Abstract
Objective: To identify the consistent gray matter (GM) volume changes from the whole brain voxel-based morphometry (VBM) studies on essential tremor (ET).Methods: The whole brain VBM studies comparing ET patients and healthy controls (HCs) were systematically searched in the PubMed, Embase and Web of Science from January 2000 to December 2017. Coordinates with significant differences in regional GM volume between ET patients and HCs were extracted from included studies and the meta-analysis was performed using effect size-based signed differential mapping (ES-SDM).Results: A total of 10 studies with 241 ET patients and 213 HCs were included in the meta-analysis. The consistent GM volume reduction was detected in the left precuneus extending to the left posterior cingulate gyrus. The subgroup meta-analysis which included studies performed on a 3.0 T scanner revealed significant GM volume increases in the bilateral frontal lobes, bilateral temporal lobes, left insula, left striatum and left pons, but obvious publication biases of these findings were detected through funnel plots and Egger's tests.Conclusions: The consistent result of our meta-analysis showed a structural damage in the left precuneus extending to the left posterior cingulate gyrus, which possibly played a role in the cognitive dysfunction and depression in ET patients. It might enhance our understanding of the pathophysiological mechanisms underlying ET.
Highlights
Essential tremor (ET) is one of the most common movement disorders, usually characterized by largely symmetrical postural and kinetic tremor of the upper limbs in the absence of other neurological signs [1]
The gray matter (GM) volumes abnormalities were found in various cerebral regions located in temporal lobe, frontal lobe, parietal lobe, precuneus, insula, caudate nucleus and so on, which mainly indicated motor networks potentially affected in ET like the cerebellothalamo-cortical network [8,9,10, 12, 13]
Studies were considered for inclusion if they (a) investigated GM volume differences between ET patients and healthy controls (HCs) using whole-brain voxel-based analysis; (b) did not find significant differences or reported significant results in a standard stereotactic space (Talairach or Montreal Neurological Institute [MNI]) with three-dimensional coordinates (x, y, z); (c) were peer-reviewed and published in English
Summary
Essential tremor (ET) is one of the most common movement disorders, usually characterized by largely symmetrical postural and kinetic tremor of the upper limbs in the absence of other neurological signs [1]. Among different kinds of studies aimed to reveal the pathophysiology of ET, the structural neuroimaging study is important and basic for the in vivo exploration of brain abnormalities. Voxel-based morphometry (VBM), the most common method in structural neuroimaging studies, is a processing technique of magnetic resonance imaging (MRI) that can detect regional morphological changes in the whole brain. During the last 20 years, a number of VBM studies detected the gray matter (GM) differences between ET patients and healthy controls (HCs) but the findings of these studies are variable and conflicting. There were quite a few studies reported no significant difference of GM volume changes between general ET patients and HCs [14,15,16,17,18]
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