Unraveling morphological brain network disparities Parkinsonian tremor from essential tremor: an artificial intelligence approach for clinical differentiation

Moxuan Zhang; Siyu Zhou; Huizhi Wang; Pengda Yang; Jinli Ding; Xiaobo Wang; Xuzhu Chen; Chaonan Zhang; Anni Wang; Yuan Gao; Qiang Liu; Yueping Li; Tianqi Xu; Zeyu Ma; Yin Jiang; Lin Shi; Chunlei Han; Yuchen Ji; Guoen Cai; Tao Feng; Jianguo Zhang; Fangang Meng

doi:10.1038/s41531-025-01107-8

Unraveling morphological brain network disparities Parkinsonian tremor from essential tremor: an artificial intelligence approach for clinical differentiation

NPJ Parkinsons Dis. 2025 Aug 22;11(1):253. doi: 10.1038/s41531-025-01107-8.

Authors

Moxuan Zhang^#^{1

2}, Siyu Zhou^#^{1

2}, Huizhi Wang^{1

2}, Pengda Yang^{1

2}, Jinli Ding³, Xiaobo Wang³, Xuzhu Chen³, Chaonan Zhang^{1

2}, Anni Wang^{1

2}, Yuan Gao^{1

2}, Qiang Liu^{1

2}, Yueping Li⁴, Tianqi Xu⁵, Zeyu Ma⁵, Yin Jiang¹, Lin Shi², Chunlei Han², Yuchen Ji⁶, Guoen Cai⁷, Tao Feng⁸, Jianguo Zhang⁹, Fangang Meng^{10

11

12}

Affiliations

¹ Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
² Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴ Department of Neurology, Fujian Medical University Union Hospital, Fujian, China.
⁵ Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
⁶ Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. lyjychen@126.com.
⁷ Department of Neurology, Fujian Medical University Union Hospital, Fujian, China. cgessmu@fjmu.edu.cn.
⁸ Center for movement disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. bxbkyjs@sina.com.
⁹ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. zjguo73@126.com.
¹⁰ Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. fgmeng@ccmu.edu.cn.
¹¹ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. fgmeng@ccmu.edu.cn.
¹² Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. fgmeng@ccmu.edu.cn.

^# Contributed equally.

Abstract

Tremor-dominant Parkinson's disease (TD) and Essential Tremor (ET) are the two most common types of tremors, posing huge challenges in diagnosis. This study was to investigate the pathogenesis of tremors using brain morphology and employ artificial intelligence techniques for distinguishing them. The cortical thickness differences in TD were primarily centered on the right precuneus, while in ET were mainly observed in the right medial orbitofrontal cortex. Subcortical analysis revealed that TD patients primarily exhibited an increase in pallidum, whereas ET patients showed a significant reduction in thalamus. Causal network analysis indicated that in TD, the right temporal lobe exhibited the highest out-degree, and gradually extended to motor control regions. In contrast, ET primarily exhibits initial changes in the prefrontal and occipital visual cortices. Finally, by incorporating these specific characteristics, we developed a machine learning model capable of accurately distinguishing between different tremor types, providing valuable insights for clinical practice.

Abstract

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