title: Decrease in cerebral and cerebellar gray matter in essential tremor: a voxel-based morphometric analysis under 3T MRI.
abstract: OBJECTIVE
  Though routine neuroimaging is usually normal in essential tremor (ET) there is clinical evidence of widespread involvement of central nervous system. This study aimed at determining morphological changes in brain of patients with ET using voxel-based morphometry (VBM) analysis and also compare the subtypes of ET.
  
  
  METHODS
  Clinical and imaging data of 20 patients (5 women, 15 men; mean age 38.2 ± 16.5 years) of ET were collected prospectively. To determine areas of gray matter (GM) atrophy, T1W volumetric MRI data of patients were compared with 17 matched control subjects using VBM analysis with Statistical Parametric Mapping 5.
  
  
  RESULTS
  Compared to controls, patients showed scattered areas of cerebral and cerebellar atrophy. Voxel-wise analysis of patients with and without head tremor showed widespread areas of GM atrophy in cerebral hemispheres of patients with head tremor. No difference was observed between the familial and nonfamilial subgroups of ET. Multiple regression analysis revealed relationship between GM atrophy and tremor severity score.
  
  
  CONCLUSIONS
  Patients with ET showed widespread areas of atrophy in both cerebellum and cerebral GM, which supports the current concept of the progressive and diffuse nature of ET. Patients with additional head tremor may represent a distinct subgroup of ET.
authors: Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India.
authors: Bhavani Shankara
authors: BS
authors: Bagepally
authors: Maya Dattatraya
authors: MD
authors: Bhatt
authors: Vijay
authors: V
authors: Chandran
authors: Jitender
authors: J
authors: Saini
authors: Rose Dawn
authors: RD
authors: Bharath
authors: M K
authors: MK
authors: Vasudev
authors: Chandrajit
authors: C
authors: Prasad
authors: Ravi
authors: R
authors: Yadav
authors: Pramod Kumar
authors: PK
authors: Pal
mesh_terms: D000328:Adult; D001284:Atrophy; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D020329:Essential Tremor / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009474:Neurons / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity