Sepúlveda Soto María Carolina, Fasano Alfonso
Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
Clin Park Relat Disord. 2019 Dec 31;3:100031. doi: 10.1016/j.prdoa.2019.100031. eCollection 2020.
Essential Tremor (ET) is one of the most common movement disorders but many controversies still exist in regards to its definition and pathophysiology. In view of the recent published criteria by the Tremor Task Force of the International Parkinson's and Movement Disorders Society (IPMDS), we intended to analyze if this has changed our view of ET and if new developments have arisen since.
A Medline search for English-written articles was done on June 15, 2019 using the keyword "Essential Tremor". Publications from November 2017 (publication date of the new tremor classification) were taken into account. Reviews, letters and original studies relevant to the subject were selected and reviewed according to the following themes: clinical characteristics, epidemiology, genetics, pathology, biomarkers and treatment.
Out of 132 publications the most relevant articles were selected and reviewed (total of 65 articles). The great majority of these studies focused on surgical treatments (new targets, new technologies) while relatively few articles addressed epidemiology, pathology and pathophysiology.
The use of the new classification is not commonly used still, excepting more recent studies on therapeutics. This is in keeping with diverse opinions and criticisms reported by the IPMDS task force members themselves. One important change has been validating ET as a heterogeneous condition and defining the ET-plus category. We propose a further sub-group classification derived from the new definition of ET-plus.
特发性震颤（ET）是最常见的运动障碍之一，但其定义和病理生理学仍存在诸多争议。鉴于国际帕金森病和运动障碍协会（IPMDS）震颤工作组最近发布的标准，我们旨在分析这是否改变了我们对ET的看法，以及自那时以来是否出现了新的进展。
2019年6月15日使用关键词“特发性震颤”在Medline上检索英文撰写的文章。考虑了2017年11月（新的震颤分类发布日期）以来的出版物。根据以下主题选择并审查了与该主题相关的综述、信函和原始研究：临床特征、流行病学、遗传学、病理学、生物标志物和治疗。
从132篇出版物中筛选出最相关的文章进行审查（共65篇）。这些研究绝大多数集中在外科治疗（新靶点、新技术），而涉及流行病学、病理学和病理生理学的文章相对较少。
除了最近关于治疗学的研究外，新分类的使用仍然不普遍。这与IPMDS工作组成员自己报告的各种意见和批评一致。一个重要的变化是将ET确认为一种异质性疾病并定义了ET加综合征类别。我们建议从ET加综合征的新定义中进一步进行亚组分类。
