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Altered brain network measures in patients with primary writing tremor

  • Functional Neuroradiology
  • Published:
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Abstract

Purpose

Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis.

Methods

This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis.

Results

There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC).

Conclusion

Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results.

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Author notes

  1. AL and KRJ contributed equally to this study.

Authors and Affiliations

  1. Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India

    Abhishek Lenka & Ketan Ramakant Jhunjhunwala

  2. Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, Karnataka, 560029, India

    Abhishek Lenka, Ketan Ramakant Jhunjhunwala, Ravi Yadav & Pramod Kumar Pal

  3. Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India

    Rajanikant Panda, Jitender Saini & Rose Dawn Bharath

Authors
  1. Abhishek Lenka
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  2. Ketan Ramakant Jhunjhunwala
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  3. Rajanikant Panda
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  4. Jitender Saini
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  6. Ravi Yadav
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  7. Pramod Kumar Pal
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Corresponding author

Correspondence to Pramod Kumar Pal.

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Funding

This study was funded by a grant from Department of Biotechnology, India (BT/PR4986/MED/30/753/2012).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the National Institute of Mental Health and Neurosciences (NIMHANS) Ethics Committee, Bangalore, India, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Lenka, A., Jhunjhunwala, K.R., Panda, R. et al. Altered brain network measures in patients with primary writing tremor. Neuroradiology 59, 1021–1029 (2017). https://doi.org/10.1007/s00234-017-1895-y

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  • DOI: https://doi.org/10.1007/s00234-017-1895-y

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