BackgroundThe various symptoms of Parkinson's disease (PD) may change differently over time as the disease progresses. Tremor usually manifests early in the disease, but unlike other motor symptoms, its severity may diminish over time. The cerebral mechanisms underlying these symptom‐specific longitudinal trajectories are unclear. Previous magnetic resonance imaging (MRI) studies have shown structural changes in brain regions associated with PD tremor, suggesting that structural changes over time may define clinical trajectories.ObjectivesThe aims were to investigate the longitudinal trajectory of PD tremor in relation to bradykinesia and rigidity, and assess whether tremor progression is related to structural changes in tremor‐related areas.MethodsWe used data from the Personalized Parkinson Project: a two‐year longitudinal study involving 520 PD patients and 60 healthy controls, who were measured twice clinically and with MRI. Mixed‐effects models were used to compare tremor, bradykinesia, and rigidity progression; investigate gray matter changes in tremor‐related regions (cerebello‐thalamo‐cortical circuit and pallidum); and calculate associations between symptom severity and brain structure. Associations across the whole brain were included to assess anatomical specificity.ResultsBradykinesia and rigidity worsened over 2 years, whereas tremor behaved differently: resting tremor severity remained stable, whereas postural and kinetic tremor severity decreased. Attenuation of postural and kinetic tremor was associated with, but not restricted to, atrophy in tremor‐related areas. Opposite relationships were observed for bradykinesia and rigidity.ConclusionsAction tremor (postural and kinetic) is an early symptom of PD, which reduces with disease progression. Longitudinal brain atrophy correlates with tremor and other motor symptoms in opposite ways. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

中文翻译：

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帕金森病动作震颤随时间的变化：临床和神经影像学相关性


背景随着疾病的进展，帕金森病 （PD） 的各种症状可能会随着时间的推移而发生不同的变化。震颤通常在疾病早期表现出来，但与其他运动症状不同，其严重程度可能会随着时间的推移而减轻。这些症状特异性纵向轨迹背后的大脑机制尚不清楚。先前的磁共振成像 （MRI） 研究表明，与 PD 震颤相关的大脑区域结构变化，表明随着时间的推移，结构变化可能定义了临床轨迹。目的目的是研究 PD 震颤与运动迟缓和强直相关的纵向轨迹，并评估震颤进展是否与震颤相关区域的结构变化有关。方法我们使用了来自个性化帕金森项目的数据：一项为期两年的纵向研究，涉及 520 名 PD 患者和 60 名健康对照者，他们进行了两次临床测量和 MRI 测量。混合效应模型用于比较震颤、运动迟缓和强直进展;研究震颤相关区域（小脑-丘脑-皮质回路和苍白球）的灰质变化;并计算症状严重程度与大脑结构之间的关联。包括整个大脑的关联以评估解剖特异性。结果运动迟缓和强直在 2 年内恶化，而震颤的表现不同：静止性震颤严重程度保持稳定，而姿势和运动性震颤严重程度下降。姿势和运动性震颤的衰减与震颤相关区域的萎缩有关，但不限于震颤相关区域的萎缩。观察到运动迟缓和僵硬的相反关系。结论动作性震颤 （姿势性和运动性） 是 PD 的早期症状，随着疾病进展而减轻。 纵向脑萎缩与震颤和其他运动症状以相反的方式相关。© 2024 作者。由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版的《运动障碍》。