Imaging the Pathophysiology of Essential Tremor-A Systematic Review.
Imaging the Pathophysiology of Essential Tremor-A Systematic Review.
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DOI：
10.3389/fneur.2021.680254
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发表时间：
2021
影响因子：
3.4
通讯作者：
Shah NJ
中科院分区：
文献类型：
--
作者：
Holtbernd F;Shah NJ
背景：特发性震颤（ET）的病理生理机制尚不清楚。最近的研究表明，小脑在震颤发生中的关键作用，ET是否构成神经退行性疾病仍存在争议。此外，越来越多的证据表明γ -氨基丁酸神经递质系统的改变与ET的病理生理有关。在这里，我们系统地回顾了结构、功能和代谢神经影像学研究，并从影像学的角度讨论了当前ET病理生理学的概念。方法：从1966年到2020年12月，我们对PubMed和Scopus进行了检索，将特发性震颤与以下任何搜索词及其相应的缩写结合起来：正电子发射断层扫描（PET）、单光子发射计算机断层扫描（SPECT）、磁共振成像（MRI）、磁共振波谱（MRS）和γ -氨基丁酸（GABA）。结果：在功能成像研究中，小脑和小脑-丘脑-皮质回路的功能连接改变是一个普遍的发现。结构成像研究的报告不太一致，没有明确的证据表明小脑神经变性。然而，弥散张量成像有力地指向小脑的微观结构变化。放射性示踪成像显示多巴胺能轴在ET中大量保留。同样，在大多数研究中，黑质铁含量和神经黑色素的测量也不显著；这与帕金森病（PD）相反。PET和MRS研究为小脑和丘脑gaba能功能障碍提供了有限的证据。结论：有强有力的证据表明，小脑在多振荡器震颤网络中起关键作用，这是震颤发生的基础。然而，小脑功能障碍是否依赖于神经退行性过程仍不清楚。多巴胺能和铁成像未提示ET与PD病理生理有实质重叠。关于ET中gaba能神经递质系统改变的证据有限。ET的临床、人口统计学和遗传异质性转化为神经影像学，可能解释了报道的各种不一致。
Background: The pathophysiology underlying essential tremor (ET) still is poorly understood. Recent research suggests a pivotal role of the cerebellum in tremor genesis, and an ongoing controversy remains as to whether ET constitutes a neurodegenerative disorder. In addition, mounting evidence indicates that alterations in the gamma-aminobutyric acid neurotransmitter system are involved in ET pathophysiology. Here, we systematically review structural, functional, and metabolic neuroimaging studies and discuss current concepts of ET pathophysiology from an imaging perspective. Methods: We conducted a PubMed and Scopus search from 1966 up to December 2020, entering essential tremor in combination with any of the following search terms and their corresponding abbreviations: positron emission tomography (PET), single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and gamma-aminobutyric acid (GABA). Results: Altered functional connectivity in the cerebellum and cerebello-thalamico-cortical circuitry is a prevalent finding in functional imaging studies. Reports from structural imaging studies are less consistent, and there is no clear evidence for cerebellar neurodegeneration. However, diffusion tensor imaging robustly points toward microstructural cerebellar changes. Radiotracer imaging suggests that the dopaminergic axis is largely preserved in ET. Similarly, measurements of nigral iron content and neuromelanin are unremarkable in most studies; this is in contrast to Parkinson's disease (PD). PET and MRS studies provide limited evidence for cerebellar and thalamic GABAergic dysfunction. Conclusions: There is robust evidence indicating that the cerebellum plays a key role within a multiple oscillator tremor network which underlies tremor genesis. However, whether cerebellar dysfunction relies on a neurodegenerative process remains unclear. Dopaminergic and iron imaging do not suggest a substantial overlap of ET with PD pathophysiology. There is limited evidence for alterations of the GABAergic neurotransmitter system in ET. The clinical, demographical, and genetic heterogeneity of ET translates into neuroimaging and likely explains the various inconsistencies reported.
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影响因子：
11.2
作者：
Bucher, SF;Seelos, KC;Oertel, WH
通讯作者：
Oertel, WH
影响因子：
4.4
作者：
Benito-Leon, Julian;Alvarez-Linera, Juan;Louis, Elan D.
通讯作者：
Louis, Elan D.
影响因子：
3.3
作者：
Asenbaum, S;Pirker, W;Brücke, T
通讯作者：
Brücke, T
DOI：
10.1016/b978-0-444-53485-9.00004-0
发表时间：
2016-01-01
期刊：
NEUROIMAGING, PT I
影响因子：
--
作者：
Buchbinder, Bradley R.
通讯作者：
Buchbinder, Bradley R.
影响因子：
2.3
作者：
Tantik Pak A;Şengül Y;Otcu Temur H;Alkan A
通讯作者：
Alkan A