Functional Anatomy of Essential Tremor: Lessons from Neuroimaging

Klaming, Ruth

doi:10.3174/ajnr.a3586

Cited by 22 publications

(17 citation statements)

References 52 publications

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“…Moreover, the differences in neuroimaging findings could be due to methodological differences. Establishment of neuroimaging consortia and datasharing may be warranted to reduce site-related technical variations, thereby improving the results [32].…”

Section: Voxel-based Morphometry Analysis In Etmentioning

confidence: 99%

Association between cortical volume loss and cognitive impairments in essential tremor

Bhalsing

Pantano

Kumar

et al. 2014

Euro J of Neurology

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Section: Voxel-based Morphometry Analysis In Etmentioning

confidence: 99%

Association between cortical volume loss and cognitive impairments in essential tremor

Bhalsing

Pantano

Kumar

et al. 2014

Euro J of Neurology

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“…Multi-modality neuroimaging studies have used Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) to study structural and metabolic changes in ET [5, 6]. These studies have reported metabolic and structural changes in the cerebellum [7–9].…”

Section: Introductionmentioning

confidence: 99%

Gray matter density loss in essential tremor: a lobule by lobule analysis of the cerebellum

et al. 2017

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BackgroundThe pathophysiological basis for essential tremor (ET) remains unclear, although evidence increasingly links it to a disordered and perhaps degenerative cerebellum. Prior imaging studies have treated the cerebellum en bloc. Our hypothesis was that regional differences in cerebellar gray matter (GM) density may better distinguish ET cases from controls.Forty-seven ET cases and 36 control subjects were imaged using magnetic resonance imaging (MRI). The cerebellum was segmented into 34 lobes using a Spatially Unbiased Infra-Tentorial Template (SUIT) atlas within the Statistical Parametric Mapping (SPM) analysis package. Age, gender and Montreal Cognitive Assessment (MoCA) scores were regressed out from the statistical models to isolate group effects. ET cases were further stratified into phenotypically-defined subgroups. The Benjamini-Hochberg False Discovery Rate procedure (BH FDR) (α = 0.1) was used to correct for multiple comparisons.ResultsWhen all ET cases and controls were compared, none of the regions met the BH FDR criteria for significance. When compared with controls, ET cases with head or jaw tremor (n = 27) had significant changes in GM density in nine cerebellar lobules, with a majority in the left cerebellar region, and each meeting the BH FDR criteria. Likewise, ET cases with voice tremor (n = 22) exhibited significant changes in 11 lobules in both left and right regions and the vermis. These analyses, in sum, indicated decreases in GM density in lobules I-IV, V, VI, VII and VIII as well as the vermis. ET cases with severe tremor (n = 20) did not show regions of change that survived the BH FDR procedure when compared to controls.ConclusionsWe showed that ET cases with various forms of cranial tremor differed from controls with respect to cerebellar GM density, with evidence of GM reduction across multiple cerebellar regions. Additional work, using a lobule-by-lobule approach, is needed to confirm these results and precisely map the regional differences in ET cases, subgroups of ET cases, and controls.

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“…Therefore, most differences between the two groups were in terms of cortical thickness and roughness. The decreased thickness in ET patients in superior frontal and precentral areas (both left and right) could account for the motor symptoms of ET 17 . The dimished left hippocampus and left rostral anterior cingulate thickness in ET patients might explain increased anxiety and depressive symptoms, which have been described 7, 55, 56 .…”

Section: Methodsmentioning

confidence: 97%

“…Over the past decade, several studies have identified brain morphometric changes in ET 17, 18 , but these changes, including their causation, remain poorly understood.…”

Section: Introductionmentioning

confidence: 99%

A data mining approach using cortical thickness for diagnosis and characterization of essential tremor

Serrano

Romero

Castillo

et al. 2017

Sci Rep

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Essential tremor (ET) is one of the most prevalent movement disorders. Being that it is a common disorder, its diagnosis is considered routine. However, misdiagnoses may occur regularly. Over the past decade, several studies have identified brain morphometric changes in ET, but these changes remain poorly understood. Here, we tested the informativeness of measuring cortical thickness for the purposes of ET diagnosis, applying feature selection and machine learning methods to a study sample of 18 patients with ET and 18 age- and sex-matched healthy control subjects. We found that cortical thickness features alone distinguished the two, ET from controls, with 81% diagnostic accuracy. More specifically, roughness (i.e., the standard deviation of cortical thickness) of the right inferior parietal and right fusiform areas was shown to play a key role in ET characterization. Moreover, these features allowed us to identify subgroups of ET patients as well as healthy subjects at risk for ET. Since treatment of tremors is disease specific, accurate and early diagnosis plays an important role in tremor management. Supporting the clinical diagnosis with novel computer approaches based on the objective evaluation of neuroimage data, like the one presented here, may represent a significant step in this direction.

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Functional Anatomy of Essential Tremor: Lessons from Neuroimaging

Cited by 22 publications

References 52 publications

Association between cortical volume loss and cognitive impairments in essential tremor

Association between cortical volume loss and cognitive impairments in essential tremor

Gray matter density loss in essential tremor: a lobule by lobule analysis of the cerebellum

A data mining approach using cortical thickness for diagnosis and characterization of essential tremor

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