GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
J Neurol Sci. 2010 Feb 15;289(1-2):144-8. doi: 10.1016/j.jns.2009.08.029. Epub 2009 Aug 31.
The traditional view of essential (ET) tremor is as a mono-symptomatic condition characterized by action tremor. Over the past decade, researchers have learned that this picture is an over-simplification. First, it is clear that many patients also have other motor manifestations (e.g., ataxic gait). Second, the presence of a variety of non-motor features, both cognitive and psychiatric, is now appreciated. Mild cognitive changes (esp. executive dysfunction) have been documented in several studies. More recently, two population-based studies have demonstrated an association between ET and dementia. Clinically, while most of these cases developed Alzheimer's disease, the neuropathological underpinnings of this dementia have not been fully explored. Psychiatric manifestations include specific personality traits, anxiety, social phobia, and depressive symptoms. Depression may be a primary manifestation of the illness rather than a secondary response to disability. The emerging view of ET is that it is a disease whose central feature is action tremor but in which both motor and non-motor features occur. As in other neurodegenerative conditions, ET appears to be more than a disease of the motor system. Further study of these non-motor phenomena will advance our understanding of disease mechanisms and enhance the quality of clinical interactions with patients.
传统观点认为原发性震颤（essential tremor，ET）是一种以动作性震颤为特征的单一症状疾病。在过去的十年中，研究人员已经了解到这种观点过于简单化。首先，许多患者确实还存在其他运动表现（例如，共济失调步态）。其次，现在已经认识到存在各种非运动特征，包括认知和精神方面的特征。在几项研究中已经记录到轻度认知改变（尤其是执行功能障碍）。最近，两项基于人群的研究表明 ET 与痴呆之间存在关联。临床上，尽管大多数此类病例发展为阿尔茨海默病，但这种痴呆症的神经病理学基础尚未得到充分探索。精神科表现包括特定的人格特质、焦虑、社交恐惧症和抑郁症状。抑郁可能是该疾病的主要表现，而不是残疾的继发反应。ET 的新兴观点认为，它是一种以动作性震颤为主要特征的疾病，但同时也存在运动和非运动特征。与其他神经退行性疾病一样，ET 似乎不仅仅是一种运动系统疾病。进一步研究这些非运动现象将有助于我们了解疾病机制，并提高与患者临床互动的质量。
