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Tremor (trembling) is one of the cardinal symptoms of Parkinson’s disease (PD). While other motor symptoms, such as bradykinesia (slowness) or rigidity (stiffness) typically worsen with disease progression, tremor may worsen, remain stable or even disappear. Researchers have found that the reduction of tremor is associated with progressive brain atrophy.
Researchers of the Center of Expertise for Parkinson and Movement Disorders at the Radboud university medical center and Donders Centre for Cognitive Neuroimaging have used two-year longitudinal clinical and MRI data from 520 PD patients from the Personalized Parkinson Project (Dutch: Parkinson Op Maat) to investigate the progression of bradykinesia, rigidity, and tremor. While bradykinesia and rigidity worsened, resting tremor remained stable. In contrast, action tremor (both postural and kinetic tremor) reduced over time. Progressive diffuse brain atrophy (measured using MRI) correlated with a reduction of action tremor, but an increase of bradykinesia and rigidity. These results showed that action tremor in PD, in contrast to other motor symptoms, reduced with disease progression. The authors suggest that progressive atrophy may disrupt processes in brain regions involved in tremor generation (the central tremor oscillator).
These findings may be of clinical relevance, for instance when PD patients have questions about their prognosis or when advanced therapies (such as deep brain stimulation) are being considered. More research is needed to predict tremor progression on an individual level, such that healthcare providers may better inform and treat PD patients with tremor.
The article is linked to research program Parkinson’s disease and other movement disorders
About the publication
van den Berg, K.R.E., Johansson, M.E., Dirkx, M.F., Bloem, B.R. and Helmich, R.C. (2025), Changes in Action Tremor in Parkinson's Disease over Time: Clinical and Neuroimaging Correlates. Mov Disord, 40: 292-304. https://doi.org/10.1002/mds.30081
