The role of the cerebellum in the pathogenesis of essential tremor

Abstract

Abnormal activity in a neuronal network in which the cerebellum is included is coherent with continuous tremor oscillation. Within the cortico-Olivo-cerebella-thalamic circuit, the inferior olive could be an oscillator by having pacemaker properties. Despite that, the olivary pacemaker hypothesis faces many contradicting findings against the concept of a single oscillator. The attention has changed from the interactions between the elements and structures of the neural network in which the oscillators are contained to concentrate on its features. These features include the intensity and direction of the connection. Deficiency in the glutamatergic system in ET may be a better explanation for abnormal cerebellar function in ET. A reduction in dentate GABA receptor levels could be a basic defect in this disease. This may be explained by the reduced production of GABA from Purkinje cells at the postsynaptic neurons. This results in the release of deep cerebellar nuclei from previous inhibition. The correlation between genetic abnormalities and cerebellar dysfunction may explain this in the future.