Department of Neurology, Columbia University, New York, NY, 10032, USA.
Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, 10032, USA.
Cerebellum. 2024 Dec;23(6):2497-2510. doi: 10.1007/s12311-023-01551-3. Epub 2023 Apr 6.
Essential tremor (ET) is a common movement disorder affecting millions of people. Studies of ET patients and perturbations in animal models have provided a foundation for the neural networks involved in its pathophysiology. However, ET encompasses a wide variability of phenotypic expression, and this may be the consequence of dysfunction in distinct subcircuits in the brain. The cerebello-thalamo-cortical circuit is a common substrate for the multiple subtypes of action tremor. Within the cerebellum, three sets of cerebellar cortex-deep cerebellar nuclei connections are important for tremor. The lateral hemispheres and dentate nuclei may be involved in intention, postural and isometric tremor. The intermediate zone and interposed nuclei could be involved in intention tremor. The vermis and fastigial nuclei could be involved in head and proximal upper extremity tremor. Studying distinct cerebellar circuitry will provide important framework for understanding the clinical heterogeneity of ET.
特发性震颤（ET）是一种常见的运动障碍，影响着数百万人。对 ET 患者的研究和动物模型的干扰为其病理生理学涉及的神经网络提供了基础。然而，ET 包含广泛的表型表达多样性，这可能是大脑中不同子电路功能障碍的结果。小脑-丘脑-皮质回路是多种运动性震颤亚型的共同基础。在小脑内，三组小脑皮质-深部小脑核连接对震颤很重要。外侧半球和齿状核可能与意向性、姿势性和等长性震颤有关。中间区和间位核可能与意向性震颤有关。蚓部和顶核可能与头部和近端上肢震颤有关。研究不同的小脑回路将为理解 ET 的临床异质性提供重要框架。
