Neural Control of Muscles in Tremor Patients

Essential tremor and Parkinson's disease cause abnormal oscillatory activity in a variety of brain structures that is transmitted to spinal motoneurons and generates tremor. Because the motoneuron pool integrates synaptic inputs from descending and spinal circuits, the decoding of its activity provides a view on all the neural pathways involved in tremor generation. We investigated tremor mechanisms by analyzing the behavior of populations of motoneurons within a single muscle, across antagonist muscle pairs, and in relation to cortical activity. We observed that tremor is caused by a common cortical input projected to all motoneurons. We also found that spinal reflex pathways contribute fundamentally to shaping tremor properties. We posit that although ET and PD tremor are centrally generated, tremor properties are strongly determined by the interaction between descending and afferent inputs to the motoneuron pool.