The metabolic anatomy of tremor in Parkinson's disease.

Abstract:

OBJECTIVE:To identify regional metabolic brain networks related specifically to the presence of tremor in PD. BACKGROUND:The pathophysiology of parkinsonian tremor is unknown. Because tremor in PD occurs mainly in repose, we used resting state PET with 18F-fluorodeoxyglucose (FDG) to identify specific metabolic brain networks associated with this clinical manifestation. METHODS:We studied two discrete groups of eight PD patients with and without tremor using FDG/PET. Both patient groups were matched for gender, age, and Unified Parkinson Disease Rating Scale ratings for akinesia and rigidity. Ten normal volunteer subjects served as controls. RESULTS:Network analysis with the Scaled Subprofile Model was performed in two steps. 1) We computed the expression of the PD-related pattern (PDRP) identified by us previously in each of the PD patients and control subjects. Although PDRP subject scores were abnormally elevated in the combined PD cohort (p < 0.005), these values did not differ in the PD patient groups with and without tremor (p = 0.36). 2) We used SSM to analyze the data from the combined PD cohort comprising both patient groups. We found that PD patients with tremor were characterized by increased expression of a metabolic network comprising the thalamus, pons, and premotor cortical regions. Subject scores for this pattern were elevated in the tremor group compared with the atremulous patient group and the normal control group (p < 0.005). CONCLUSIONS:The findings suggest that PD patients with tremor are characterized by distinct increases in the functional activity of thalamo-motor cortical projections. Modulation of this functional anatomic pathway is likely to be the mechanism for successful interventions for the relief of parkinsonian tremor.

journal_name

Neurology

journal_title

Neurology

authors

Antonini A,Moeller JR,Nakamura T,Spetsieris P,Dhawan V,Eidelberg D

doi

10.1212/wnl.51.3.803

subject

Has Abstract

pub_date

1998-09-01 00:00:00

pages

803-10

issue

3

eissn

0028-3878

issn

1526-632X

journal_volume

51

pub_type

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