Abstract
Symptoms of essential tremor (ET) are similar to those of Parkinson’s disease (PD) during their initial stages. Presently, there are few stable biomarkers available on a neuroanatomical level for distinguishing between these two diseases. However, few investigations have directly compared the changes in brain volume and assessed the compensatory effects of a change in the parts of the brain associated with PD and with ET. To determine the compensatory and/or degenerative anatomical changes in the brains of PD and ET patients, the present study tested, via two voxel-based morphometry (VBM) approaches (Basic vs. DARTEL VBM processing), the anatomical brain images of 10 PD and 10 ET patients, as well as of 13 age-matched normal controls, obtained through a 3T magnetic resonance scanner. These findings indicate that PD and ET caused specific patterns of brain volume alterations in the brains examined. In addition, our observations also revealed compensatory effects, or self-reorganization, occurring in the thalamus and the middle temporal gyrus in the PD and ET patients, due perhaps in part to the enhanced thalamocortical sensorimotor interaction and the head-eye position readjustment, respectively, in these PD and ET patients. Such a distinction may lend itself to use as a biomarker for differentiating between these two diseases.
Highlights
IntroductionPatients with Parkinson’s disease (PD) and essential tremor (ET) share some common symptoms (such as resting tremor) during their initial stages of illness
Patients with Parkinson’s disease (PD) and essential tremor (ET) share some common symptoms during their initial stages of illness
CHANGES IN VOLUME OF BRAIN AREAS FOR PD PATIENTS AS COMPARED TO NORMAL SUBJECTS (PD vs. CT) Both voxel-based morphometry (VBM) methods consistently found brain volumes to have decreased in the brain areas of the lentiform nucleus (LN), the IN, the middle frontal gyrus (MFG), and the cerebellar vermis in the PD group when compared to the normal controls
Summary
Patients with Parkinson’s disease (PD) and essential tremor (ET) share some common symptoms (such as resting tremor) during their initial stages of illness. The voxel-based morphometry (VBM) technique has been applied often for studying brain volume changes in PD and other degenerative brain diseases These studies have shown brain atrophy to exist in many cortical and subcortical regions, in the basal ganglia [BG, which contains five nuclei: the caudate nucleus (CN), the putamen (PT), the globus pallidus (GP), the sub-thalamic nucleus (STN), and the substantia nigra (SN)] within the PD group (Gazzaniga et al, 2008; Mink, 2008; Dum and Strick, 2009; Watts et al, 2011). Among the brain areas that increased in volume are the frontal lobe, the temporo-parietal junction (TPJ), the parietal lobe, the insula (IN), the anterior cingulate cortex (ACC), the BG, and the thalamus, as has been reported in the literature Few of these findings were wholly consistent with each other (see Table 1). This issue of brain volume increases detected with VBM in PD groups will require further examination
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