• A Quattrone, A Cerasa, D Messina, G Nicoletti, G E Hagberg, L Lemieux, F Novellino, P Lanza, G Arabia, and M Salsone.
• Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy. a.quattrone@isn.cnr.it
• AJNR Am J Neuroradiol. 2008 Oct 1;29(9):1692-7.

Background And PurposeOur aim was to investigate the presence of brain gray matter (GM) abnormalities in patients with different forms of essential tremor (ET).Materials And MethodsWe used optimized voxel-based morphometry (VBM) and manually traced single region-of-interest analysis in 50 patients with familial ET and in 32 healthy subjects. Thirty patients with ET had tremor of the arms (a-ET), whereas the remaining 20 patients had both arm and head tremor (h-ET).ResultsVBM showed marked atrophy of the cerebellar vermis in the patients with h-ET with respect to healthy subjects (P(corrected) < .001). Patients with a-ET showed a trend toward a vermal GM volume loss that did not reach a significant difference with respect to healthy controls (P(uncorrected) < .01). The region-of-interest analysis showed a reduction of the cerebellar volume (CV) in the h-ET group (98.2 +/- 13.6 mm(3)) compared with healthy controls (110.5 +/- 15.5 mm(3), P < .012) as well as in the entire vermal area (790.3 +/- 94.5 mm(2), 898.6 +/- 170.6 mm(2), P < .04 in h-ET and control groups, respectively).ConclusionsAtrophy of the cerebellar vermis detected in patients with h-ET strongly supports the evidence for the involvement of the cerebellum in the pathophysiology of ET. The lack of a significant CV loss observed in patients with a-ET suggests that a-ET and h-ET might represent distinct subtypes of the same disease.

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