Differential Pattern of Cerebellar Atrophy in Tremor-Predominant and Akinetic/Rigidity-Predominant Parkinson’s Disease

• Published in: Cerebellum (London, England) England), 2017-06, Vol.16 (3), p.623-628
• Main Authors: Piccinin, Camila Callegari, Campos, Lidiane Soares, Guimarães, Rachel Paes, Piovesana, Luiza Gonzaga, dos Santos, Maria Cristina Arci, Azevedo, Paula Christina, Campos, Brunno Machado, de Rezende, Thiago Junqueira Ribeiro, Amato-Filho, Augusto, Cendes, Fernando, D’Abreu, Anelyssa
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analysis of covariance; Atrophy; Basal ganglia; Biomedical and Life Sciences; Biomedicine; Brain Mapping; Cerebellar Diseases - pathology; Cerebellum; Cerebellum - pathology; Cortex; Female; Humans; Image Processing, Computer-Assisted - methods; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; Morphometry; Movement disorders; Neural Pathways - pathology; Neural Pathways - physiopathology; Neurobiology; Neurodegenerative diseases; Neurology; Neurosciences; Original Paper; Parkinson Disease - pathology; Parkinson Disease - physiopathology; Parkinson's disease; Substantia grisea; Tremor; Tremor - pathology; Tremor - physiopathology
• ISSN: 1473-4222; 1473-4230
• DOI: 10.1007/s12311-016-0834-5

Parkinson’s disease (PD) is an akinetic-rigid disorder characterized by basal ganglia dysfunction and a possible cerebello-thalamo-cortical circuit involvement. This study aims to investigate the pattern of cerebellar involvement in PD and to assess whether it correlates with clinical parameters. MRI scans were acquired from 50 healthy controls (HC) and 63 patients; 44 were classified as tremor-predominant-PD (PDT) and 19 as akinetic/rigidity-predominant-PD (PDAR). We designed an analysis of covariance including the three groups and contrasted as follows: (1) all 63 PD vs HC, (2) PDT vs HC, (3) PDAR vs HC, and (4) PDT vs PDAR. For a precise evaluation of the cerebellum, we used the SUIT tool for voxel-based morphometry. Applying p =  0.001 and extent threshold = 20 voxels, the overall PD group vs HC showed decreased gray matter (GM) in the left lobules VI and crus I. The PDT group showed decreased cerebellar GM when compared with HC at left lobules VI, VIIb, and VIIIa; at right lobules Crus I, VIIb, and VIIIb; and vermal lobules VI and VIIIa. When compared with PDAR, PDT also showed a decrease in the left lobules VIIIa ( p <  0.001). There were small clusters of both positive and negative correlation between disease duration and PDT group. The PDAR group showed no cerebellar changes. Our findings support the growing evidence of cerebellar involvement in the pathogenesis of the resting tremor.