{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:02:16Z","timestamp":1785762136642,"version":"3.56.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T00:00:00Z","timestamp":1638748800000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>We examined for the first time the imaging characteristics of Holmes tremor (HT) through multimodal 3D medical imaging.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>Three patients with Holmes tremor who visited the Affiliated Hospital of Chengdu University of TCM from August 2018 to April 2021 were retrospectively investigated to summarize their clinical and imaging data.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Holmes tremor in two of the three patients was caused by hypertensive cerebral hemorrhage and in the third patient induced by hemorrhage due to ruptured brain arteriovenous malformations. HT occurred 1 to 24\u2009months after the primary disease onset and manifested as a tremor in the contralateral limb, mostly in the upper portion. Cranial MRI showed that the lesions involved the thalamus in all three patients. The damaged thalamic nuclei included the ventral anterior nucleus, ventral lateral nucleus and ventromedial lateral nucleus, and the damaged nerve fibers included left thalamocortical tracts in one patient. In the other two patients, the damaged thalamic nuclei included the centromedian and dorsomedial nucleus, and the damaged nerve fibers included left cerebellothalamic and thalamocortical tracts. One patient showed significant improvement after treatment with pramipexole while the other two patients exhibited a poor response, one of whom had no response to the treatment with pramipexole and was only significantly relieved by clonazepam.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We used multimodal 3D medical imaging for the first time to analyze the pathogenesis of HT and found that multiple thalamic nuclei were damaged. The damaged nuclei and nerve fiber tracts of two patients were different from those of the third patient, with different clinical manifestations and therapeutic effects. Therefore, it is speculated that there may be multiple pathogeneses for HT.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12883-021-02503-2","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T07:02:28Z","timestamp":1638774148000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Study on the pathogenesis of Holmes tremor by multimodal 3D medical imaging: case reports of three patients"],"prefix":"10.1186","volume":"21","author":[{"given":"Min","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anrong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suoguo","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7459-6922","authenticated-orcid":false,"given":"Huan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,6]]},"reference":[{"key":"2503_CR1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1212\/WNL.40.1.62","volume":"40","author":"MR Samie","year":"1990","unstructured":"Samie MR, Selhorst JB, Koller WC. Post-traumatic midbrain tremors. Neurology. 1990;40:62\u20136.","journal-title":"Neurology"},{"key":"2503_CR2","first-page":"801","volume":"99","author":"ZQ Liu","year":"2019","unstructured":"Liu ZQ, Wan ZR, Jia XT, Yang XZ, Fang XX, Zhang ZY. Clinical features and short-term prognosis of Holmes' tremor. Zhonghua Yi Xue Za Zhi. 2019;99:801\u20135.","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"2503_CR3","first-page":"360","volume":"122","author":"A Gajos","year":"2010","unstructured":"Gajos A, Bogucki A, Schinwelski M, So\u0142tan W, Rudzi\u0144ska M, Budrewicz S, et al. The clinical and neuroimaging studies in Holmes tremor. Acta Neurol Scand. 2010;122:360\u20136.","journal-title":"Acta Neurol Scand"},{"key":"2503_CR4","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/j.neuroimage.2012.01.021","volume":"62","author":"B Fischl","year":"2012","unstructured":"Fischl B. FreeSurfer Neuroimage. 2012;62:774\u201381.","journal-title":"FreeSurfer Neuroimage"},{"key":"2503_CR5","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1016\/j.neuroimage.2018.08.012","volume":"183","author":"JE Iglesias","year":"2018","unstructured":"Iglesias JE, Insausti R, Lerma-Usabiaga G, Bocchetta M, Van Leemput K, Greve DN, et al. A probabilistic atlas of the human thalamic nuclei combining ex vivo MRI and histology. Neuroimage. 2018;183:314\u201326.","journal-title":"Neuroimage"},{"issue":"Suppl 3","key":"2503_CR6","first-page":"2","volume":"13","author":"G Deuschl","year":"1998","unstructured":"Deuschl G, Bain P, Brin M. Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee. Mov Disord. 1998;13(Suppl 3):2\u201323.","journal-title":"Mov Disord"},{"key":"2503_CR7","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.3171\/2015.2.JNS141098","volume":"122","author":"C Kilbane","year":"2015","unstructured":"Kilbane C, Ramirez-Zamora A, Ryapolova-Webb E, Qasim S, Glass GA, Starr PA, et al. Pallidal stimulation for Holmes tremor: clinical outcomes and single-unit recordings in 4 cases. J Neurosurg. 2015;122:1306\u201314.","journal-title":"J Neurosurg"},{"key":"2503_CR8","first-page":"558","volume":"10","author":"M Alqwaifly","year":"2016","unstructured":"Alqwaifly M. Treatment responsive Holmes tremor: case report and literature review. Int J Health Sci (Qassim). 2016;10:558\u201362.","journal-title":"Int J Health Sci (Qassim)"},{"key":"2503_CR9","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1002\/mds.870090225","volume":"9","author":"P Krack","year":"1994","unstructured":"Krack P, Deuschl G, Kaps M, Warnke P, Schneider S, Traupe H. Delayed onset of \u201crubral tremor\u201d 23 years after brainstem trauma. Mov Disord. 1994;9:240\u20132.","journal-title":"Mov Disord"},{"key":"2503_CR10","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1007\/s00702-017-1780-1","volume":"124","author":"A Gajos","year":"2017","unstructured":"Gajos A, Budrewicz S, Koszewicz M, Bie\u0144kiewicz M, D\u0105browski J, Ku\u015bmierek J, et al. Is nigrostriatal dopaminergic deficit necessary for Holmes tremor to develop? The DaTSCAN and IBZM SPECT study. J Neural Transm (Vienna). 2017;124:1389\u201393.","journal-title":"J Neural Transm (Vienna)"},{"key":"2503_CR11","volume-title":"Neurologisch-topische Diagnostik: Anatomie-Funktion-Klinik","author":"P Duus","year":"2003","unstructured":"Duus P. Neurologisch-topische Diagnostik: Anatomie-Funktion-Klinik, vol. 299: Naval press; 2003."},{"key":"2503_CR12","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1002\/ana.25618","volume":"86","author":"J Joutsa","year":"2019","unstructured":"Joutsa J, Shih LC, Fox MD. Mapping holmes tremor circuit using the human brain connectome. Ann Neurol. 2019;86:812\u201320.","journal-title":"Ann Neurol"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-021-02503-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-021-02503-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-021-02503-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T19:05:19Z","timestamp":1638817519000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcneurol.biomedcentral.com\/articles\/10.1186\/s12883-021-02503-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2503"],"URL":"https:\/\/doi.org\/10.1186\/s12883-021-02503-2","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"22 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Each patient gave written consent to their personal or clinical details and to any identifying images to be published in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"473"}}