1. Contextualizing the pathology in the essential tremor cerebellar cortex: a patholog-omics approach
- Author
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Sheng-Han Kuo, Chloë A. Kerridge, Peter A. Sims, Regina T. Martuscello, Phyllis L. Faust, Elan D. Louis, Arnulf H. Koeppen, Jean Paul G. Vonsattel, Daniel Trujillo Diaz, and Debotri Chatterjee
- Subjects
Male ,0301 basic medicine ,Cerebellum ,Pathology ,medicine.medical_specialty ,Degenerative Disorder ,Essential Tremor ,Biology ,Article ,Pathology and Forensic Medicine ,Cerebellar Cortex ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Degenerative disease ,medicine ,Cerebellar Degeneration ,Humans ,Spinocerebellar Ataxias ,Aged ,Aged, 80 and over ,Dystonia ,Essential tremor ,Parkinson Disease ,Middle Aged ,Multiple System Atrophy ,medicine.disease ,Axons ,030104 developmental biology ,medicine.anatomical_structure ,nervous system ,Dystonic Disorders ,Cerebellar cortex ,Spinocerebellar ataxia ,Female ,sense organs ,Neurology (clinical) ,030217 neurology & neurosurgery - Abstract
Several morphological changes, centered in/around Purkinje cells (PCs), have been identified in the cerebellum of essential tremor (ET) patients. These changes have not been contextualized within a broader degenerative disease spectrum, limiting their interpretability. To address this, we compared the severity and patterning of degenerative changes within the cerebellar cortex in patients with ET, other neurodegenerative disorders of the cerebellum (spinocerebellar ataxias (SCAs), multiple system atrophy (MSA)], and other disorders that may involve the cerebellum [Parkinson's disease (PD), dystonia]. Using a postmortem series of 156 brains [50 ET, 23 SCA (6 SCA3; 17 SCA 1, 2 or 6), 15 MSA, 29 PD, 14 dystonia, 25 controls], we generated data on 37 quantitative morphologic metrics, which were grouped into 8 broad categories: (1) PC loss, (2) heterotopic PCs, (3) PC dendritic changes, (4) PC axonal changes (torpedoes), (5) PC axonal changes (other than torpedoes), (6) PC axonal changes (torpedo-associated), (7) basket cell axonal hypertrophy, (8) climbing fiber-PC synaptic changes. Our analyses used z scored raw data for each metric across all diagnoses (5772 total data items). Principal component analysis revealed that diagnostic groups were not uniform with respect to cerebellar pathology. Dystonia and PD each differed from controls in only 2/37 metrics, whereas ET differed in 21, SCA3 in 8, MSA in 19, and SCA1/2/6 in 26 metrics. Comparing ET with primary disorders of cerebellar degeneration (i.e., SCAs), we observed a spectrum of changes reflecting differences of degree, being generally mild in ET and SCA3 and more severe in SCA1/2/6. Comparative analyses across morphologic categories demonstrated differences in relative expression, defining distinctive patterns of changes in these groups. Thus, the degree of cerebellar degeneration in ET aligns it with a milder end in the spectrum of cerebellar degenerative disorders, and a somewhat distinctive signature of degenerative changes marks each of these disorders.
- Published
- 2019