Objectives

Essential tremor with resting tremor (rET) often exhibits severer clinical features and more extensive functional impairment than essential tremor without resting tremor (ETwr). However, the pathophysiology of rET is still unclear. This study aims to use resting-state functional magnetic resonance imaging (rs-fMRI) to explore the alterations of brain activity between the drug-naïve patients of rET and ETwr.

Methods

We recruited 19 patients with rET, 31 patients with ETwr and 25 healthy controls (HCs) to undergo a 3.0-T rs-fMRI examination. The differences of regional brain spontaneous activity between the rET, ETwr and HCs, as well as between total ET (rET + ETwr) and HCs were measured by amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF). The relationships between the altered brain measurements and the clinical scores were analyzed.

Results

Compared with HCs, both ET subgroups showed significantly decreased ALFF or fALFF values in the basal ganglia, inferior orbitofrontal gyrus and insula. The rET group specifically showed decreased ALFF values in the hippocampus and motor cortices, while the ETwr group specifically evidenced increased ALFF and fALFF values in the cerebellum.

Discussion

Regional spontaneous activity in rET and ETwr share common changes and have differences, which may suggest that the functional activities in the limbic system and cerebellum are different between the two subtypes. Improved insights into rET and ETwr subtypes and the different brain spontaneous activity will be valuable for improving our understanding of the pathophysiology of the disease.

中文翻译：

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在有和没有静息性震颤的特发性震颤中改变自发性大脑活动：静息态 fMRI 研究。

目标

与不伴有静止性震颤的特发性震颤 (ETwr) 相比，伴有静止性震颤 (rET) 的特发性震颤通常表现出更严重的临床特征和更广泛的功能障碍。然而，rET 的病理生理学仍不清楚。本研究旨在使用静息状态功能磁共振成像 (rs-fMRI) 来探索未接受药物治疗的 rET 和 ETwr 患者之间大脑活动的变化。

方法

我们招募了 19 名 rET 患者、31 名 ETwr 患者和 25 名健康对照 (HC) 进行 3.0-T rs-fMRI 检查。通过低频波动幅度（ALFF）和部分ALFF（fALFF）的幅度来测量rET，ETwr和HC之间以及总ET（rET + ETwr）和HC之间的区域脑自发活动的差异。分析了改变的大脑测量值与临床评分之间的关​​系。

结果

与 HC 相比，两个 ET 亚组的基底神经节、眶额下回和岛叶的 ALFF 或 fALFF 值均显着降低。rET 组特别显示海马和运动皮质中的 ALFF 值降低，而 ETwr 组特别显示小脑中的 ALFF 和 fALFF 值增加。

讨论

rET 和 ETwr 的区域自发活动具有共同的变化和差异，这可能表明两种亚型之间边缘系统和小脑的功能活动不同。更好地了解 rET 和 ETwr 亚型以及不同的大脑自发活动对于提高我们对该疾病的病理生理学的理解是有价值的。