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J Neural Transm (Vienna). 2019 May;126(5):597-606. doi: 10.1007/s00702-019-01992-3. Epub 2019 Mar 19.

Abnormal hippocampal subfields are associated with cognitive impairment in Essential Tremor.

Author information

1
Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India.
2
Department of Neurology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India.
3
Symbiosis Center for Medical Image Analysis, Symbiosis International (Deemed) University, Lavale, Mulshi, Pune, Maharashtra, 412115, India.
4
Symbiosis Institute of Technology, Symbiosis International (Deemed) University, Lavale, Mulshi, Pune, Maharashtra, 412115, India.
5
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India.
6
Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India.
7
Department of Neurology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, 560029, India. palpramod@hotmail.com.

Abstract

Multi-domain cognitive impairment (CI) has been frequently described in patients with essential tremor (ET). However, the exact neuroanatomical basis for this impairment is uncertain. This study aims to ascertain the role of the hippocampal formation in cognitive impairment in ET. Forty patients with ET and 40 age, gender and education matched healthy controls (HC) were enrolled. Cognition was assessed using a structured neuropsychological battery and patients were categorized as ET with CI (ETCI) and ET without CI (ETNCI). Automatic segmentation of hippocampal subfields was performed using FreeSurfer 6.0. The obtained volumes were correlated with scores of neuropsychological tests. Significant atrophy of the left subiculum, CA4, granule-cell layer of dentate gyrus, right molecular layer, and hypertrophy of bilateral parasubiculum, right hippocampus-amygdala-transition-area, bilateral hippocampal tail (HT) and widening of right hippocampal fissure was observed in ET. Trends toward atrophy of right subiculum, and widening of left HF was also observed. Comparison of HC and ETCI revealed atrophy of right subiculum, hypertrophy of bilateral parasubiculum, HT, and widening of left HF. ETCI showed a trend toward widening of right HF. ETNCI had isolated left parasubicular hypertrophy and in comparison, to ETNCI the ETCI subgroup had atrophy of bilateral fimbria. Significant correlations were observed between the volumes of HT, HF, fimbria and scores of tests for executive function, working and verbal memory. Patients with ET have significant volumetric abnormalities of several hippocampal subfields and these abnormalities may be important contributors for some forms of cognitive impairment observed in ET.

KEYWORDS:

Cognitive impairment; Essential tremor; Hippocampus

PMID:
30888510
DOI:
10.1007/s00702-019-01992-3

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