Brain gray matter changes in essential arm tremor patients: Voxel-based morphometry

Objective: To investigate the abnormalities of brain gray matter volume in patients with clinically-confirmed essential tremor (ET) of the hands only. Methods: We analyzed brain gray matter voxel of 17 patients (younger than 55 years) with ET of the hands only and 17 healthy controls matched in age, gender and education by optimized voxel-based morphometry (VBM). Results: VBM showed marked expansion of the bilateral cerebella, occipital fusiform cortices, and precentral lobes (P_uncorrected <0.005) in ET patients compared with the controls. Atrophy was only detected in left parietal lobe. We also found volume enlargement in the thalamus, midbrain, and melluda of the left side by region of interest (ROI) analysis (P_uncorrected < 0.005). Conclusion: Patients with arm tremor show expansion of gray matter, which might represent the adaptive reorganizational compensation through the increased demand on the visuospatial control of skilled movements in ET patients with early-stage arm tremor. These morphological changes may help to assess early stage and distinguish subtype of ET.