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Updated: Feb 9, 2026

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Essential tremor and the cerebellum.

Elan D Louis1

  • 1Department of Neurology and Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, United States; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States.

Handbook of Clinical Neurology
|June 13, 2018
PubMed
Summary

Essential tremor (ET) is a progressive neurologic disease often linked to cerebellar dysfunction. Research suggests Purkinje cell abnormalities in the cerebellum are central to ET, impacting treatments like medications and deep-brain stimulation.

Keywords:
cerebellumessential tremorneurodegenerationpurkinje cell

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Area of Science:

  • Neuroscience
  • Neurology

Background:

  • Essential tremor (ET) is a prevalent, progressive neurologic disorder.
  • Clinical signs include tremors, gait ataxia, and cognitive deficits, often linked to cerebellar dysfunction.

Purpose of the Study:

  • To review the evidence implicating cerebellar dysfunction in Essential Tremor (ET).
  • To explore the role of Purkinje cells and cerebellar pathways in ET pathogenesis and treatment.

Main Methods:

  • Review of neuroimaging studies showing cerebellar abnormalities in ET patients.
  • Analysis of postmortem studies identifying microscopic changes in ET brains.
  • Examination of treatment mechanisms targeting cerebellar function.

Main Results:

  • Neuroimaging reveals functional, metabolic, and structural cerebellar abnormalities in ET.
  • Postmortem studies indicate degenerative changes primarily in Purkinje cells.
  • Pharmacotherapies enhancing GABAergic neurotransmission and deep-brain stimulation targeting cerebellar outflow pathways are effective.

Conclusions:

  • The cerebellum and its systems are strongly implicated as the root cause of ET.
  • Purkinje cell dysfunction leading to reduced cerebellar inhibition is a key hypothesis.
  • Targeting cerebellar pathways offers effective therapeutic strategies for ET.