Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
Hum Brain Mapp. 2021 Jul;42(10):3156-3167. doi: 10.1002/hbm.25425. Epub 2021 Mar 26.
Neuroimaging studies using a variety of techniques have demonstrated abnormal patterns of spontaneous brain activity in patients with essential tremor (ET). However, the findings are variable and inconsistent, hindering understanding of underlying neuropathology. We conducted a meta-analysis of whole-brain resting-state functional neuroimaging studies in ET compared to healthy controls (HC), using anisotropic effect-size seed-based d mapping, to identify the most consistent brain activity alterations and their relation to clinical features. After systematic literature search, we included 13 studies reporting 14 comparisons, describing 286 ET patients and 254 HC. Subgroup analyses were conducted considering medication status, head tremor status, and methodological factors. Brain activity in ET is altered not only in the cerebellum and cerebral motor cortex, but also in nonmotor cortical regions including prefrontal cortex and insula. Most of the results remained unchanged in subgroup analyses of patients with head tremor, medication-naive patients, studies with statistical threshold correction, and the large subgroup of studies using functional magnetic resonance imaging. These findings not only show consistent and robust abnormalities in specific brain regions but also provide new information on the biology of patient heterogeneity, and thus help to elucidate the pathophysiology of ET.
使用各种技术的神经影像学研究表明，原发性震颤（ET）患者的自发性大脑活动存在异常模式。然而，这些发现是可变的和不一致的，阻碍了对潜在神经病理学的理解。我们对 ET 患者与健康对照（HC）进行了全脑静息态功能神经影像学研究的荟萃分析，使用各向异性效应大小种子基础 d 映射，以确定最一致的大脑活动改变及其与临床特征的关系。经过系统的文献搜索，我们纳入了 13 项研究，共描述了 286 名 ET 患者和 254 名 HC，报告了 14 项比较。考虑到药物状态、头部震颤状态和方法学因素进行了亚组分析。ET 患者的大脑活动不仅在小脑和大脑运动皮层发生改变，而且在包括前额叶皮层和脑岛在内的非运动皮层区域也发生改变。在头部震颤患者、未经药物治疗的患者、使用统计阈值校正的研究以及使用功能磁共振成像的大量亚组研究的亚组分析中，大多数结果保持不变。这些发现不仅显示了特定脑区存在一致且稳健的异常，还提供了关于患者异质性生物学的新信息，从而有助于阐明 ET 的病理生理学。
