{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:47:02Z","timestamp":1763038022640,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004700","name":"Taipei Medical University","doi-asserted-by":"publisher","award":["TMU112-AE1-B19"],"award-info":[{"award-number":["TMU112-AE1-B19"]}],"id":[{"id":"10.13039\/501100004700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: The role of the cerebellum in Parkinson\u2019s disease (PD), particularly in tremor-dominant subtypes, is increasingly recognized. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) provide anatomical and metabolic insights, suggesting compensatory hyperactivity or degenerative changes in the cerebellum in PD. Volumetric analysis of cerebellar structures in MRI images, combined with metabolic profiles from MRS, offers possibilities for differentiating PD from essential tremor (ET). The cerebellum may be a potential therapeutic target due to its role in neurocircuitry of PD and ET. Methods: Brain structural data were obtained using MRI, and cerebellar metabolic profiles, focusing on the quantification of N-acetylaspartate (NAA), choline, and creatine peaks were obtained using MRS. This study enrolled patients with ET and PD, both with and without tremor, as well as disease controls with cerebellar atrophy (including spinocerebellar ataxia and multiple system atrophy). Volumetric analysis of cerebellar structures was performed. Differences in MRI and MRS parameters were analyzed using one-way analysis of covariance with a significance threshold of p &lt; 0.05. Results: From November 2018 to March 2023, 111 patients were enrolled, including 29 ET, 29 cerebellar atrophy, 12 PD without tremor, and 41 PD with tremor. No significant differences in cerebellar volume and N-acetylaspartate\/creatine and choline\/creatine ratios were found between ET and PD with tremor. Conclusions: This preliminary retrospective study suggests similarities in cerebellar structures and metabolic profiles between ET and PD, highlighting the need for advanced imaging techniques to better differentiate between these conditions. Future research should integrate clinical data, such as tremor severity and cognitive assessments, to explore the relationships with cerebellar MRI parameters.<\/jats:p>","DOI":"10.3390\/diagnostics14212430","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T08:44:04Z","timestamp":1730364244000},"page":"2430","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cerebellar Structural and N-Acetylaspartate, Choline, and Creatine Metabolic Profiles in Parkinson\u2019s Disease and Essential Tremor"],"prefix":"10.3390","volume":"14","author":[{"given":"Chien-Tai","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei 110, Taiwan"},{"name":"Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3538-3430","authenticated-orcid":false,"given":"Cheng-Chang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei 110, Taiwan"},{"name":"International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Yen-Ting","family":"Chen","sequence":"additional","affiliation":[{"name":"Taipei Neuroscience Institute, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Department of Medical Imaging, Shuang Ho Hospital, Taipei Medical University, New Taipei 235, Taiwan"},{"name":"Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-Ping","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei 110, Taiwan"},{"name":"Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lung","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei 110, Taiwan"},{"name":"Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Taipei Neuroscience Institute, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5334\/tohm.712","article-title":"Tremor in Parkinson\u2019s Disease: From Pathophysiology to Advanced Therapies","volume":"12","author":"Abusrair","year":"2022","journal-title":"Tremor Other Hyperkinet Mov."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1152\/jn.01132.2015","article-title":"Cerebellar role in Parkinson\u2019s disease","volume":"116","author":"Mirdamadi","year":"2016","journal-title":"J. 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