Differential diagnosis of essential tremor and Parkinson’s disease can be challenging due to overlapping clinical presentations, but these diseases differ in neuropathological features, which may be detected using diffusion spectrum imaging. We identified parts of a tremor-related cerebello-thalamo-cortical network based on diffusion spectrum imaging that differed among a cohort comprising essential tremor and Parkinson’s patients, and healthy-controls. The patient groups had minimally-overlapping areas of abnormal microstructure in the tremor-network, and these were significantly correlated with clinical and kinetic measures of tremor severity. A future DSI-based marker of tremor-network microstructure may aid in differential diagnosis of essential tremor and Parkinson’s disease.
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