Essential tremor (ET) is a complex, neurodegenerative disorder that includes motor and non-motor symptoms. There is growing interest in its non-motor features, including sleep disturbances (SD). There are no studies evaluating the brain structural correlates of SD in ET. We aimed to identify brain microstructural changes related to SD in ET. SD was evaluated using the Pittsburg sleep quality index (PSQI). Diffusion tensor imaging (DTI), with reported measures being fractional anisotropy (FA) and apparent diffusion coefficient (ADC), was used to evaluate microstructural brain changes. DTI data were compared in ET patients with vs. without SD. The mean age of 40 ET patients was 49.20 ± 21.06 years. The mean PSQI score was 6.13 ± 3.99, and 18 (45.0%) patients had SD. The mean PSQI score of patients with vs. without SD was 9.78 ± 2.98 vs. 3.14 ± 1.28 (p < 0.001). Patients with vs. without SD differed significantly with respect to several DTI findings: right (R) superior cerebellar peduncle ADC (p = 0.04), left (L) dorsolateral prefrontal cortex FA (p < 0.01), L frontooccipital fasciculus FA (p = 0.02), R posterior corona radiata (RPCR) FA (p = 0.01), L posterior corona radiata FA (p = 0.04), R posterior thalamic radiation (RPTR) FA (p = 0.02), and fornix FA (p = 0.03) Significant correlations between PSQI scores and RPCR FA (r = − 0.50, p = 0.02) and RPTR FA (r = − 0.67, p = 0.001) were also observed. Our findings suggest that certain brain changes may be associated with the clinical expression of SD in ET. These changes are discussed in terms of their possible neuroanatomical and physiological significance.

原发性震颤（ET）是一种复杂的神经退行性疾病，包括运动和非运动症状。人们越来越关注它的非运动功能，包括睡眠障碍（SD）。尚无研究评估ET中SD的脑结构相关性。我们旨在确定与ET中SD相关的大脑微结构变化。使用匹兹堡睡眠质量指数（PSQI）评估SD。扩散张量成像（DTI）的方法是分数各向异性（FA）和表观扩散系数（ADC），用于评估大脑的微结构变化。比较有或无SD的ET患者的DTI数据。40名ET患者的平均年龄为49.20±21.06岁。PSQI平均得分为6.13±3.99，有18名（45.0％）患者患有SD。有或没有SD的患者的平均PSQI评分分别为9.78±2.98和3.14±1.28（p  <0.001）。有或没有SD的患者在几个DTI表现方面有显着差异：右（R）小脑 上肢蒂ADC（p  = 0.04），左（L）背外侧前额叶皮质FA（p <0.01），L额枕筋膜FA（p = 0.02），R后冠状 放射（FA ）（p  = 0.01），L后冠状放射（FA）（p = 0.04），R丘脑后放射（RPTR）FA（p  = 0.02）和穹）FA（p  = 0.03） PSQI评分与RPCR FA（r  = − 0.50，p  = 0.02）和RPTR FA（r  = − 0.67，p = 0.001）。我们的发现表明，某些大脑变化可能与ET中SD的临床表达有关。根据它们可能的神经解剖学和生理学意义讨论了这些变化。