Tracking the central and peripheral origin of tremor.
Tracking the central and peripheral origin of tremor.
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追踪震颤的中枢和外周起源。
DOI：
10.1016/j.clinph.2018.04.607
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Kuo,Sheng-Han
中科院分区：
文献类型：
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作者：
Pan,Ming-Kai;Kuo,Sheng-Han
人体运动控制是一个高度复杂的过程，需要非凡的精度，以达到最佳的速度和精度的每一个动作。运动控制系统的功能障碍导致各种运动障碍，如帕金森病、肌张力障碍和共济失调。神经系统如何在生理和病理条件下实时控制运动尚不清楚，部分原因是运动和相应的神经生理学相当复杂。震颤是一种具有丰富信息（相位、频率和振幅）的运动，可以实时跟踪其与大脑中振荡神经元活动的关联，为研究人类运动控制提供了一个非常独特的平台（McAuley和Marsden， 2000）。此外，不同类型的震颤的不同频率可以允许分离来自不同来源的运动的每个组成部分。正常情况下，人的肢体有自然发生的震颤，称为“生理性震颤”，它源于独特的运动单元发射特性和感觉-运动回路中的机械共振和反射共振（McAuley和Marsden， 2000）。因此，生理性震颤在起源上被认为是“外周性”的，负重会通过改变反射回路的生物物理特性来降低震颤频率（Raethjen et al., 2004; Lakie et al., 2015）。另一方面，原发性震颤（ET）是最常见的运动障碍（Louis and Ferreira, 2010），被认为是由小脑-丘脑皮质环产生的，可能与异常的浦肯野细胞突触组织有关（Lin ET al., 2014），并且由于一部分ET患者对酒精有反应，可能受到gaba能神经传递的调节（Lou and Jankovic, 1991）。因此，ET被认为是起源的“中心”（Hellwig等人，2001；Lu等人，2015）。重量载荷不会降低中央产生的震颤的频率（Gironell et al., 2004），反而会抑制振幅，因为震颤的中心驱动因素保持不变。两种类型的震颤（中枢性或外周性）频率相似；因此，通常很难区分两者（图1A）。
Human motor control is a highly complex process that requires extraordinary precision to achieve optimal speed and accuracy of each movement. The dysfunction of the motor control system leads to a variety of movement disorders such as parkinsonism, dystonia, and ataxia. How the nervous system governs the movements in both physiological and pathological conditions in real time remains unclear, partly due to the rather complex nature of movements and the corresponding neurophysiology. Tremor is a type of movement with enriched information (phase, frequency, and amplitude) that can be tracked in real time to correlate with oscillatory neuronal activities in the brain, providing a very unique platform to study human motor control (McAuley and Marsden, 2000). In addition, the distinct frequencies of different types of tremor can allow to separate each component of movements derived from diverse sources.Normally, human limbs have naturally-occurring tremor, called “physiological tremor”, which is originated from the unique motor unit firing properties and the mechanical and reflex resonance in the sensori-motor loop (McAuley and Marsden, 2000). Physiological tremor is thus considered “peripheral” in origin, and weight loading will decrease the tremor frequency by altering the biophysical property of the reflex loop (Raethjen et al., 2004; Lakie et al., 2015). On the other hand, essential tremor (ET), the most common movement disorder (Louis and Ferreira, 2010), is thought to be generated from the cerebello-thalamocortical loop, possibly related to the abnormal Purkinje cell synaptic organization (Lin et al., 2014), and could be modulated by GABAergic neurotransmission because a subset of ET patients responds to alcohol (Lou and Jankovic, 1991). Thus, ET is considered “central” in origin (Hellwig et al., 2001; Lu et al., 2015). Weight loading will not decrease the frequency of centrally generated tremor (Gironell et al., 2004) but rather dampen the amplitude because the central driver for tremor remains unchanged. Both types of tremor (central or peripheral in origin) are at the similar frequency; therefore, it is often difficult to distinguish one from another (Fig. 1A).