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Der Nervenarzt

, Volume 89, Issue 4, pp 408–415 | Cite as

Pathophysiologie des Tremors

  • M. Muthuraman
  • A. Schnitzler
  • S. Groppa
Leitthema

Zusammenfassung

Tremor ist klinisch als rhythmische, oszillierende Bewegung von Körperpartien definiert, die funktionell zu einer Beeinträchtigung der Koordination und Ausführung zielgerichteter Bewegungen führen kann. Er kann Symptom einer Grunderkrankung sein, wie beispielweise der Ruhetremor bei Morbus Parkinson, oder als eigenständige Krankheit auftreten, wie z. B. der essenzielle oder der orthostatische Tremor. Bei der Entstehung von Tremor spielen sowohl zerebrale als auch spinale und muskuläre Mechanismen eine wichtige Rolle. Die vorliegende Arbeit stellt die Ergebnisse neuer bildgebender und elektrophysiologischer Untersuchungen dar, die zu wichtigen Fortschritten in unserem Verständnis der Pathophysiologie von Tremorerkrankungen geführt haben. Wir diskutieren Modelle für die Entstehung des Ruhetremors bei M. Parkinson, des essenziellen und des orthostatischen Tremors. Dabei schildern wir die aktuellen Weiterentwicklungen vom klassischen Generator-Modell mit einer Beteiligung einzelner zerebraler Regionen hin zu einer Netzwerkperspektive, in der pathologische Oszillationen durch Interaktionen in den neuronalen Netzwerken entstehen und sich ausbreiten. Dabei werden insbesondere neue translationale Ansätze vorgestellt, die als Grundlage für die Entwicklung neuer Therapiestrategien dienen könnten.

Schlüsselwörter

Morbus Parkinson Essenzieller Tremor Orthostatischer Tremor Aktionstremor Bildgebung 

Pathophysiology of tremor

Abstract

Tremor is clinically defined as a rhythmic, oscillating movement of parts of the body, which functionally leads to impairment of the coordination and execution of targeted movements. It can be a symptom of a primary disease, such as resting tremor in Parkinson’s disease or occur as an independent disease, such as essential or orthostatic tremor. For the development of tremor, cerebral components as well as mechanisms at the spinal and muscular level play an important role. This review presents the results of new imaging and electrophysiological studies that have led to important advances in our understanding of the pathophysiology of tremor. We discuss pathophysiological models for the development of resting tremor in Parkinson’s disease, essential and orthostatic tremor. We describe recent developments starting from the classical generator model, with an onset of pathological oscillations in distinct cerebral regions, to a network perspective in which tremor arises and spreads through existing anatomical or newly emerged pathological brain networks. In particular translational approaches are presented and discussed. These could serve in the future as a basis for the development of new therapeutic strategies.

Keywords

Parkinson’s disease Essential tremor Orthostatic tremor Action tremor Imaging 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Muthuraman, A. Schnitzler und S. Groppa geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Sektion für Bewegungsstörungen und Neurostimulation, Biomedizinische Statistik und multimodale Signalverarbeitung, Klinik und Poliklinik für NeurologieJohannes Gutenberg-Universität MainzMainzDeutschland
  2. 2.Klinik für NeurologieUniversitätsklinik Düsseldorf, Heinrich-Heine-UniversitätDüsseldorfDeutschland

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