In quest of the oscillator(s) in tremor: are we getting closer?

Abstract

This scientific commentary refers to ‘The nature of tremor circuits in parkinsonian and essential tremor’ by Cagnan et al. (10.1093/brain/awu250). Periodic oscillatory activity is abundant in the nervous system (Gray, 1994), both in health and in disease. Ion channels, membrane potentials, action potentials of single neurons and macroscopic brain regions all show periodic oscillations (hereafter ‘oscillations’). Within this framework, the neuronal oscillators that generate tremor, an oscillatory phenomenon in its own right, are being sought. However, attempts to define the neuronal substrate/s that generate rest and postural tremors in Parkinson’s disease and essential tremor face a number of conceptual difficulties. Correlation does not imply causality, thus strong coherence between tremor and neuronal oscillations could be the result of peripheral feedback to the nervous system. Many researchers have therefore focused on active manipulation of tremor phenomena. However, the ability to attenuate or modulate tremor by stimulating a certain brain structure does not necessarily prove that this locus is the tremor generator. What features can be used to distinguish between the tremor generator and the downstream neuronal pathways that transmit the oscillatory signal? In this issue of Brain , Cagnan et al. (2014) address this …