Resting and action tremor in Parkinson’s disease: pathophysiological insights from long-term STN-DBS

Résumé fourni par la source

Tremor is a well-recognized sign of Parkinson's disease (PD), yet its long-term evolution remains unclear, particularly regarding the relationship between resting and action tremor. This retrospective study examined resting and action tremor using specific UPDRS-III subitems in 301 PD patients treated with bilateral subthalamic nucleus deep brain stimulation (STN-DBS), assessed preoperatively and at one-year follow-up, with 108 and 57 patients re-evaluated at ten and 15 years, respectively. Most patients (61.8%) had both tremor types, with smaller subsets showing isolated resting (14.3%), action (10.6%), or no tremor (13.3%). Resting tremor responded better to L-Dopa, STN-DBS, and their combination than action tremor (p < 0.05) and remained stable long-term. In contrast, action tremor worsened over time, particularly in tremor-dominant and mixed phenotypes (p < 0.05). A moderate association between tremor types was observed OFF-medication (ρ = 0.59), weakening under treatment (ρ = 0.23/0.30). Action tremor also correlated weakly with bradykinesia and rigidity (ρ = 0.19/0.21). Overall, these differences suggest distinct pathophysiology and neural circuits for resting and action tremor in PD.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.