one or multiple localizations within the basal gangliathalamo-cortical loop may cause rest tremor, and an active contribution of the cerebellum and the cerebello-thalamo-cortical projections has been postulated.

Objective

To compare the pattern of grey matter volume in PD patients with and without tremor to identify structural correlates of rest tremor.

Methods

Voxel-based morphometry (VBM) of a high-resolution 3 Tesla, T1-weighted MR images, pre-processed according to an optimized protocol using SPM2, was performed in 24 patients with mild to moderate PD comparing local grey matter volume in patients with (n = 14) and without rest tremor (n = 10).

Results

Grey matter volume is decreased in the right quadrangular lobe and declive of the cerebellum in PD with tremor compared to those without (PFDR < 0.05).

Conclusions

These results demonstrate for the first time morphological changes in the cerebellum in PD patients with rest tremor and highlight the involvement of the cerebellum and cerebello- thalamo-cortical circuit in the pathogenesis of parkinsonian rest tremor.

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Authors and Affiliations

  1. Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10 Room 5N240 (MSC1428), Center Drive, Bethesda, MD, 20892, USA

    D. H. Benninger MD

  2. Dept. of Neurology, University Hospital of Zurich, Zurich, Switzerland

    D. H. Benninger MD, C. L. Bassetti MD & D. Waldvogel MD

  3. Dept. of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland

    S. Thees MD, MSc & S. S. Kollias MD

  4. Dept. of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Leipzig, Germany

    S. Thees MD, MSc

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  1. D. H. Benninger MD
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  2. S. Thees MD, MSc
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  3. S. S. Kollias MD
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  4. C. L. Bassetti MD
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Correspondence to D. H. Benninger MD.

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Benninger, D.H., Thees, S., Kollias, S.S. et al. Morphological differences in Parkinson’s disease with and without rest tremor. J Neurol 256, 256–263 (2009). https://doi.org/10.1007/s00415-009-0092-2

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  • DOI: https://doi.org/10.1007/s00415-009-0092-2

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