IRCCS Neuromed, Pozzilli (IS), Italy.
Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
Eur Radiol. 2019 Dec;29(12):6634-6642. doi: 10.1007/s00330-019-06267-9. Epub 2019 May 28.
We investigated changes in gray matter (GM) and white matter (WM) in the whole brain, including both cortical and subcortical structures, and their relationship with tremor severity, psychiatric symptoms, and cognitive impairment in patients affected by essential tremor (ET).
We studied 19 ET patients and 15 healthy subjects (HS). All the subjects underwent a 3-T MRI study based on 3D-T1 and diffusion tensor images. For the GM analysis, cortical thickness was assessed by using the Computational Anatomy Tool, basal ganglia and thalamus volumes by using the FMRIB software library, and cerebellum lobular volumes by using the spatial unbiased atlas template. For the WM assessment, we performed a voxel-wise analysis by means of tract-based spatial statistics. Patients' tremor severity and psychiatric and cognitive disorders were evaluated by means of standard clinical scales. Neuroimaging data were correlated with clinical scores.
We found significantly smaller right and left thalamic volumes in ET patients than in HS, which correlated with cognitive scores. We did not observe any significant differences either in cortical thickness or in cerebellar lobular volumes between patients and HS. WM abnormalities were detected in most hemisphere bundles, particularly in the corticospinal tract, cerebellar peduncles, and corpus callosum. The WM abnormalities significantly correlated with tremor severity, cognitive profile, and depression.
Our study indicates that ET is characterized by several GM and WM changes of both infra- and supratentorial brain structures. The results may help to better understand mechanisms underlying tremor severity and psychiatric and cognitive impairment in ET.
• We performed a comprehensive evaluation of gray and white matter in the same sample of patients with essential tremor using recently developed data analysis methods. • Essential tremor is characterized by widespread gray and white matter changes in both infra- and supratentorial brain structures. The results may help to better understand motor and non-motor symptoms in patients with essential tremor.
我们研究了原发性震颤（ET）患者全脑灰质（GM）和白质（WM）的变化，包括皮质和皮质下结构，并探讨其与震颤严重程度、精神症状和认知障碍的关系。
我们研究了 19 例 ET 患者和 15 例健康对照者（HS）。所有受试者均行 3T MRI 检查，包括 3D-T1 和弥散张量成像。GM 分析采用计算解剖工具评估皮质厚度，采用 FMRIB 软件库评估基底节和丘脑体积，采用空间无偏模板评估小脑叶体积。WM 评估采用基于体素的空间统计学方法。采用标准临床量表评估患者的震颤严重程度和精神及认知障碍。对神经影像学数据与临床评分进行相关性分析。
我们发现 ET 患者右侧和左侧丘脑体积明显小于 HS，且与认知评分相关。患者与 HS 之间皮质厚度或小脑叶体积无显著差异。在大多数脑半球束中发现 WM 异常，特别是皮质脊髓束、小脑脚和胼胝体。WM 异常与震颤严重程度、认知特征和抑郁显著相关。
本研究表明 ET 患者存在幕上和幕下脑结构 GM 和 WM 的多种改变。结果可能有助于更好地理解 ET 患者震颤严重程度、精神和认知障碍的发病机制。
• 我们使用最新的数据分析方法对同一批 ET 患者的灰质和白质进行了全面评估。• ET 患者存在广泛的幕上和幕下脑结构 GM 和 WM 改变。这些结果可能有助于更好地理解 ET 患者的运动和非运动症状。
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