Table_1_A Voxel-Wise Meta-Analysis of Gray Matter Abnormalities in Essential Tremor.DOCX

Objective: To identify the consistent gray matter (GM) volume changes from the whole brain voxel-based morphometry (VBM) studies on essential tremor (ET).Methods: The whole brain VBM studies comparing ET patients and healthy controls (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 10 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 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, which possibly played a role in the cognitive dysfunction and depression in ET patients. It might enhance our understanding of the pathophysiological mechanisms underlying ET.

研究目的：旨在识别帕金森病（ET）患者与正常对照者（HCs）的全脑基于体素形态学（VBM）研究中，大脑灰质（GM）体积变化的稳定性。研究方法：对PubMed、Embase和Web of Science数据库中，自2000年1月至2017年12月期间发表的全脑VBM研究进行了系统检索，比较ET患者与HCs之间的区域GM体积差异显著的坐标值，从所纳入的研究中提取这些坐标值，并使用基于效应量签定的差异映射（ES-SDM）进行荟萃分析。研究结果：共纳入10项研究，包括241名ET患者和213名HCs，荟萃分析结果显示，左侧顶叶延伸至左侧后扣带回区域存在一致的GM体积减少。亚组荟萃分析，包括在3.0T扫描仪上进行的成像研究，揭示了双侧额叶、双侧颞叶、左侧岛叶、左侧纹状体和左侧脑桥的GM体积显著增加，但通过漏斗图和Egger检验检测到这些发现存在明显的发表偏倚。研究结论：我们荟萃分析的一致结果揭示了左侧顶叶延伸至左侧后扣带回区域的脑结构损伤，这可能在ET患者的认知功能障碍和抑郁中发挥作用，可能有助于加深我们对ET潜在病理生理机制的理解。