Rong Luo1,2, PingLei Pan2,3, Yun Xu4,5,6, Ling Chen7. 1. Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, 210008, People's Republic of China. 2. Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, People's Republic of China. 3. Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, People's Republic of China. 4. Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, 210008, People's Republic of China. xuyun20042001@aliyun.com. 5. Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, People's Republic of China. xuyun20042001@aliyun.com. 6. Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, People's Republic of China. xuyun20042001@aliyun.com. 7. Laboratory of Reproductive Medicine, Department of Physiology, Nanjing Medical University, No. 818 Tianyuan East Road, Nanjing, Jiangsu Province, 211166, People's Republic of China. lingchen@njmu.edu.cn.
Abstract
BACKGROUND: Voxel-based morphometry (VBM) has been used to study human brain gray matter (GM) alterations in essential tremor (ET) for over one decade. However, the literature revealed heterogeneous findings. METHODS: We therefore conducted a coordinate-based meta-analysis to synthesize the VBM studies to examine which brain regions show the most reliable GM alterations in patients with ET relative to healthy controls. RESULTS: A total of 16 original VBM studies, comprising 387 patients with ET and 355 healthy controls, were included in this meta-analysis. This quantitative meta-analysis revealed no evidence of robust and reliable alterations in regional brain GM structures in ET. Meta-regression analyses indicate that many moderators (e.g., MR field strength, statistical methodology, age, onset age, gender, illness severity, illness duration, and family history) account for some of the heterogeneity in GM across studies. CONCLUSIONS: High heterogeneity in GM alterations across studies may reflect true heterogeneity in ET regarding the clinic, etiology, and pathology, as well as possibly the VBM methodological variations. Currently, this heterogeneity limits the use of VBM as a reliable tool to distinguish ET from healthy controls. In order to improve reproducibility of VBM results in ET, future research may benefit from increasing the sample size, comprehensively subtyping ET phenotypes, and using well-designed and standardized imaging acquisition and analytical protocols. Furthermore, data sharing should be considered as a high priority.
BACKGROUND: Voxel-based morphometry (VBM) has been used to study human brain gray matter (GM) alterations in essential tremor (ET) for over one decade. However, the literature revealed heterogeneous findings. METHODS: We therefore conducted a coordinate-based meta-analysis to synthesize the VBM studies to examine which brain regions show the most reliable GM alterations in patients with ET relative to healthy controls. RESULTS: A total of 16 original VBM studies, comprising 387 patients with ET and 355 healthy controls, were included in this meta-analysis. This quantitative meta-analysis revealed no evidence of robust and reliable alterations in regional brain GM structures in ET. Meta-regression analyses indicate that many moderators (e.g., MR field strength, statistical methodology, age, onset age, gender, illness severity, illness duration, and family history) account for some of the heterogeneity in GM across studies. CONCLUSIONS: High heterogeneity in GM alterations across studies may reflect true heterogeneity in ET regarding the clinic, etiology, and pathology, as well as possibly the VBM methodological variations. Currently, this heterogeneity limits the use of VBM as a reliable tool to distinguish ET from healthy controls. In order to improve reproducibility of VBM results in ET, future research may benefit from increasing the sample size, comprehensively subtyping ET phenotypes, and using well-designed and standardized imaging acquisition and analytical protocols. Furthermore, data sharing should be considered as a high priority.
Authors: Laura Bindel; Christoph Mühlberg; Victoria Pfeiffer; Matthias Nitschke; Annekatrin Müller; Mirko Wegscheider; Jost-Julian Rumpf; Kirsten E Zeuner; Jos S Becktepe; Julius Welzel; Miriam Güthe; Joseph Classen; Elinor Tzvi Journal: Cerebellum Date: 2022-09-09 Impact factor: 3.648