Muthuraman M, Schnitzler A, Groppa S
Sektion für Bewegungsstörungen und Neurostimulation, Biomedizinische Statistik und multimodale Signalverarbeitung, Klinik und Poliklinik für Neurologie, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
Klinik für Neurologie, Universitätsklinik Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland.
Nervenarzt. 2018 Apr;89(4):408-415. doi: 10.1007/s00115-018-0490-8.
Tremor is clinically defined as a rhythmic, oscillating movement of parts of the body, which functionally leads to impairment of the coordination and execution of targeted movements. It can be a symptom of a primary disease, such as resting tremor in Parkinson's disease or occur as an independent disease, such as essential or orthostatic tremor. For the development of tremor, cerebral components as well as mechanisms at the spinal and muscular level play an important role. This review presents the results of new imaging and electrophysiological studies that have led to important advances in our understanding of the pathophysiology of tremor. We discuss pathophysiological models for the development of resting tremor in Parkinson's disease, essential and orthostatic tremor. We describe recent developments starting from the classical generator model, with an onset of pathological oscillations in distinct cerebral regions, to a network perspective in which tremor arises and spreads through existing anatomical or newly emerged pathological brain networks. In particular translational approaches are presented and discussed. These could serve in the future as a basis for the development of new therapeutic strategies.
震颤在临床上被定义为身体部分部位有节奏的摆动运动,从功能上来说,这会导致目标运动的协调和执行受损。它可能是原发性疾病的症状,如帕金森病中的静止性震颤,也可能作为一种独立疾病出现,如特发性震颤或直立性震颤。对于震颤的发生,大脑成分以及脊髓和肌肉层面的机制都起着重要作用。本综述介绍了新的影像学和电生理研究结果,这些研究在我们对震颤病理生理学的理解方面取得了重要进展。我们讨论了帕金森病静止性震颤、特发性震颤和直立性震颤发生的病理生理模型。我们描述了从经典的发生器模型开始的最新进展,即病理振荡在不同脑区开始,到一种网络观点,即震颤通过现有的解剖学或新出现的病理性脑网络产生并传播。特别介绍并讨论了转化方法。这些方法未来可作为开发新治疗策略的基础。