Cerebral control of unimanual and bimanual movements: an H2(15)O PET study.

We measured regional cerebral blood flow (rCBF) during unimanual and bimanual movements using H2(15)O PET. Six healthy volunteers performed unimanual, bimanual-symmetric and bimanual-asymmetric ballistic finger movements. The study was designed to minimize anticipation and preparation of movements. Data were analysed using SPM. Unpredictably paced unimanual movements resulted in significant activation of contralateral primary motor-somatosensory cortex (M1-S1) and mesial frontal cortex (p < 0.001). Performance of symmetric bimanual movements resulted in bilateral activation, but no additional activation of mesial frontal cortex was shown. Comparison of asymmetric with symmetric bimanual movements revealed additional recruitment of mesial frontal cortex (p< 0.001). We suggest that rostral mesial frontal cortex facilitates asymmetric non-mirrored bimanual finger movements.

A positron emission tomography study of cerebral activation associated with essential and writing tremor.

OBJECTIVE: To compare the abnormal patterns of cerebral activation associated with essential and writing tremors. DESIGN: Positron emission tomography using oxygen 15-labeled water was utilized to determine regional cerebral blood flow. Positron emission tomography images that were taken of the brain in individual patients were coregistered with magnetic resonance images of the same brain to ascertain accurate localization of cerebral activation in single patients. Patients with essential tremor underwent scanning at rest, during involuntary postural tremor, and during passive wrist oscillation. Normal control subjects underwent scanning at rest and during voluntary and passive wrist oscillation. Patients with writing tremor underwent scanning while they were holding a pen to paper with consequent involuntary tremor and again while they were holding a pen in the same supinated arm without tremor. SETTING: Research hospital. PATIENTS OR OTHER PARTICIPANTS: Seven patients with essential tremor, six patients with writing tremor, and six matched control subjects. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Regional cerebral blood flow. RESULTS: Essential tremor was associated with abnormal bilateral cerebellar, red nuclear, and thalamic activation. Writing tremor was also associated with abnormal bilateral cerebellar activation. Voluntary wrist oscillation in control subjects caused only ipsilateral cerebellar activation. These findings were evident in single patients, when positron emission tomography images were coregistered with magnetic resonance images and on group analysis of the pooled positron emission tomography data after transformation into stereotaxic space. CONCLUSION: These results indicate that both essential and writing tremors are associated with abnormal bilateral overactivity of cerebellar connections.