ArticleCerebellum (London, England)2021
Essential Tremor versus "ET-plus": A Detailed Postmortem Study of Cerebellar Pathology.
Article in Cerebellum (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Pooled it
- Speech, voice, and language outcomes following deep brain stimulation: A systematic review.PloS one · 2024Pooled it
- "Advanced ET" Is a More Appropriate Term Than "ET-Plus".European journal of neurology · 2026Article
- Predictors of Incident Dementia in a Cohort of Elders with Essential Tremor: A Prospective, Longitudinal Study.Neuro-degenerative diseases · 2026Article
- Longitudinal Trajectories in Essential Tremor: Evidence From A Seven-Year Follow-Up of Motor and Non-Motor Symptoms.European journal of neurology · 2026Article
- An Investigation of Heterogeneity in Cerebellar Cortical Pathology Across Essential Tremor Cases: A Cluster Analysis.Cerebellum (London, England) · 2026Article
- Comparative study of the pathology in anterior versus posterior hemispheric regions of cerebellum in essential tremor and controls.Acta neuropathologica · 2026Article
- Sleep Disturbances and Their Correlates in Essential Tremor and Essential Tremor Plus: A Questionnaire-Based Case-Control Study.Tremor and other hyperkinetic movements (New York, N.Y.) · 2026Article
- Structural brain changes in the development of essential tremor: toward early diagnosis.Frontiers in aging neuroscience · 2026Article
- Corpus Callosum Structural Alterations in Essential Tremor with and Without Resting Tremor: A Multimodal MRI Study.Tremor and other hyperkinetic movements (New York, N.Y.) · 2025Article
- Locus Coeruleus Degeneration in Essential Tremor With Mild Cognitive Impairment: A Neuromelanin MRI Study.CNS neuroscience & therapeutics · 2025Article
- Bedside clinical assessment of patients with common upper limb tremor and algorithmic approach.Asian biomedicine : research, reviews and news · 2024Review
- Six Myths and Misconceptions about Essential Tremor.Tremor and other hyperkinetic movements (New York, N.Y.) · 2024Review
- Exploring White Matter Microstructure with Symptom Severity and Outcomes Following Deep Brain Stimulation in Tremor Syndromes.Tremor and other hyperkinetic movements (New York, N.Y.) · 2024Article
- Gene Expression Analysis of Laser-Captured Purkinje Cells in the Essential Tremor Cerebellum.Cerebellum (London, England) · 2023Article
- Age and Sex Affect Essential Tremor (ET) Plus: Clinical Heterogeneity in ET Based on the National Survey in China.Aging and disease · 2023Article
- Longitudinal study of clinical and neurophysiological features in essential tremor.European journal of neurology · 2023Article
- Ataxias: Hereditary, Acquired, and Reversible Etiologies.Seminars in neurology · 2023Article
- Postmortem Cerebellar Volume Is Not Reduced in Essential Tremor: A Comparison with Multiple System Atrophy and Controls.Journal of Parkinson's disease · 2023Article
- Deep brain stimulation for essential tremor versus essential tremor plus: should we target the same spot in the thalamus?Frontiers in human neuroscience · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
Essential tremor (ET) is among the most prevalent movement disorders, and by some accounts, the most common form of cerebellar degeneration. Over the past 15 years, we have carefully documented a large number of postmortem changes within the cerebellum; these cerebellar changes differ significantly between ET and controls. A recent Consensus Classification of tremor proposed that ET patients with other neurological signs aside from action tremor (e.g., parkinsonism, ataxia, cognitive changes, dystonia) should be segregated off as "ET-plus". This diagnostic concept has raised considerable controversy and its validity is not yet established. Indeed, "ET-plus" has not been distinguished from ET based on differences in genetics, pathology or prognosis. Here we determine whether ET cases differ from "ET-plus" cases in underlying pathological changes in the postmortem brain. We examined postmortem brains from 50 ET cases (24 ET and 26 ET-plus), using a set of 14 quantitative metrics of cerebellar pathology determined by histologic and immunohistochemical methods. These metrics reflect changes across the Purkinje cell (PC) body (PC counts, empty baskets, heterotopias), PC dendrites (swellings), PC axon (torpedoes and associated axonal changes), basket cell axonal hypertrophy and climbing fiber-PC dendrite synaptic changes. ET and ET-plus were similar with respect to 13 of 14 cerebellar pathologic metrics (p > 0.05). Only one metric, the linear density of thickened PC axon profiles, differed between these groups (ET = 0.529 ± 0.397, ET-plus = 0.777 ± 0.477, p = 0.013), although after correcting for multiple comparisons, there were no differences. If ET-plus were indeed a different entity, then the underlying pathological basis should be distinct from that of ET. This study demonstrated there were no pathological differences in cerebellar cortex between ET versus ET-plus cases. These data do not support the notion that ET and ET-plus represent distinct clinical-pathological entities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.