Brain structural changes in essential tremor: voxel-based morphometry at 3-Tesla.
BACKGROUND
Abnormalities in cerebello-thalamo-cortical pathways have been suggested as a basis for essential tremor (ET). Two voxel-based morphometry (VBM) studies, each using a 1.5-T magnet, evaluated ET patients, leading to contradictory results. Using a 3-T magnet, we assessed whether white or gray matter changes occurred in ET patients vs. controls.


METHODS
We recruited 19 ET patients (mean age 69.8+/-9.4 years) and 20 age and gender-matched controls. 3-T MRI data were analyzed using the Statistical Parametric Mapping (SPM) 5 package.


RESULTS
In case-control comparisons, white matter changes were seen in several areas (right cerebellum, left medulla, right parietal lobe, and right limbic lobe); gray matter changes were seen in several areas as well (bilateral cerebellum, bilateral parietal lobes, right frontal lobe, and right insula) (p<0.001, uncorrected at a voxel level). Compared with controls, ET patients with severe tremor had white matter changes in the midbrain, both occipital lobes, and right frontal lobe, and gray matter changes bilaterally in the cerebellum (p<0.001, uncorrected at a voxel level).


CONCLUSIONS
Structural white and gray abnormalities may be detected in ET patients using VBM and a high-field MRI scanner. Such changes may be related to the pathological substrates associated with this disease.
Benito-León
Julián
J
Departamento de Neurología, Hospital Universitario 12 de Octubre, Madrid, Spain. jbenitol@meditex.es
Alvarez-Linera
Juan
J
Hernández-Tamames
Juan Antonio
JA
Alonso-Navarro
Hortensia
H
Jiménez-Jiménez
Félix Javier
FJ
Louis
Elan D
ED
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D002531:Cerebellum / Q000473:pathology / Q000503:physiopathology; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D020329:Essential Tremor / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology
D015415:Biomarkers