A Voxel-Wise Meta-Analysis on the Cerebellum in Essential Tremor.

Ioannis Mavroudis,Symela Chatzikonstantinou,Alin Ciobica,Foivos Petrides,Eleni Karantali,Alin-Constantin Iordache,Romeo Dobrin,Dimitrios Kazis,Jack Mckenna,Constantin Trus

doi:10.3390/medicina57030264

Abstract

Background and Objectives: Essential tremor is a chronic progressive neurological condition. The clinical presentation of essential tremor is heterogeneous and includes involuntary tremor on hands or arms and progressively on head, jaw, and voice. More extensive and complex symptoms may also be noticed in several patients. Many studies have been carried out to identify biomarkers to help the diagnosis, however, all the efforts have not shown any substantial results yet. Materials and Methods: Here, we aimed to perform a voxel-based meta-analysis using a dedicated cerebellar mask to clarify whether the results from the previous studies are robust and have any clinical significance. We included studies with a total of 377 essential tremor patients and 338 healthy control individuals. Results: A significant regional decrease in the volume of the gray matter was detected in the right cerebellar hemispheric lobule IV/V, and in the cerebellar vermic lobule IV/V. Conclusions: This is the first study focused on the cerebellum and using a specific cerebellar mask, which increases the sensitivity. It showed regional statistically significant changes that could not be seen in the whole-brain analysis.

Highlights

Introduction iationsEssential tremor is a neurological disorder with heterogeneous clinical presentation.Patients with essential tremor exhibit involuntary tremor on hands or arms
We searched the online database of PubMed with the keywords (“essential tremor” OR “ET”) and (“Voxelbased” OR “morphometry” OR “voxel-based morphometry (VBM)”)
The current current study study is is not not the the first first Voxel-wise meta-analysis focused on the the cerebellum cerebellum using aa specific specific cerebellar cerebellar mask, which which increases increases the sensitivity sensitivity of caching regional changes that could not be seen in the whole-brain analysis

Summary

Introduction

Essential tremor is a neurological disorder with heterogeneous clinical presentation. Patients with essential tremor exhibit involuntary tremor on hands or arms. Some patients may have tremor of the head, the jaw, and voice [1,2,3,4]. According to the revised diagnostic criteria, the diagnosis of essential tremor demands isolated action tremor on both upper limbs with a minimum duration of three years, with or without tremor in the head, voice, and lower limbs [5]. Additional neurological findings—such as dystonia, ataxia, and/or parkinsonism—might be absent, mild memory impairment and impaired tandem gait can be present, and these patients are diagnosed with essential tremor plus syndrome [5]. The clinical presentation of essential tremor is heterogeneous and includes involuntary tremor on hands or arms and progressively on head, jaw, and voice.

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