Objective: This study aims to use resting-state functional magnetic resonance imaging (rs-fMRI) to explore the alterations of brain activity in drug-naïve patients with Essential tremor with resting tremor (rET) and without resting tremor(ETwr).

Background: Patients with rET often exhibits severer clinical features and more extensive functional impairment than patients with ETwr. However, the pathophysiology of rET is still unclear.

Method:  We recruited 19 patients of rET, 31 patients of 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 were measured by amplitude of low-frequency fluctuation (ALFF) (two sample t-test, corrected with AlphaSim, p < 0.05). The relationships between the altered brain measurements and the clinical scores were analyzed.

Results:  Compared with HCs, both ET subgroups showed significantly decreased ALFF values in the right putamen, left caudate and right inferior orbitofrontal gyrus. The rET group specifically showed the decreased ALFF values in the right insula and hippocampus. While the ETwr group specifically was evidenced with decreased ALFF values in the bilateral inferior temporal gyri and right middle cingulate gyrus, and increased ALFF values in the right cerebellum.

Conclusion: Regional spontaneous activity in rET and ETwr share common changes and have differences, which may suggest that the functional activity in 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.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/altered-spontaneous-brain-activity-in-essential-tremor-with-and-without-resting-tremor-a-resting-state-fmri-study/