Objective: This study used resting-state fMRI to evaluate intrinsic brain activity in drug-naive patients with essential tremor with and without head tremor.

Background: Head tremor (HT) is present in nearly 35% to 48% of the essential tremor (ET) patients. Several clinical studies find ET patients with and without HT differ: i.e. HT more likely to be female, had an older age of onset than the patients without HT, suggesting that HT patients have a distinct clinical phenotype. Besides, with the aid of structural neuroimaging techniques, grey matter loss in the cerebellar vermis and entire cerebellum were detected in HT patients. The resting-state functional MRI (r-fMRI) enables the examination of synchronous regional cerebral activity alterations by using the amplitude of low-frequency fluctuation (ALFF) analysis. However, few report has applied ALFF in HT patients study.

Methods: We enrolled 20 ET patients with head tremor (h-ET), 27 ET patients without head tremor (a-ET), and 27 healthy controls (HCs). All participants underwent r-fMRI scans on a 3-T MR system. The ALFF of blood oxygen level-dependent signals was used to characterize regional cerebral function. We assessed the relationship between ALFF value of regions where the three groups showed significant differences and clinical indices of ET patients.

Results: Compared with HCs, the h-ET patients showed significantly increased ALFF values in bilateral posterior lobe of cerebellum, the upper portion of the cerebellar vermis and fronto-temporal cortex, while decreased ALFF values in left pre- and postcentral gyrus. Compared with HCs, a-ET patients exhibited increased ALFF values in right thalamus and fronto-temporal cortex, while decreased ALFF values in left supplementary motor area, pre- and postcentral gyrus. When compared with a-ET patients, the h-ET patients showed significantly enhanced ALFF in bilateral cerebellum VIII and Crus II, while decrease ALFF in right cerebellum VI and right postcentral gyrus. Besides, aberrant ALFF in left cerebellum VIII and right cerebellum VI were associated with the tremor severity and abnormal ALFF in left precentral gyrus was associated with the age of onset and duration of tremor in h-ET patients.

Conclusions: Our study, the first demonstrated that drug-naive h-ET and a-ET patients display different intrinsic brain activities. Besides, this study suggested the posterior lobe of cerebellum may be potential neural substrates of h-ET.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/resting-state-fmri-study-on-drug-naive-essential-tremor-patients-with-head-tremor/