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Published in: Current Neurology and Neuroscience Reports 9/2013

01-09-2013 | Neuroimaging (DJ Brooks)

The Pathophysiology of Essential Tremor and Parkinson’s Tremor

Authors: Rick C. Helmich, Ivan Toni, Günther Deuschl, Bastiaan R. Bloem

Published in: Current Neurology and Neuroscience Reports | Issue 9/2013

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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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Metadata
Title
The Pathophysiology of Essential Tremor and Parkinson’s Tremor
Authors
Rick C. Helmich
Ivan Toni
Günther Deuschl
Bastiaan R. Bloem
Publication date
01-09-2013
Publisher
Springer US
Published in
Current Neurology and Neuroscience Reports / Issue 9/2013
Print ISSN: 1528-4042
Electronic ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-013-0378-8

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