Preprint Review Version 1 This version is not peer-reviewed

Essential Tremor: A Focused Literature Review on its Pathophysiology, Neurophysiology, Etiology, and Management

Version 1 : Received: 2 November 2024 / Approved: 4 November 2024 / Online: 4 November 2024 (13:28:14 CET)

How to cite: Bradley, C.; Garrison, N.; Washington, A.; Wood, B. Essential Tremor: A Focused Literature Review on its Pathophysiology, Neurophysiology, Etiology, and Management. Preprints 2024, 2024110170. https://doi.org/10.20944/preprints202411.0170.v1 Bradley, C.; Garrison, N.; Washington, A.; Wood, B. Essential Tremor: A Focused Literature Review on its Pathophysiology, Neurophysiology, Etiology, and Management. Preprints 2024, 2024110170. https://doi.org/10.20944/preprints202411.0170.v1

Abstract

Essential Tremor (ET) is among the most common neurological movement disorders, with incidence rates increasing with age. The disorder is characterized by a bilateral action tremor of the upper limbs, enduring for a minimum of three years in duration, and shows early signs of onset with progression over time. Recent terminology has categorized a subcategory of ET, known as Essential-Tremor Plus (ET-Plus), which consists of a combination of symptoms that include tremors at rest and additional neurological signs. This includes memory impairment, gait disturbances, or various other neurological symptoms that do not have full clinical significance for diagnosis and suggest a more complex underlying neurological condition. Abnormalities located primarily in the cerebellum, including the loss and damage to Purkinje Cells (PC), were core pathological features of cerebellar damage in postmortem ET. Given the complexity and uncertainty of the pathophysiological aspects of tremor generation, treatment options are still limited, and current therapeutic measures lack the capacity to fully alleviate symptoms. In consideration, there are current pharmaceutical, stimulation, and genetic studies being conducted to characterize the etiology and pathophysiology of ET and aid in the reduction of progression and symptoms. In this review, we will discuss various aspects of ET including neurophysiology, pathophysiology, genetic factors and etiology, treatment options and future directions of advancements for ET management.

Keywords

Deep Brain Stimulation (DBS); Essential Tremor Plus (ET-Plus); Genome Wide Association Studies (GWAS); Magnetic Resonance Imaging (MRI); Mechanism of Action (MOA); Parkinson’s disease (PD); Purkinje cells (PC); Tremor stability index (TSI); Next Generation Sequencing (NGS); Long-read sequencing (LRS); Huntington's disease (HD), Spinocerebellar Ataxias (SCAs)

Subject

Biology and Life Sciences, Neuroscience and Neurology

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