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Semin Neurol 2017; 37(02): 127-134
DOI: 10.1055/s-0037-1601558
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pathophysiology and Management of Parkinsonian Tremor

Rick C. Helmich
1   Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
2   Department of Neurology and Parkinson Centre Nijmegen (ParC), Radboud University Medical Centre, Nijmegen, The Netherlands
,
Michiel F. Dirkx
1   Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
2   Department of Neurology and Parkinson Centre Nijmegen (ParC), Radboud University Medical Centre, Nijmegen, The Netherlands
› Author Affiliations
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Publication History

Publication Date:
16 May 2017 (online)

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Abstract

Parkinson's tremor is one of the cardinal motor symptoms of Parkinson's disease. The pathophysiology of Parkinson's tremor is different from that of other motor symptoms such as bradykinesia and rigidity. In this review, the authors discuss evidence suggesting that tremor is a network disorder that arises from distinct pathophysiological changes in the basal ganglia and in the cerebellothalamocortical circuit. They also discuss how interventions in this circuitry, for example, deep brain surgery and noninvasive brain stimulation, can modulate or even treat tremor. Future research may focus on understanding sources for the large variability between patients in terms of treatment response, on understanding the contextual factors that modulate tremor (stress, voluntary movements), and on focused interventions in the tremor circuitry.

Keywords

Parkinson's disease - tremor - basal ganglia - treatment
 

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