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The pathophysiology of essential tremor and parkinson's tremor
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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“and meanwhile 25% Parkinsonian cases lack resting tremor (Helmich et al., 2013).”
From A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor (2018) · cites this paper as Helmich et al., 2013
In the citing paper
“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).”
From A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor (2018) · cites this paper as Helmich et al., 2013
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“However, its existence does not fully corroborate the diagnosis of PD because it exists in approximately 20% of ET cases (Elble and Koller, 1990; Cohen et al., 2003) and meanwhile 25% Parkinsonian cases lack resting tremor (Helmich et al., 2013).”
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Metadata
- 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
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Neurology and Neuroscience Reports (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- 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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