Cited by 294Neurological disorders and treatmentsMotor Control and AdaptationTranscranial Magnetic Stimulation Studies

The pathophysiology of essential tremor and parkinson's tremor

Helmich, Rick C., Toni, Ivan, Deuschl, Günther, Bloem, Bastiaan R.·2013·Current Neurology and Neuroscience Reports

Abstract

We review recent evidence about the pathophysiology of essential tremor and tremor in Parkinson's disease. We believe that a network perspective is necessary to understand this common neurological symptom, and that knowledge of cerebral network dysfunction in tremor disorders will help to develop new therapies. Both essential tremor and Parkinson's tremor are associated with increased activity in the cerebellothalamocortical circuit. However, different pathophysiological mechanisms lead to tremulous activity within this circuit. In Parkinson's disease, evidence suggests that dopaminergic dysfunction of the pallidum triggers increased activity in the cerebellothalamocortical circuit. In essential tremor, GABAergic dysfunction of the cerebellar dentate nucleus and brain stem, possibly caused by neurodegeneration in these regions, may lead to tremulous activity within the cerebellothalamocortical circuit. In both disorders, network parameters such as the strength and directionality of interregional coupling are crucially altered. Exciting new research uses these network parameters to develop network-based therapies, such as closed-loop deep brain stimulation and transcranial magnetic or direct current stimulation.

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Crossref · 10.1007/s11910-013-0378-8

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105 of 105 references verified0 citation errors · 0 not checkable

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  • Approximately 25% of Parkinsonian cases lack resting tremor.

    “and meanwhile 25% Parkinsonian cases lack resting tremor (Helmich et al., 2013).”
  • The increased mechanical resonance in the arms by straining the forearm muscles and tendons may activate the proprioceptive feedback pathway regulated by the Golgi tendon organ, which senses changes in muscle tension and modulates the stretch reflex with afferent Ib fibers.

    “While both of the arms are rested, the increased mechanical resonance in the arms by straining the forearm muscles and tendons may activated the proprioceptive feedback pathway regulated by the Golgi tendon organ, which senses changes in muscle tension and modulates the stretch reflex with afferent Ib fibers together (Prochazka and Gorassini, 1998; Helmich et al., 2013).”

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Authors
Helmich, R. C., Toni, I., Deuschl, G., & Bloem, B. R.
Affiliations
  • Radboud University Nijmegen (NL)
  • Christian-Albrechts-Universität zu Kiel (DE)
Corresponding author
Helmich, Rick C.
Venue
Current Neurology and Neuroscience Reports
Published
2013-07-27
Volume
13
Issue
9
Pages
378-378
ISSN
  • 1528-4042 (ISSN-L)
  • 1534-6293
OpenAlex
W2032330693
Cited by
294
References
106
Citations by year
2026: 13 · 2025: 37 · 2024: 33 · 2023: 27 · 2022: 30 · 2021: 25 · 2020: 16 · 2019: 23 · 2018: 22 · 2017: 22 · 2016: 15 · 2015: 16 · 2014: 10 · 2013: 3
FWCI
1.93
Type
journal article
Language
en
Open access
closed
Locations
  • Current Neurology and Neuroscience Reports (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Neurological disorders and treatments
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
essential tremor, Parkinson's disease, tremor pathophysiology, dopaminergic dysfunction, globus pallidus, GABAergic dysfunction, cerebellar dentate nucleus, brainstem, closed-loop deep brain stimulation, transcranial magnetic stimulation, direct current stimulation
MeSH terms
Animals, Electric Stimulation Therapy, gamma-Aminobutyric Acid, Humans, Movement Disorders, Nerve Net, Parkinson Disease, Essential Tremor

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