Tremor-Dominant Form of Parkinson’s Disease

This review addresses tremor, which is among the maladaptive and difficult-to-treat symptoms of Parkinson’s disease (PD). Along with classical resting tremor, patients with PD may experience postural and kinetic types of tremor, reflecting the multimodal mechanism of its formation, which involves multiple neurotransmitter systems. Unpredictable therapeutic responses and mixed responses to levodopa also reflect the roles of multiple underlying pathophysiological processes. Among medication-based methods for tremor correction, preference is given to dopamine receptor agonists because of their wide range of pharmaceutical effects and high efficacy in relation to the major motor and various non-motor manifestations. Evidence of the efficacy of advanced neurosurgical and non-invasive treatment methods is not always convincing; there have been no large-scale comparative studies assessing their efficacy in patients with tremor-dominant forms of PD.