Tremor is an important and common symptom in patients with multiple sclerosis (MS). It constituted one of the three core features of MS triad described by Charcot in the last century. Tremor could have a drastic impact on patients’ quality of life. This paper provides an overview of tremor in MS and future perspectives with a particular emphasis on its epidemiology (prevalence: 25–58%), clinical characteristics (i.e., large amplitude 2.5–7 Hz predominantly postural or intention tremor vs. exaggerated physiological tremor vs. pseudo-rhythmic activity arising from cerebellar dysfunction vs. psychogenic tremor), pathophysiological mechanisms (potential implication of cerebellum, cerebello-thalamo-cortical pathways, basal ganglia, and brainstem), assessment modalities (e.g., tremor rating scales, Stewart–Holmes maneuver, visual tracking, digitized spirography and accelerometric techniques, accelerometry–electromyography coupling), and therapeutic options (i.e., including pharmacological agents, botulinum toxin A injections; deep brain stimulation or thalamotomy reserved for severe, disabling, or pharmaco-resistant tremors). Some suggestions are provided to help overcome the unmet needs and guide future therapeutic and diagnostic studies in this complex disorder.

中文翻译：

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多发性硬化症中的震颤——概述和未来展望


震颤是多发性硬化症（MS）患者的重要且常见的症状。它构成了上世纪夏科描述的MS三联征的三个核心特征之一。震颤可能会对患者的生活质量产生巨大影响。本文概述了多发性硬化症的震颤以及未来的前景，特别强调其流行病学（患病率：25-58%）、临床特征（即大幅度 2.5-7 Hz 主要是姿势性或意向性震颤与夸张的生理性震颤与夸张的生理性震颤）小脑功能障碍与心因性震颤引起的伪节律活动）、病理生理学机制（小脑、小脑-丘脑-皮质通路、基底神经节和脑干的潜在影响）、评估方式（例如震颤评定量表、斯图尔特-霍姆斯演习） 、视觉跟踪、数字化呼吸描记术和加速测量技术、加速测量-肌电图耦合）以及治疗选择（即包括药物、A型肉毒毒素注射；深部脑刺激或丘脑切开术用于治疗严重、致残或耐药性震颤）。提供了一些建议来帮助克服未满足的需求并指导这种复杂疾病的未来治疗和诊断研究。