Cerebellar Atrophy in Essential Tremor Using an Automated Segmentation Method

Cerasa, Antonio; Messina, Demetrio; Nicoletti, Giuseppe; Novellino, Fabiana; Lanza, P.; Condino, Francesca; Arabia, Gennarina; Salsone, Maria; Quattrone, Aldo

doi:10.3174/ajnr.a1544

Cited by 127 publications

(122 citation statements)

References 14 publications

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“…6,8,9 VBM is a morphologic technique that performs a statistical mapping of differences in brain morphology voxel-by-voxel, which produces gray matter "attenuation" or "concentration" measures or volume differences between the 2 groups; alternatively, manual/automatic volumetry is a quantitative measurement of specific brain regions in individual brains. 9,10 Quantitative morphologic assessment of individual brain structures is often based on volumetric measurements. Volume changes are intuitive features because they might explain atrophy or dilation due to illness.…”

Section: Discussionmentioning

confidence: 99%

“…This approach provides advantages similar to those of manual ROI drawing, 13,14 without the potential for rater bias, offering an anatomically accurate rendering of regional volumes. 10 Total intracranial volume was calculated and was used to correct the regional brain volume measurements. 15 Normalized hippocampal values were calculated as follows: [raw hippocampal volume/total intracranial volume] ϫ 1000.…”

Section: Automated Hippocampal Volumetrymentioning

confidence: 99%

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Advanced MRI Morphologic Study Shows No Atrophy in Healthy Individuals with Hippocampal Hyperintensity

Labate

Cerasa

Cherubini

et al. 2013

AJNR Am J Neuroradiol

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SUMMARY:We have already shown that brain MR imaging of healthy individuals frequently reveals either unilateral or bilateral Hh, which is considered a hallmark of hippocampal sclerosis. We performed a follow-up (5-year interval) clinical and advanced imaging study of these individuals to address whether Hh may have masked occult brain atrophy or contributed to a later onset of epilepsy. Subjects with Hh (n ϭ 13) underwent a detailed clinical-imaging protocol, with a 3T scan and were studied with automated hippocampal segmentation (FreeSurfer), whole brain voxel-based morphometry, and shape analysis. All 13 subjects with Hh had normal neurologic examination findings with no cognitive impairment. Multimodal structural neuroimaging methods did not show clear evidence of significant volumetric changes between subjects with or without Hh. We clearly showed that Hh is not associated with any occult brain atrophy; furthermore, none of the healthy subjects with MR imaging evidence of Hh developed epilepsy or trouble with cognition. ABBREVIATIONS:FDR ϭ false discovery rate; Hh ϭ hippocampal hyperintensity; Hs ϭ hippocampal sclerosis; TLE ϭ temporal lobe epilepsy; VBM ϭ voxel-based

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Section: Discussionmentioning

confidence: 99%

Section: Automated Hippocampal Volumetrymentioning

confidence: 99%

Advanced MRI Morphologic Study Shows No Atrophy in Healthy Individuals with Hippocampal Hyperintensity

Labate

Cerasa

Cherubini

et al. 2013

AJNR Am J Neuroradiol

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“…Several MR imaging studies, published in the past decade, sought to detect ET-specific morphologic abnormalities. Most studies highlighted atrophic changes in different lobules of the cerebellum 32,33 (but also in other brain regions 34,35 ).…”

Section: The Need For Neuroimaging Markers As a Diagnostic Tool For Etmentioning

confidence: 99%

“…Whole-brain analysis, on the other hand, allows exploration of widespread networks but may not be specific enough, with the risk of ignoring smaller regions and nuclei. 41 The data that make up all of the neuroimaging descriptions of ET were acquired at different magnet field strengths (most at 1.5T 32,33,36,40,46 and 3T 34,35,41,42,44 ). Accordingly, contrast and resolution, the parameters that, for the most part, guide the interpretation and analysis of the images, cannot be assumed constant.…”

Section: Potential Bias In Et Neuroimaging Studiesmentioning

confidence: 99%

Functional Anatomy of Essential Tremor: Lessons from Neuroimaging

Klaming

2013

American Journal of Neuroradiology

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SUMMARY:The neuropathogenetic processes underlying essential tremor appear to cause subtle morphologic changes in neural networks that include multiple brain structures, primarily the cerebellum, brain stem, frontal lobes, and thalamus. One of the main challenges of neuroimaging in essential tremor is differentiating disease-specific markers from the spectrum of structural changes that occur due to aging. This review discusses recent neuroimaging studies in the light of current knowledge of the neuropsychology and pathology of the disease. We suggest that the application of multiple macroscopic and microscopic neuroimaging modalities, combined with personalized information relative to cognitive and behavioral symptoms, is the prerequisite for a comprehensive classification and correct diagnosis of essential tremor. ABBREVIATIONS: ET ϭ essential tremor

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“…Much of the literature supports that ET is a disorder of cerebellar dysregulation, including the presence of intention tremor [Leegwater- Kim et al 2006;Louis et al 2009b], gait ataxia [Singer et al 1994;Stolze et al 2001], oculomotor abnormalities [Helmchen et al 2003] and problems with dysrhythmia and motor learning [Trillenberg et al 2006;Avanzino et al 2009;Bares et al 2010;Farkas et al 2006;Shill et al 2009;Kronenbuerger et al 2007]. In addition, postmortem studies in ET have indicated the presence of a variety of structural and degenerative changes in the cerebellum, including increased number of Purkinje cell axonal swellings ('torpedoes') [Louis et al 2007b;Axelrad et al 2008], increased number of displaced or heterotopic Purkinje cells [Kuo et al 2011], reduction in number of Purkinje cells in some studies [Axelrad et al 2008] [Bucher et al 1997], positron emission tomography [Jenkins et al 1993;Wills et al 1994;Colebatch et al 1990], 1 H magnetic resonance spectroscopic imaging [Louis et al 2002;Pagan et al 2003], diffusion tensor imaging [Shin et al 2008;Klein et al 2011;Nicoletti et al 2010], voxelbased morphometry [Benito-Leon et al 2009;Quattrone et al 2008] and studies using other automated volumetric methods [Cerasa et al 2009] which demonstrate the presence of functional, metabolic and structural abnormalities in the cerebellum of ET patients.…”

Section: Current Literature On the Relationships Between Et And Cognimentioning

confidence: 99%

The cognitive side of essential tremor: what are the therapeutic implications?

Janicki

Cosentino

Louis

2013

Ther Adv Neurol Disord

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While essential tremor (ET) has traditionally been categorized as a pure motor disease, cross-sectional and longitudinal studies of cognition in ET have demonstrated that these patients may have cognitive dysfunction. Recent epidemiological studies demonstrate an association between ET (particularly with onset after age 65) and increased risk for cognitive impairment and dementia. Although existing studies have generally conceptualized cognitive changes in ET as consistent with a 'frontosubcortical' or 'corticocerebellar' profile, results from these same studies suggest that cognitive impairment in ET may in fact be heterogeneous. Furthermore, the underlying mechanisms remain uncertain. Cognitive changes could be a byproduct of the cerebellar dysfunction of ET itself; alternately, they may be a feature of concomitant neurodegenerative diseases that have been associated in several studies with ET, including Alzheimer's disease, Parkinson's disease or progressive supranuclear palsy. While the study of cognitive dysfunction in ET has received research attention in recent years, the results of these studies have not been translated into the clinical domain and clinical practice. This review first summarizes the current literature on the potential relationships between ET and cognitive change. We then suggest areas of further clinical evaluation and treatment; these suggestions are directed at physicians caring for ET patients who may demonstrate or complain of cognitive impairment. As we discuss, clinicians should ideally screen ET patients for possible signs or symptoms of cognitive impairment in addition to assessing for psychiatric comorbidity and quality of life. These recommendations are in contrast to most current clinical practice, which does not routinely include such assessment among ET patients. To our knowledge, there have been no pharmacotherapeutic trials to date of any agent for cognitive change associated with ET. We believe that studies for this indication are now called for. Future efforts in this direction will also need to take into account the pathobiology of cognitive changes in ET, which itself is an area that is ripe for future investigations.

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Cerebellar Atrophy in Essential Tremor Using an Automated Segmentation Method

Cited by 127 publications

References 14 publications

Advanced MRI Morphologic Study Shows No Atrophy in Healthy Individuals with Hippocampal Hyperintensity

Advanced MRI Morphologic Study Shows No Atrophy in Healthy Individuals with Hippocampal Hyperintensity

Functional Anatomy of Essential Tremor: Lessons from Neuroimaging

The cognitive side of essential tremor: what are the therapeutic implications?

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