Essential tremor: Clinical perspectives and pathophysiology.

Essential tremor: Clinical perspectives and pathophysiology.
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DOI:
10.1016/j.jns.2022.120198
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发表时间:
2022-04-15
影响因子:
4.4
通讯作者:
Kuo, Sheng-Han
Kuo, Sheng-Han
中科院分区:
医学3区
文献类型:
--
作者:
Pan, Ming-Kai;Kuo, Sheng-Han

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特发性震颤(ET)是最常见的神经系统疾病之一,可高度致残。近年来,对ET的临床前景和病理生理学的研究提高了我们对ET的认识。具体而言,ET的临床异质性,与震颤和其他神经功能障碍,如肌张力障碍,共济失调和认知功能障碍的共存,已被确定。小脑被认为是震颤发生的关键脑区,并且小脑的结构改变在ET中已被广泛研究。最后,提出了四种主要的ET病理生理学:1)环境暴露于β-咔啉生物碱和随后的橄榄小脑过度兴奋,2)小脑GABA缺乏,3)与小脑振荡活动相关的攀爬纤维突触病理学,4)小脑外振荡活动。虽然这四种理论并不相互排斥,但它们可以代表不同的ET亚型,表明多种类型的异常脑回路可以导致动作震颤。
Essential tremor (ET) is one of the most common neurological disorders and can be highly disabling. In recent years, studies on the clinical perspectives and pathophysiology have advanced our understanding of ET. Specifically, clinical heterogeneity of ET, with co-existence of tremor and other neurological features such as dystonia, ataxia, and cognitive dysfunction, has been identified. The cerebellum has been found to be the key brain region for tremor generation, and structural alterations of the cerebellum have been extensively studied in ET. Finally, four main ET pathophysiologies have been proposed: 1) environmental exposures to β-carboline alkaloids and the consequent olivocerebellar hyper-excitation, 2) cerebellar GABA deficiency, 3) climbing fiber synaptic pathology with related cerebellar oscillatory activity, 4) extra-cerebellar oscillatory activity. While these four theories are not mutually exclusive, they can represent distinctive ET subtypes, indicating multiple types of abnormal brain circuitry can lead to action tremor.
DOI: 10.1093/brain/awu250
发表时间: 2014-12
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影响因子: --
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