Objective: To identify the consistent gray matter (GM) volume changes from the whole brain voxel-based morphometry (VBM) studies on essential tremor (ET).

Background: ET is one of the most common movement disorders, but the pathophysiological mechanism of ET remains poorly understood. During the last 20 years, a number of VBM studies detected the gray matter (GM) differences between ET patients and healthy controls (HCs) to explore the pathophysiology of ET. However, the findings of these studies are variable and conflicting.

Methods: The whole brain VBM studies comparing ET patients and HCs were systematically searched in the PubMed, Embase and Web of Science from January 2000 to December 2017. Coordinates with significant differences in regional GM volume between ET patients and HCs were extracted from included studies and the meta-analysis was performed using effect size-based signed differential mapping (ES-SDM).

Results: A total of ten studies with 241 ET patients and 213 HCs were included in the meta-analysis. The consistent GM volume reduction was detected in the left precuneus extending to the left posterior cingulate gyrus. The whole-brain Jackknife sensitivity analysis showed the result was largely replicable. The subgroup meta-analysis which included studies performed on a 3.0 T scanner revealed significant GM volume increases in the bilateral frontal lobes, bilateral temporal lobes, left insula, left striatum and left pons, but obvious publication biases of these findings were detected through funnel plots and Egger’s tests.

Conclusions: The consistent result of our meta-analysis showed a structural damage in the left precuneus extending to the left posterior cingulate gyrus, and potentially indicated the involvement of the default mode network, which may enhance our understanding of the pathophysiological mechanisms underlying ET.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-voxel-wise-meta-analysis-of-gray-matter-abnormalities-in-essential-tremor/