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Chapter 40 - The Pathophysiology of Tremor

from Section 3: - Hyperkinetic Movement Disorders

Published online by Cambridge University Press:  07 January 2025

By
Rick Helmich ,
Michiel F. Dirkx  and
Ming-Kai Pan
Edited by
Erik Ch. Wolters  and
Christian R. Baumann
Erik Ch. Wolters
Affiliation:
Universität Zürich
Christian R. Baumann
Affiliation:
Universität Zürich
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Summary

Tremor, which is defined as an oscillatory and rhythmic movement of a body part, is the most common movement disorder worldwide. The most frequent tremor syndromes are tremor in Parkinson’s disease, essential tremor, and dystonic tremor syndromes, whereas Holmes tremor, orthostatic tremor, and palatal tremor are less common in clinical practice. The pathophysiology of tremor consists of enhanced oscillatory activity in brain circuits, which are ofen modulated by tremor-related afferent signals from the periphery. The cerebello-thalamo-cortical circuit and the basal ganglia play a key role in most neurologic tremor disorders, but with different roles in each disorder. Here we review the pathophysiology of tremor, focusing both on neuronal mechanisms that promote oscillations (automaticity and synchrony) and circuit-level mechanisms that drive and maintain pathologic oscillations.

Keywords

tremorpathophysiologyParkinson’s diseaseessential tremordystonic tremorbasal gangliacerebellumthalamusneuroimaging
Type
Chapter
Information
International Compendium of Movement Disorders , pp. 499 - 512
Publisher: Cambridge University Press
Print publication year: 2025

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