震颤显性帕金森病(TDPD)和特发性震颤加综合征(ETP)是常见的震颤显性神经系统疾病。尽管基底神经节丘脑皮质(BGTC)和小脑丘脑皮质(CTC)网络与震颤发生有关,不同疾病间功能连接改变的程度尚不确定.本研究旨在评估TDPD和ETP中BGTC和CTC的功能连通性。25例TDPD患者行静息状态功能MRI检查,ETP和22个健康对照(HC)。在预处理和去噪之后,使用属于BGTC和CTC的ROI在FDR<0.05下进行基于种子-体素的连通性。Fahn-Tolosa-Marin震颤量表(FTMRS)与FDR<0.05时的平均连通性值相关。与HC相比,TDPD显示小脑和pre之间的连通性降低,中央后回.同时,ETP显示苍白球和枕骨皮质之间的连通性降低,precuneus,与HC相比,cuneus。与ETP相比,TDPD显示中央前回之间的连通性增加,苍白球,SNc与默认模式网络(DMN),小脑与上级之间的连通性降低,观察到中额回。震颤严重程度与TDPD中SNc和DMN的连通性呈正相关,与ETP中的苍白球连接呈负相关。BGTC的模式,反恐委员会的参与是有区别的,即TDPD中BGTC节点的连通性更高,ETP中小脑节点的连通性更高。苍白虫参与ETP的有趣观察表明BGTC在ETP的发病机理中的作用。并表明TDPD和ETP中震颤发生概念的相似性。
Tremor dominant Parkinson\'s disease (TDPD) and essential tremor plus (ETP) syndrome are commonly encountered tremor dominant neurological disorders. Although the basal ganglia thalamocortical (BGTC) and cerebello thalamocortical (CTC) networks are implicated in tremorogenesis, the extent of functional connectivity alterations across disorders is uncertain. This study aims to evaluate functional connectivity of the BGTC and CTC in TDPD and ETP. Resting state functional MRI was acquired for 25 patients with TDPD, ETP and 22 healthy controls (HC). Following pre-processing and denoising, seed-to-voxel based connectivity was carried out at FDR < 0.05 using ROIs belonging to the BGTC and CTC. Fahn-Tolosa-Marin tremor rating scale (FTMRS) was correlated with the average connectivity values at FDR < 0.05. Compared to HC, TDPD showed decreased connectivity between cerebellum and pre, post central gyrus. While, ETP showed decreased connectivity between pallidum and occipital cortex, precuneus, cuneus compared to HC. In comparison to ETP, TDPD showed increased connectivity between precentral gyrus, pallidum, SNc with the default mode network (DMN), and decreased connectivity between cerebellum with superior, middle frontal gyrus was observed. Tremor severity positively correlated with connectivity between SNc and DMN in TDPD, and negatively correlated with pallidal connectivity in ETP. Pattern of BGTC, CTC involvement is differential i.e., higher connectivity of the BGTC nodes in TDPD, and higher connectivity of cerebellar nodes in ETP. The interesting observation of pallidal involvement in ETP suggests the role of BGTC in the pathogenesis of ETP, and indicated similarities in concepts of tremor genesis in TDPD and ETP.