Department of Neurology, Medical University of Graz, Graz, Austria.
James J. and Joan A. Gardner Family Center for Parkinson's disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
J Neurol Sci. 2022 Apr 15;435:120208. doi: 10.1016/j.jns.2022.120208. Epub 2022 Mar 4.
Functional tremor is the most common functional movement disorder. It can be diagnosed with clinically definite certainty at the bedside by ascertaining its inconsistent (distractibility, frequency variability) and incongruent features (entrainment, ballistic suppression), requiring no additional neurological investigations except, in selected cases, those serving to elevate the diagnostic category to laboratory supported using accelerometry and surface electromyography. In the background of excessive attention to the affected body part and abnormal beliefs and expectations, functional correlates include the impairment of emotion processing, sense of agency, and abnormal connectivity between limbic and motor regions. While the treatment options remain under-studied, promising interventions in physiotherapy, cognitive behavioral therapy, and other psychotherapies are under evaluation to assessing their efficacy in attenuating this important source of neurological disability. This article is part of the Special Issue "Tremor" edited by Daniel D. Truong, Mark Hallett, and Aasef Shaikh.
功能性震颤是最常见的功能性运动障碍。通过确定其不一致性(易分散性、频率可变性)和不协调性特征(诱发、弹道抑制),可以在床边临床明确诊断,除了在特定情况下需要进行一些神经学检查以提高诊断类别为实验室支持的加速度计和表面肌电图检查外,无需进行其他神经学检查。在过度关注受影响身体部位以及异常信念和预期的背景下,功能性相关因素包括情绪处理、主体感和边缘与运动区域之间异常连通性的损伤。虽然治疗选择仍在研究中,但正在评估物理治疗、认知行为疗法和其他心理疗法中的有前途的干预措施,以评估它们在减轻这种重要神经功能障碍来源方面的疗效。本文是由 Daniel D. Truong、Mark Hallett 和 Aasef Shaikh 编辑的特刊“震颤”的一部分。