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Functional Anatomy of Essential Tremor: Lessons from Neuroimaging

R. Klaming and J. Annese
American Journal of Neuroradiology August 2014, 35 (8) 1450-1457; DOI: https://doi.org/10.3174/ajnr.A3586
R. Klaming
aFrom The Brain Observatory, San Diego, California; and Department of Radiology, University of California, San Diego, San Diego, California.
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J. Annese
aFrom The Brain Observatory, San Diego, California; and Department of Radiology, University of California, San Diego, San Diego, California.
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    Fig 1.

    Comparison among images of the cerebellum obtained with different hardware and in different imaging conditions. In vivo 1.5T MR image (A) of a patient with ET, in vivo 3T MR image (B) of the same patient, postmortem high-resolution 1.5T MR image (C) acquired in situ, and 1.5T MR image (D) of formaldehyde-fixed specimen obtained ex situ. The direct comparison between the modalities shows the morphologic detail intrinsic to the cerebellar cortex and the potential of different scans (and different scanners) to reveal geometric complexity and contrast between the cerebellar cortex and WM. A, Sagittal T1 3D inversion recovery fast-spoiled gradient recalled (FSPGR); matrix size, 256 × 256; pixel spacing, 1/1 mm; section spacing, 1.2 mm; section thickness, 1.2 mm. B, T1 FSPGR; matrix size, 256 × 256; pixel spacing, isometric 1 mm; section spacing, 1 mm; section thickness, 1 mm. C, High-resolution inversion recovery T1 spoiled gradient recalled imaging; matrix size, 512 × 512; pixel spacing, 0.5273 × 0.5273 mm; section spacing, 0.7 mm; section thickness, 0.7 mm. D, High-resolution coronal T1 3D inversion recovery FSPGR; matrix size, 512 × 512; pixel spacing, 0.5 × 0.5 mm; section spacing, 1 mm; section thickness, 1 mm.

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    Fig 2.

    Summary of observed or measured phenomena derived from multiple neuroimaging modalities, neuropsychological testing, and postmortem examination (indicated by differently colored symbols). The location of neuroimaging results was projected onto tomographic anatomic images of the brain acquired during the sectioning process7: Purkinje cell loss,25 presence of Lewy bodies,25,27 reduced fractional anisotropy,40,41,46 placing of deep brain stimulation electrode,18 GM loss,32,34,35 increased blood flow,8,47,48,49 WM loss,34 increased ADC,44 increased mean diffusivity,40,41,42 increased axial diffusivity,42 reduced NAA/total creatine.52 Bs indicates brain stem; Cd*, caudate; Cb*, cerebellum; cc*, corpus callosum; dl PFC, dorsolateral prefrontal cortex; Dt*, dentate nucleus; ec*, external capsule; FL*, frontal lobes; GP*, globus pallidus; icp*, inferior cerebellar peduncle; Ins*, insula; ic*, internal capsule; IPL*, inferior parietal cortex; LF-WM, lateral frontal WM; (L) PL-WM, (left) parietal WM; Md*, medulla; MFG, medial frontal gyrus; MTG*, middle temporal gyrus; OL*, occipital lobes; OF-WM, orbitofrontal WM; PL-WM, parietal WM; Pons*, pons; R*, red nucleus; R FP-WM, right frontoparietal WM; RLL, right limbic lobe; RR, retrorubal area of midbrain; SmC, sensorimotor cortex, scp*, superior cerebellar peduncle; SN*, substantia nigra; SPL*, superior parietal lobule; Str*, striatum; TL*, temporal WM; Th*, thalamus; VIM, ventral intermediate nucleus of the thalamus; Ver*, vermis. The asterisks denote anatomic abbreviations from Mai et al.54

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American Journal of Neuroradiology: 35 (8)
American Journal of Neuroradiology
Vol. 35, Issue 8
1 Aug 2014
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R. Klaming, J. Annese
Functional Anatomy of Essential Tremor: Lessons from Neuroimaging
American Journal of Neuroradiology Aug 2014, 35 (8) 1450-1457; DOI: 10.3174/ajnr.A3586

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Functional Anatomy of Essential Tremor: Lessons from Neuroimaging
R. Klaming, J. Annese
American Journal of Neuroradiology Aug 2014, 35 (8) 1450-1457; DOI: 10.3174/ajnr.A3586
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