Clinical features, pathophysiology, treatment, and controversies of tremor in dystonia

• Type of Material: Article
• Authors: Pattamon Panyakaew, Chulalongkorn University; Hyder Jinnah, Emory University; Aasef G Shaikh, Case Western Reserve University
• Language: English
• Date: 2022-03-05
• Publisher: ELSEVIER
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 Published by Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jns.2022.120199
• Title of Journal or Parent Work: JOURNAL OF THE NEUROLOGICAL SCIENCES
• Volume: 435
• Start Page: 120199
• End Page: 120199
• Keywords: Cerebellum; CONSENSUS STATEMENT; Neurosciences & Neurology; PARKINSON; Tremor; HEAD; DISEASE; REST; Life Sciences & Biomedicine; ONSET; CERVICAL DYSTONIA; Clinical Neurology; Neurosciences; Oscillations; DEEP BRAIN-STIMULATION; CLASSIFICATION; Basal ganglia; Dystonia; Science & Technology; TEMPORAL DISCRIMINATION

Abstract

Dystonia and tremor frequently co-occur. In some cases, they have shared biological mechanisms, while in others dystonia and tremor are two comorbid conditions. The term “dystonic tremor” is used to describe tremor in those who have dystonia. Two mutually exclusive definitions of “dystonic tremor” were proposed. According to one definition, dystonic tremor is the tremor in the dystonic body part. An alternate definition of dystonic tremor entails irregular and jerky oscillations that have saw tooth appearance with or without overt dystonia. This paper outlines the differences in two definitions of dystonic tremor and identifies their limitations. Given the diverse views defining “dystonic tremor”, this paper will use the term “tremor in dystonia”. In addition, we will outline different ways to separate the subtypes of tremor in dystonia. Then we will discuss pathophysiological mechanisms derived from the objective measures and single neuron physiology analyses of tremor in dystonia. This article is part of the Special Issue" "Tremor" "edited by Daniel D. Truong, Mark Hallett, and Aasef Shaikh.