The Cerebellum

, Volume 16, Issue 3, pp 623–628 | Cite as

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

  • Camila Callegari Piccinin
  • Lidiane Soares Campos
  • Rachel Paes Guimarães
  • Luiza Gonzaga Piovesana
  • Maria Cristina Arci dos Santos
  • Paula Christina Azevedo
  • Brunno Machado Campos
  • Thiago Junqueira Ribeiro de Rezende
  • Augusto Amato-Filho
  • Fernando Cendes
  • Anelyssa D’Abreu
Original Paper


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.


Parkinson’s disease Cerebellum Resting tremor Voxel-based morphometry Suit 



The authors thank Dr. J.H. Friedman for critically reviewing this manuscript and his invaluable suggestions.

This work was supported by FAPESP (Sao Paulo Research Foundation), grant number 2013/02660-8 and by CNPq (National Counsel of Technological and Scientific Development), grant number 74873/2010-2.

Contributorship Statement

Author roles:

1) Research project:

A. Conception: ADA, CCP, LSC, FC

B. Organization: ADA, CCP, LSC


2) Statistical analysis



C. Review and critique: ADA, FC

3) Manuscript

A. Writing of the first draft: CCP, ADA

B. Review and critique: ADA, FC, LGP, LSC, RPG, ACAF

Compliance with Ethical Standards


This work was supported by FAPESP (Sao Paulo Research Foundation), grant number 2013/02660-8 and by CNPq (National Counsel of Technological and Scientific Development), grant number 74873/2010-2.

Competing Interests

The authors declare that they have no conflict of interest.

Financial Disclosure of All Authors

Camila C Piccinin: Research grant from FAPESP

Lidiane S Campos: Educational grant from Ipsen

Rachel P Guimarães: Research grant from FAPESP

Luiza G Piovesana: Educational grant from Ipsen

Maria C A Santos: Research grant from FAPESP

Paula Christina Azevedo: None

Brunno M Campos: Research grant from FAPESP

Thiago Junqueira Ribeiro de Rezende: Research grant from FAPESP

Augusto C Amato-Filho: None

Fernando Cendes: Supported by grants from FAPESP and CNPq, BRAZIL

Anelyssa D’Abreu: Travel grant from TEVA; lecture fees from Torrent; consulting fees from EMS; research grant from FAPESP and CNPq, Brazil


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Camila Callegari Piccinin
    • 1
  • Lidiane Soares Campos
    • 2
  • Rachel Paes Guimarães
    • 1
  • Luiza Gonzaga Piovesana
    • 2
  • Maria Cristina Arci dos Santos
    • 1
  • Paula Christina Azevedo
    • 2
  • Brunno Machado Campos
    • 1
  • Thiago Junqueira Ribeiro de Rezende
    • 1
  • Augusto Amato-Filho
    • 3
  • Fernando Cendes
    • 1
    • 2
  • Anelyssa D’Abreu
    • 1
    • 2
  1. 1.Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasBrazil
  2. 2.Department of NeurologyUniversity of CampinasCampinasBrazil
  3. 3.Department of RadiologyUniversity of CampinasCampinasBrazil

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