Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits?
Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits?
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DOI：
10.1093/brain/aws023
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发表时间：
2012-11
期刊：
影响因子：
--
通讯作者：
Bloem BR
中科院分区：
文献类型：
--
作者：
Helmich RC;Hallett M;Deuschl G;Toni I;Bloem BR
帕金森氏症的震颤有几个神秘的特征。在临床上，四分之三的帕金森氏病患者中只有三人出现震颤，并且震颤显性患者通常比非震颤患者遵循更良性的病程。在病理生理学上，震颤与两个不同回路中的活动改变有关：基底神经节，主要受帕金森病中多巴胺耗竭的影响，以及小脑-丘脑-皮质回路，也涉及许多其他震颤。本综述的目的是整合这些临床和病理生理特征震颤帕金森病。我们首先描述震颤显性和非震颤型帕金森病亚型之间的临床和病理差异，然后总结最近关于震颤病理生理学的研究。我们还讨论了一个新提出的“调光开关模型”，解释震颤作为两个电路的联合行动：基底神经节触发震颤发作和小脑丘脑皮层电路产生震颤。最后，我们解决了几个重要的悬而未决的问题：为什么静止性震颤在自愿运动过程中停止，为什么它对多巴胺能治疗有可变的反应，为什么它表明一种良性帕金森病亚型，为什么它的表达随着疾病的进展而减少。
Tremor in Parkinson's disease has several mysterious features. Clinically, tremor is seen in only three out of four patients with Parkinson's disease, and tremor-dominant patients generally follow a more benign disease course than non-tremor patients. Pathophysiologically, tremor is linked to altered activity in not one, but two distinct circuits: the basal ganglia, which are primarily affected by dopamine depletion in Parkinson's disease, and the cerebello-thalamo-cortical circuit, which is also involved in many other tremors. The purpose of this review is to integrate these clinical and pathophysiological features of tremor in Parkinson's disease. We first describe clinical and pathological differences between tremor-dominant and non-tremor Parkinson's disease subtypes, and then summarize recent studies on the pathophysiology of tremor. We also discuss a newly proposed ‘dimmer-switch model’ that explains tremor as resulting from the combined actions of two circuits: the basal ganglia that trigger tremor episodes and the cerebello-thalamo-cortical circuit that produces the tremor. Finally, we address several important open questions: why resting tremor stops during voluntary movements, why it has a variable response to dopaminergic treatment, why it indicates a benign Parkinson's disease subtype and why its expression decreases with disease progression.
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影响因子：
5.7
作者：
Baudrexel, Simon;Witte, Torsten;Hilker, Ruediger
通讯作者：
Hilker, Ruediger
影响因子：
4.1
作者：
Choi, Seong-Min;Lee, Seung-Han;Cho, Ki-Hyun
通讯作者：
Cho, Ki-Hyun
影响因子：
1.9
作者：
Albo, Z;Di Prisco, GV;Ding, MZ
通讯作者：
Ding, MZ
影响因子：
6
作者：
Benninger, David H.;Thees, Sebastian;Waldvogel, Daniel
通讯作者：
Waldvogel, Daniel
DOI：
10.1073/pnas.1000496107
发表时间：
2010-05-04
影响因子：
11.1
作者：
Bostan, Andreea C.;Dum, Richard P.;Strick, Peter L.
通讯作者：
Strick, Peter L.