Evidence map›Paper›PMID 34820148›Full record

ReviewTremor and other hyperkinetic movements (New York, N.Y.)2021

The Role of the Cerebellum in Tremor - Evidence from Neuroimaging.

Kevin R E van den Berg, Rick C Helmich

Open access · goldAbstract readReview
In one paragraph

Review in Tremor and other hyperkinetic movements (New York, N.Y.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 1 pooled it
5.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.

  1. Pooled it
  2. Essential Tremor Suppression with a Novel Anti-Tremor Orthosis: A Randomized Crossover Trial.Movement disorders : official journal of the Movement Disorder Society · 2025
    Trial
  3. Article
  4. Article
  5. Temporal Dynamics of Parkinson's Disease Tremor: Clinical and Neuroimaging Insights.Movement disorders : official journal of the Movement Disorder Society · 2026
    Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Empathy and alexithymia in essential tremor.Frontiers in psychiatry · 2026
    Article
  11. Review
  12. Article
  13. Defining the Rhythm: Developing a New Method to Describe Tremor and Myoclonus.Movement disorders : official journal of the Movement Disorder Society · 2025
    Article
  14. Phenotypical Differentiation of Tremor Using Time Series Feature Extraction and Machine Learning.Movement disorders : official journal of the Movement Disorder Society · 2025
    Article
  15. Article
  16. Review
  17. Article
  18. Observational
  19. Pathophysiological Role of Primary Motor Cortex in Essential Tremor.Movement disorders : official journal of the Movement Disorder Society · 2025
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Kevin R E van den BergCentre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands.ORCID 0000-0002-8971-4282
Rick C HelmichCentre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands.ORCID 0000-0003-4035-6573
Radboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Neuroimaging research has played a key role in identifying which cerebral changes are associated with tremor. Here we will focus on the cerebellum, which may drive tremor oscillations, process tremor-related afferents, modulate activity in remote brain regions, or a combination. Methods: On the 6 Results: In ET, tremor-related activity is found in motor areas of the bilateral cerebellum, and altered functional connectivity within and outside the cerebellum correlates with tremor severity. Furthermore, ET is associated with cerebellar atrophy, but also with compensatory structural changes outside the cerebellum (e.g. supplementary motor area). In PD, tremor-related cerebellar activity and increased cerebello-thalamic coupling has been found. Emerging evidence suggests that the cerebellum plays a key role in dopamine-resistant rest tremor and in postural tremor. Cerebellar structural alterations have been identified in PD, but only some relate to tremor. DT is associated with more widespread cerebral networks than other tremor types. Discussion: In ET, the cerebellum likely acts as an oscillator, potentially due to loss of inhibitory mechanisms. In contrast, in PD the cerebellum may be a modulator, which contributes to tremor oscillations by influencing the thalamo-cortical system. The precise role of the cerebellum in DT remains unclear. We recommend that future research measures tremor-related activity directly by combining electrophysiology with neuroimaging, while brain stimulation techniques may be used to establish causality. Highlights: This review of neuroimaging studies has provided convincing evidence that the cerebellum plays a key role in the pathophysiology of ET, PD tremor, and dystonic tremor syndromes. This contribution may consist of driving tremor oscillations, processing tremor-related afferents, modulating activity in remote brain regions, or all the above.

Indexed as

Essential TremorMotor CortexCerebellumHumansNeuroimagingTremorcerebellumdystoniamagnetic resonance imagingParkinson’s diseasepositron emission tomographytremor

Identifiers

PMID34820148
PMCPMC8603856
OpenAlexW3213363906

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.