Frederique Mc Boonstra1, Gustavo Noffs2, Thushara Perera3, Vilija G Jokubaitis4, Adam P Vogel5, Bradford A Moffat1, Helmut Butzkueven4, Andrew Evans6, Anneke van der Walt7, Scott C Kolbe8. 1. Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia. 2. Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia/Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC, Australia. 3. The Bionics Institute, East Melbourne, VIC, Australia/Department of Medical Bionics, University of Melbourne, Parkville, VIC, Australia. 4. Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia. 5. Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC, Australia/The Bionics Institute, East Melbourne, VIC, Australia/Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany/Redenlab, Melbourne, VIC, Australia. 6. Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia/The Bionics Institute, East Melbourne, VIC, Australia. 7. Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia/The Bionics Institute, East Melbourne, VIC, Australia/Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia. 8. Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia/Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.
Abstract
BACKGROUND: Tremor is present in almost half of multiple sclerosis (MS) patients. The lack of understanding of its pathophysiology is hampering progress in development of treatments. OBJECTIVES: To clarify the structural and functional brain changes associated with the clinical phenotype of upper limb tremor in people with MS. METHODS: Fifteen healthy controls (46.1 ± 15.4 years), 27 MS participants without tremor (46.7 ± 11.6 years) and 42 with tremor (46.6 ± 11.5 years) were included. Tremor was quantified using the Bain score (0-10) for overall severity, handwriting and Archimedes spiral drawing. Functional magnetic resonance imaging activations were compared between participants groups during performance of a joystick task designed to isolate tremulous movement. Inflammation and atrophy of cerebello-thalamo-cortical brain structures were quantified. RESULTS: Tremor participants were found to have atrophy of the cerebellum and thalamus, and higher ipsilateral cerebellar lesion load compared to participants without tremor (p < 0.020). We found higher ipsilateral activation in the inferior parietal lobule, the premotor cortex and supplementary motor area in MS tremor participants compared to MS participants without tremor during the joystick task. Finally, stronger activation in those areas was associated with lower tremor severity. CONCLUSION: Subcortical neurodegeneration and inflammation along the cerebello-thalamo-cortical and cortical functional neuroplasticity contribute to the severity of tremor in MS.
BACKGROUND:Tremor is present in almost half of multiple sclerosis (MS) patients. The lack of understanding of its pathophysiology is hampering progress in development of treatments. OBJECTIVES: To clarify the structural and functional brain changes associated with the clinical phenotype of upper limb tremor in people with MS. METHODS: Fifteen healthy controls (46.1 ± 15.4 years), 27 MS participants without tremor (46.7 ± 11.6 years) and 42 with tremor (46.6 ± 11.5 years) were included. Tremor was quantified using the Bain score (0-10) for overall severity, handwriting and Archimedes spiral drawing. Functional magnetic resonance imaging activations were compared between participants groups during performance of a joystick task designed to isolate tremulous movement. Inflammation and atrophy of cerebello-thalamo-cortical brain structures were quantified. RESULTS:Tremorparticipants were found to have atrophy of the cerebellum and thalamus, and higher ipsilateral cerebellar lesion load compared to participants without tremor (p < 0.020). We found higher ipsilateral activation in the inferior parietal lobule, the premotor cortex and supplementary motor area in MS tremorparticipants compared to MS participants without tremor during the joystick task. Finally, stronger activation in those areas was associated with lower tremor severity. CONCLUSION:Subcortical neurodegeneration and inflammation along the cerebello-thalamo-cortical and cortical functional neuroplasticity contribute to the severity of tremor in MS.
Entities:
Keywords:
Multiple sclerosis; functional magnetic resonance imaging; magnetic resonance imaging
Authors: Myrte Strik; Camille J Shanahan; Anneke van der Walt; Frederique M C Boonstra; Rebecca Glarin; Mary P Galea; Trevor J Kilpatrick; Jeroen J G Geurts; Jon O Cleary; Menno M Schoonheim; Scott C Kolbe Journal: Hum Brain Mapp Date: 2021-03-05 Impact factor: 5.038
Authors: Myrte Strik; L Eduardo Cofré Lizama; Camille J Shanahan; Anneke van der Walt; Frederique M C Boonstra; Rebecca Glarin; Trevor J Kilpatrick; Jeroen J G Geurts; Jon O Cleary; Menno M Schoonheim; Mary P Galea; Scott C Kolbe Journal: Brain Commun Date: 2021-03-16