Objective: We aimed to evaluate cerebral blood flow (CBF) in patients with untreated ET, de novo tremor-dominant PD (PDT) and age- and gender- matched controls using a three-dimensional (3D) continuous pulse arterial spin labeling (ASL) technique.

Background: Essential tremor (ET) is the most common motor disorder in the elderly, while the etiology and pathophysiology of ET are still little to be known and it remains a challenge to differentiate ET from tremor-dominant Parkinson’s disease (PDT ) in the early stage. To date, there are few studies that have examined changes of cerebral blood flow(CBF) , that may be a potential biomarkers to differentiate untreated patients with ET from those with de novo PDT and indicate correlation between non-motor manifestations and abnormal metabolic brain regions.

Method: Twenty-four untreated ET patients, 25 de novo PDT patients and 49 healthy control subjects who underwent clinical examination, motor and cognitive evaluations were recruited. Three-dimensional continuous pulse arterial spin labeling (3D pCASL) scan were used to investigate CBF with a voxel-based brain analysis. The voxel-wise ANOVA and t tests were performed with p value set at < .001 corrected using AlphaSim taking a contiguous cluster of at least 125 voxels as significant.

Results: No significant differences were found in CBF between patients with ET and control group. The patient with PDT showed relatively decreased metabolic brain regions including left superior frontal gyrus , left middle frontal gyrus and occipital lobe sub-gyral comparing with controls, while relative increased region were seen in the right superior frontal gyrus. When comparing ET with PDT, the hyperperfusion regions were seen in the right cerebellum posterior lobe, left caudate, bilateral middle frontal gyrus, left Lingual Gyrus and left parietal Lobe sub-gyral.

Conclusion: These imaging data showed altered metabolic patterns of tremor disorders, which indicated different pathophysiological mechanism.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/different-patterns-of-cortical-and-subcortical-perfusion-changes-in-essential-tremor-and-tremor-dominant-parkinsons-disease-using-voxel-based-analysis-of-3d-arterial-spin-labeling-imaging/