Essential tremor is not a neurodegenerative disease

Author:

Rajput Ali H1,Adler Charles H2,Shill Holly A3,Rajput Alex4

Affiliation:

1. Movement Disorders Program, Neurology Division, University of Saskatchewan/Saskatoon Health Region, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.

2. Parkinson’s Disease & Movement Disorders Center, Mayo Clinic Scottsdale, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA

3. Banner Sun Health Research Institute, 10515 W. Santa Fe Drive, Sun City, AZ 85351, USA

4. Movement Disorders Program, Neurology Division, University of Saskatchewan/Saskatoon Health Region, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada

Abstract

SUMMARY The pathophysiology of essential tremor (ET) remains unknown. Standard neuropathological studies have reported no consistent changes but a detailed study found neurodegeneration in all ET cases – 24% demonstrated lower brainstem Lewy body (LB) inclusions and 76% experienced a loss of cerebellar Purkinje cells (PCs) and its sequelae. We review the evidence on neurodegeneration in ET. The prevalence of LB inclusions in ET brains is similar to that in the asymptomatic general population. These incidental LB disease cases have evidence for reduced striatal tyrosine hydroxylase levels, as found in Parkinson’s disease, but there is no evidence for reduced tyrosine hydroxylase levels in ET patients. Reduced mean PC counts in ET cases compared with the controls reported by some studies could not be replicated by others. Most ET cases have the same number of PCs as controls of a comparable age. Neither the lower brainstem LB inclusions nor the cerebellar PC loss represent the neurodegenerative basis of ET. Further studies are needed to determine the pathophysiology of ET.

Publisher

Future Medicine Ltd

Subject

Clinical Neurology

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