Open AccessThe cerebral tremor circuit in a patient with Holmes tremor
Author(s) -
Nieuwhof Freek,
Bie Rob M.A.,
Praamstra Peter,
Munckhof Pepijn,
Helmich Rick C.
Publication year - 2020
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51143
Subject(s) - connectome , lesion , medicine , neuroscience , cerebellar vermis , cerebral cortex , functional connectivity , cerebellum , pathology , psychology
The cerebral network associated with Holmes tremor has never been determined directly. A previous study reported a brain network that is functionally connected, in healthy individuals, to different lesions that cause Holmes tremor (lesion connectome). We report a 71‐year‐old man with severe left‐sided tremor caused by a microbleed near the right red nucleus. Using accelerometry‐fMRI, we show tremor‐related activity in contralateral sensorimotor cortex and cerebellar vermis. This network was distinct from, but functionally coupled to, the Holmes lesion connectome. We propose that Holmes tremor involves three distinct cerebral mechanisms: a structural lesion, an intermediate lesion connectome, and symptom‐related activity.