Fig. 4

Pathways in ET. Pathways of cerebellar error-correction in ET. The suggested neurodegeneration results in a relative decrease of excitatory neurotransmitter Glu, resulting in a hypothetical net decreased inhibitory effect from Purkinje cells on the dentate nucleus in ET. This will in turn lead to an imbalance in the cerebellar error correction, based on a relative decrease of the effect induced by the excitatory feedback response from the sensory system of ongoing movement. The MEGA-PRESS voxels were acquired at 3 T, separately for the R and L cerebellum, including both the Purkinje layer, and the subcortical dentatus nucleus. The MEGA-PRESS-voxel (either R or L) is represented by a dotted square. Labels (1) and (2) represent two specifically reported locations of structural-functional aberrations in ET versus healthy controls (see Discussion for more details). Excitatory and inhibitory synaptic stimulation is represented by green and yellow circles, respectively. (The image of a Purkinje cell was obtained from Gray’s anatomy, 1918 edition, in the public domain)