Resting State fMRI Demonstrates a Disturbance of the Cerebello-Cortical Circuit in Essential Tremor

Individuals with essential tremor (ET) have postural and active movement abnormalities. Disturbances in the cerebello-thalamo-cortical circuit may contribute to the several motor symptoms of ET. Resting state fMRI provides a valuable, noninvasive tool to study intrinsic activation in the human brain, particularly in the brains of individuals with neuropsychiatric diseases. To investigate the low frequency oscillation features of intrinsic activation in ET in this study, we performed a resting state fMRI analysis in 24 patients with ET and 23 healthy controls. The amplitudes of low frequency fluctuation (ALFF) were analyzed. When compared with healthy controls, patients showed significantly enhanced ALFF in the bilateral cerebral cortex, which is related to motor function, including the pre- and post-central gyrus, supplementary motor area and paracentral lobule. The larger ALFF value in the right precentral gyrus is related to a longer duration of tremor. The decreased ALFF in the bilateral cerebellum was also observed in patients. In addition, aberrant ALFF in the right cerebellar tonsil was negatively associated with the duration of tremor. Our findings suggest that abnormalities exist in the intrinsic activation of brain regions in patients with ET. These findings provide noninvasive evidence that supports the hypothesis that the abnormality of intrinsic activity in the cerebello-cerebral cortex pathway could be associated with the motor-related symptoms of ET. Furthermore, the duration of a tremor might relate to the severity of the alterations to the motor system of ET.