Background Essential tremor involves the cerebellum, yet quantitative analysis of dentate nucleus neurons has not been conducted. Objectives To quantitatively compare neuronal density or neuronal number in the dentate nucleus of essential tremor versus age‐matched controls. Methods Using a 7‐μm thick Luxol fast blue hematoxylin and eosin‐stained paraffin section, dentate nucleus neuronal density (neurons/mm2) was determined in 25 essential tremor cases and 25 controls. We also applied a stereological approach in a subset of four essential tremor cases and four controls to estimate total dentate nucleus neuronal number. Results Dentate nucleus neuronal density did not differ between essential tremor cases and controls (P = 0.44). Total dentate nucleus neuronal number correlated with neuronal density (P = 0.007) and did not differ between essential tremor cases and controls (P = 0.95). Conclusions Neuronal loss, observed in the Purkinje cell population in essential tremor, did not seem to similarly involve the dentate nucleus in essential tremor. © 2020 International Parkinson and Movement Disorder Society

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