Abstract
There are many lines of evidence supporting the idea that essential tremor is more than simply a monosymptomatic disorder and that all the clinical manifestations of this frequent disorder are sustained by a neurodegenerative process. The most important lines of evidence in favor of a neurodegenerative nature of essential tremor are: the anatomic and neuroimaging data demonstrating a pathologic process involving the cerebellum and/or brainstem; the progression of symptom severity with disease duration; and the lack of spontaneous remission of this condition. All of this evidence is supported by recent studies that are summarized in this review.
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References
Axelrad JE, Louis ED, Honig LS et al (2008) Reduced Purkinje cell number in essential tremor: a postmortem study. Arch Neurol 65:101–107
Bagepally BS, Bhatt MD, Chandran V et al. (2011) Decrease in cerebral and cerebellar gray matter in essential tremor: a voxel-based morphometric analysis under 3T MRI. J Neuroimaging. doi:10.1111/j.1552-6569.2011.00598.x. (E-pub ahead of print)
Benito-León J, Alvarez-Linera J, Hernández-Tamames JA, Alonso-Navarro H, Jiménez-Jiménez FJ, Louis ED (2009) Brain structural changes in essential tremor: voxel-based morphometry at 3-tesla. J Neurol Sci 287:138–142
Cerasa A, Passamonti L, Novellino F et al (2010) Fronto-parietal overactivation in patients with essential tremor during stroop task. NeuroReport 21:148–151
Cohen O, Pullman S, Jurewicz E, Watner D, Louis ED (2003) Rest tremor in patients with essential tremor prevalence, clinical correlates, and electrophysiologic characteristics. Arch Neurol 60:405–410
Daniels C, Peller M, Wolff S et al (2006) Voxel-based morphometry shows no decreases in cerebellar gray matter volume in essential tremor. Neurology 67:1452–1456
Deuschl G, Wenzelburger R, Löffler K, Raethjen J, Stolze H (2000) Essential tremor and cerebellar dysfunction clinical and kinematic analysis of intention tremor. Brain 123:1568–1580
Duane DD, Vermilion KJ (2002) Cognitive deficits in patients with essential tremor. Neurology 58:1706
Elble RJ (2000) Essential tremor frequency decreases with time. Neurology 55:1547–1551
Erickson-Davis CR, Faust PL, Vonsattel JP, Gupta S, Honig LS, Louis ED (2010) “Hairy baskets’’ associated with degenerative purkinje cell changes in essential tremor. J Neuropathol Exp Neurol 69:262–271
Gasparini M, Bonifati V, Fabrizio E et al (2001) Frontal lobe dysfunction in essential tremor a preliminary study. J Neurol 248:399–402
Greco CM, Hagerman RJ, Tassone F et al (2002) Neuronal intranuclear inclusions in a new cerebellar tremor/ataxia syndrome among fragile X carriers. Brain 125:1760–1771
Helmchen C, Hagenow A, Miesner J et al (2003) Eye movement abnormalities in essential tremor may indicate cerebellar dysfunction. Brain 126:1319–1332
Klebe S, Stolze H, Grensing K, Volkmann J, Wenzelburger R, Deuschl G (2005) Influence of alcohol on gait in patients with essential tremor. Neurology 65:96–101
Klein JC, Lorenz B, Kang JS et al (2011) Diffusion tensor imaging of white matter involvement in essential tremor. Hum Brain Mapp 32:890–896
Kronenbuerger M, Konczak J, Ziegler W et al (2009) Balance and motor speech impairment in essential tremor. Cerebellum 8:389–398
Lombardi WJ, Woolston DJ, Roberts JW, Gross RE (2001) Cognitive deficits in patients with essential tremor. Neurology 57:785–790
Louis ED (2005) Essential tremor. Lancet Neurol 4:100–110
Louis ED (2010) Essential tremor. Evolving clinicopathological concepts in an era of intensive post-mortem enquiry. Lancet Neurol 9:613–622
Louis ED, Shungu DC, Chan S, Mao X, Jurewicz EC, Watner D (2002) Metabolic abnormality in the cerebellum in patients with essential tremor: a proton magnetic resonance spectroscopic imaging study. Neurosci Lett 333:17–20
Louis ED, Jurewicz EC, Watner D (2003) Community-based data on associations of disease duration and age with severity of essential tremor: implications for disease pathophysiology. Mov Disord 18:90–93
Louis ED, Honig LS, Vonsattel JP, Maraganore DM, Borden S, Moskowitz CB (2005) Essential tremor associated with focal nonnigral lewy bodies: a clinicopathologic study. Arch Neurol 62:1004–1007
Louis ED, Vonsattel JP, Honig LS et al (2006a) Essential tremor associated with pathologic changes in the cerebellum. Arch Neurol 63:1189–1193
Louis ED, Vonsattel JP, Honig LS, Ross GW, Lyons KE, Pahwa R (2006b) Neuropathologic findings in essential tremor. Neurology 66:1756–1759
Louis ED, Faust PL, Vonsattel JP et al (2007) Neuropathological changes in essential tremor: 33 cases compared with 21 controls. Brain 130:3297–3307
Louis ED, Faust PL, Vonsattel JP et al (2009a) Torpedoes in Parkinson’s disease, Alzheimer’s disease, essential tremor, and control brains. Mov Disord 24:1600–1605
Louis ED, Faust PL, Vonsattel JP et al (2009b) Older onset essential tremor: more rapid progression and more degenerative pathology. Mov Disord 24:1606–1612
Louis ED, Benito-León J, Vega-Quiroga S, Bermejo-Pareja F, Neurological Disorders in Central Spain (NEDICES) Study Group (2010a) Faster rate of cognitive decline in essential tremor cases than controls a prospective study. Eur J Neurol 17:1291–1297
Louis ED, Rios E, Rao AK (2010b) Tandem gait performance in essential tremor: clinical correlates and association with midline tremors. Mov Disord 25:1633–1638
Louis ED, Asabere N, Agnew A et al (2011a) Rest tremor in advanced essential tremor: a post-mortem study of nine cases. J Neurol Neurosurg Psychiatry 82:261–265
Louis ED, Agnew A, Gillman A, Gerbin M, Viner AS (2011b) Estimating annual rate of decline: prospective, longitudinal data on arm tremor severity in two groups of essential tremor cases. J Neurol Neurosurg Psychiatry 82:761–765
Louis ED, Faust PL, Ma KJ, Yu M, Cortes E, Vonsattel JP (2011c) Torpedoes in the cerebellar vermis in essential tremor cases vs. controls. Cerebellum (Epub ahead of print)
Louis ED, Faust PL, Vonsattel JP (2011d) Purkinje cell loss is a characteristic of essential tremor. Parkinsonism Relat Disord 17:406–409
Martinelli P, Rizzo G, Manners D et al (2007) Diffusion-weighted imaging study of patients with essential tremor. Mov Disord 22:1182–1185
Matsumoto R, Nakano I, Arai N, Oda M, Yagishita S, Hashizume Y (1998) Loss of the dentate nucleus neurons is associated with torpedo formation: a morphometric study in progressive supra-nuclear palsy and dentatorubro-pallidoluysian atrophy. Acta Neuropathol 95:149–153
Nicoletti G, Manners D, Novellino F et al (2010) Diffusion tensor MRI changes in cerebellar structures of patients with familial essential tremor. Neurology 74:988–994
Pagan FL, Butman JA, Dambrosia JM, Hallett M (2003) Evaluation of essential tremor with multi-voxel magnetic resonance spectroscopy. Neurology 60:1344–1347
Putzke JD, Whaley NR, Baba Y, Wszolek ZK, Uitti RJ (2006) Essential tremor: predictors of disease progression in a clinical cohort. J Neurol Neurosurg Psychiatry 77:1235–1237
Quattrone A, Cerasa A, Messina D et al (2008) Essential head tremor is associated with cerebellar vermis atrophy: a volumetric and voxel-based morphometry MR imaging study. AJNR Am J Neuroradiol 29:1692–1697
Rajput AH, Rajput A (2011) Significance of cerebellar purkinje cell loss to pathogenesis of essential tremor. Parkinsonism Relat Disord 17:410–412
Rajput AH, Offord KP, Beard CM, Kurland LT (1984) Essential tremor in Rochester, Minnesota: a 45-year study. J Neurol Neurosurg Psychiatry 47:466–470
Rajput A, Robinson CA, Rajput AH (2004) Essential tremor course and disability: a clinicopathologic study of 20 cases. Neurology 62:932–936
Rajput AH, Robinson CA, Rajput ML, Rajput A (2011) Cerebellar Purkinje cell loss is not pathognomonic of essential tremor. Parkinsonism Relat Disord 17:16–21
Rao AK, Gillman A, Louis ED (2011) Quantitative gait analysis in essential tremor reveals impairments that are maintained into advanced age. Gait Posture 34:65–70
Shill HA, Adler CH, Sabbagh MN et al (2008) Pathologic findings in prospectively ascertained essential tremor subjects. Neurology 70:1452–1455
Shin DH, Han BS, Kim HS, Lee PH (2008) Diffusion tensor imaging in patients with essential tremor. AJNR Am J Neuroradiol 29:151–153
Singer C, Sanchez-Ramos J, Weiner W (1994) Gait abnormality in essential tremor. Mov Disord 9:193–196
Stolze H, Petersen G, Raethjen J, Wenzelburger R, Deuschl G (2001) The gait disorder of advanced essential tremor. Brain 124:2278–2286
Trillenberg P, Führer J, Sprenger A et al (2006) Eye–hand coordination in essential tremor. Mov Disord 21:373–379
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Bonuccelli, U. Essential tremor is a neurodegenerative disease. J Neural Transm 119, 1383–1387 (2012). https://doi.org/10.1007/s00702-012-0878-8
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DOI: https://doi.org/10.1007/s00702-012-0878-8