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01-05-2020 | Tremor | Original Communication

Functional disconnection of the dentate nucleus in essential tremor

Authors: Sankalp Tikoo, Sara Pietracupa, Silvia Tommasin, Matteo Bologna, Nikolas Petsas, Komal Bharti, Alfredo Berardelli, Patrizia Pantano

Published in: Journal of Neurology | Issue 5/2020

Abstract

Despite previous functional MRI studies on alterations within the cerebello-thalamo-cortical circuit in patients with essential tremor (ET), the specific role of disconnection of the dentate nucleus (DN), the main output cerebellar pathway, still needs clarification. In this study, we evaluated DN functional connectivity (FC) changes and their relationship with motor and non-motor symptoms in ET. We studied 25 ET patients and 26 healthy controls. Tremor severity was assessed using the Fahn–Tolosa–Marin tremor rating scale (FTM-TRS) and tremor amplitude and frequency were evaluated using kinematic techniques. Cognitive profile was assessed by montreal cognitive assessment (MoCA) and frontal assessment battery (FAB). All participants underwent a 3 T MRI protocol including resting-state blood oxygenation level dependent and diffusion tensor sequences. We used a seed-based approach to investigate DN FC and to explore the diffusion properties of cerebellar peduncles. There was significantly decreased DN FC with cortical, subcortical, and cerebellar areas in ET patients compared with healthy controls. Correlation analysis showed that: (1) the DN FC with the supplementary motor area, pre and postcentral gyri, and prefrontal cortex negatively correlated with FTM-TRS score and disease duration; (2) DN FC changes in the thalamus and caudate negatively correlated with peak tremor frequency, changes in the cerebellum positively correlated with tremor amplitude, and changes in the bilateral thalamus negatively correlated with tremor amplitude, and (3) DN FC with the associative prefrontal and parietal cortices, basal ganglia, and thalamus positively correlated with the MoCA score. Diffusion abnormalities were found in the three cerebellar peduncles, which did not correlate with clinical scores.

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Title: Functional disconnection of the dentate nucleus in essential tremor
Authors: Sankalp Tikoo
Sara Pietracupa
Silvia Tommasin
Matteo Bologna
Nikolas Petsas
Komal Bharti
Alfredo Berardelli
Patrizia Pantano
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keyword: Tremor
Published in: Journal of Neurology / Issue 5/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-09711-9

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Functional disconnection of the dentate nucleus in essential tremor

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