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特发性震颤:当前治疗方法的文献综述

Essential Tremors: A Literature Review of Current Therapeutics.

作者信息

Patel Maurya D, Patel Muskaan, Jani Rutva, Patel Kishan G, Patel Priyansh, Gandhi Siddharth Kamal

机构信息

Department of Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College, Ahmedabad, IND.

Department of Internal Medicine, Hinduhridaysamrat Balasaheb Thackeray Medical College (HBTMC) and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai, IND.

出版信息

Cureus. 2024 May 1;16(5):e59451. doi: 10.7759/cureus.59451. eCollection 2024 May.

DOI:10.7759/cureus.59451
PMID:38826876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11141324/
Abstract

Essential tremors (ETs) commonly manifest as involuntary shaking of the hands that disrupt daily activities. These tremors involve the central motor network of the cerebellum, thalamus, and cortical networks, leading to different clinical phenotypes. The goal of this review was to establish evidence-based recommendations for effective care and simplify decisions for those dealing with ET. For this narrative literature review, we conducted a thorough search using core keywords such as "essential tremor" and "therapy." From the 27 selected articles, relevant data were presented regarding pathophysiology, medications, and other treatment options, with necessary supplemental data such as side effects and use cases. This paper examines treatments for ET, including commonly prescribed medications such as propranolol and primidone; invasive treatments such as deep brain stimulation, focused ultrasound thalamotomy, transcranial magnetic stimulation, and some surgical methods; and non-invasive methods such as the neuromodulation technique of transcutaneous afferent patterned stimulation. Overall, this study presents a synthesized understanding of the currently available modalities for managing ETs. It is intended to guide care providers in choosing the best possible method to contain symptoms.

摘要

特发性震颤(ETs)通常表现为手部的不自主抖动,这会干扰日常活动。这些震颤涉及小脑、丘脑和皮质网络的中枢运动网络,导致不同的临床表型。本综述的目的是为ET的有效护理建立循证建议,并简化ET患者的治疗决策。对于这篇叙述性文献综述,我们使用“特发性震颤”和“治疗”等核心关键词进行了全面搜索。从27篇选定的文章中,呈现了有关病理生理学、药物和其他治疗选择的相关数据,以及诸如副作用和病例等必要的补充数据。本文探讨了ET的治疗方法,包括常用药物如普萘洛尔和扑米酮;侵入性治疗如深部脑刺激、聚焦超声丘脑切开术、经颅磁刺激和一些手术方法;以及非侵入性方法如经皮传入模式刺激的神经调节技术。总体而言,本研究对目前可用的ET管理模式进行了综合理解。旨在指导护理人员选择控制症状的最佳方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296a/11141324/b47ec573a384/cureus-0016-00000059451-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296a/11141324/b87b023e70ea/cureus-0016-00000059451-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296a/11141324/b47ec573a384/cureus-0016-00000059451-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296a/11141324/b87b023e70ea/cureus-0016-00000059451-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/296a/11141324/b47ec573a384/cureus-0016-00000059451-i02.jpg

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1
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本文引用的文献

1
Trial of Botulinum Toxin for Isolated or Essential Head Tremor.肉毒杆菌毒素治疗孤立性或原发性头部震颤的试验。
N Engl J Med. 2023 Nov 9;389(19):1753-1765. doi: 10.1056/NEJMoa2304192.
2
Comparative Effectiveness of Transcutaneous Afferent Patterned Stimulation Therapy for Essential Tremor: A Randomized Pragmatic Clinical Trial.经皮传入模式刺激治疗特发性震颤的疗效比较:一项随机实用临床试验。
Tremor Other Hyperkinet Mov (N Y). 2023 Oct 16;13:38. doi: 10.5334/tohm.798. eCollection 2023.
3
Cerebellar repetitive transcranial magnetic stimulation versus propranolol for essential tremor.
小脑重复经颅磁刺激与普萘洛尔治疗特发性震颤的比较。
Brain Behav. 2023 Mar;13(3):e2926. doi: 10.1002/brb3.2926. Epub 2023 Feb 17.
4
The Hidden Burden of Disease and Treatment Experiences of Patients with Essential Tremor: A Retrospective Claims Data Analysis.特发性震颤患者的疾病负担和治疗体验的隐性问题:一项回顾性理赔数据分析。
Adv Ther. 2022 Dec;39(12):5546-5567. doi: 10.1007/s12325-022-02318-8. Epub 2022 Oct 14.
5
Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials.肉毒毒素治疗神经疾病中的特发性震颤和手部震颤:一项随机对照试验的荟萃分析。
Toxins (Basel). 2022 Mar 10;14(3):203. doi: 10.3390/toxins14030203.
6
Deep Brain Stimulation for Arm Tremor: A Randomized Trial Comparing Two Targets.深部脑刺激治疗手臂震颤:比较两个靶点的随机试验
Ann Neurol. 2022 May;91(5):585-601. doi: 10.1002/ana.26317. Epub 2022 Mar 14.
7
The Pathophysiology and Treatment of Essential Tremor: The Role of Adenosine and Dopamine Receptors in Animal Models.特发性震颤的病理生理学和治疗:动物模型中腺苷和多巴胺受体的作用。
Biomolecules. 2021 Dec 2;11(12):1813. doi: 10.3390/biom11121813.
8
Imaging the Pathophysiology of Essential Tremor-A Systematic Review.原发性震颤病理生理学的影像学研究——一项系统综述
Front Neurol. 2021 Jun 16;12:680254. doi: 10.3389/fneur.2021.680254. eCollection 2021.
9
Tolerability and Efficacy of Customized IncobotulinumtoxinA Injections for Essential Tremor: A Randomized, Double-Blind, Placebo-Controlled Study.特发性震颤中定制型依库珠单抗毒素 A 注射的耐受性和疗效:一项随机、双盲、安慰剂对照研究。
Toxins (Basel). 2020 Dec 20;12(12):807. doi: 10.3390/toxins12120807.
10
Managing Essential Tremor.原发性震颤的管理。
Neurotherapeutics. 2020 Oct;17(4):1603-1621. doi: 10.1007/s13311-020-00899-2.