{"doi":"10.1002/mds.28022","title":"Re‐emergent Tremor in Parkinson's Disease: The Role of the Motor Cortex","abstract":"BACKGROUND: Parkinson's disease patients may show a tremor that appears after a variable delay while the arms are kept outstretched (re-emergent tremor). The objectives of this study were to investigate re-emergent tremor pathophysiology by studying the role of the primary motor cortex in this tremor and making a comparison with rest tremor. METHODS: We enrolled 10 Parkinson's disease patients with both re-emergent and rest tremor. Tremor was assessed by spectral analysis, corticomuscular coherence and tremor-resetting produced by transcranial magnetic stimulation over the primary motor cortex. We also recorded transcranial magnetic stimulation-evoked potentials generated by motor cortex stimulation during rest tremor, tremor suppression during wrist extension, and re-emergent tremor. Spectral analysis, corticomuscular coherence, and tremor resetting were compared between re-emergent tremor and rest tremor. RESULTS: Re-emergent tremor showed significant corticomuscular coherence, causal relation between motor cortex activity and tremor muscle and tremor resetting. The P60 component of transcranial magnetic stimulation-evoked potentials reduced in amplitude during tremor suppression, recovered before re-emergent tremor, was facilitated at re-emergent tremor onset, and returned to values similar to those of rest tremor during re-emergent tremor. Compared with rest tremor, re-emergent tremor showed similar corticomuscular coherence and tremor resetting, but slightly higher frequency. CONCLUSIONS: Re-emergent tremor is causally related with the activity of the primary motor cortex, which is likely a convergence node in the network that generates re-emergent tremor. Re-emergent tremor and rest tremor share common pathophysiological mechanisms in which the motor cortex plays a crucial role. © 2020 International Parkinson and Movement Disorder Society.","journal":"Movement Disorders","year":2020,"id":65619,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":56,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7723,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":347465,"name":"Daniele Belvisi","orcid":"0000-0001-8681-3050","position":1,"is_corresponding":false},{"id":347466,"name":"Maria Ilenia De Bartolo","orcid":"0000-0002-8747-9805","position":2,"is_corresponding":false},{"id":347467,"name":"A Fabbrini","orcid":"0000-0003-3906-0230","position":3,"is_corresponding":false},{"id":347468,"name":"Matteo Costanzo","orcid":"0000-0002-4369-014X","position":4,"is_corresponding":false},{"id":347469,"name":"Felipe Vial","orcid":"0000-0002-3293-2924","position":5,"is_corresponding":false},{"id":347470,"name":"Antonella Conte","orcid":"0000-0002-6338-2961","position":6,"is_corresponding":false},{"id":255823,"name":"Mark Hallett","orcid":"0000-0002-3180-6811","position":7,"is_corresponding":false},{"id":347471,"name":"Alfredo Berardelli","orcid":"0000-0003-3598-3142","position":8,"is_corresponding":false},{"id":340041,"name":"Giorgio Leodori","orcid":"0000-0002-6631-6740","position":0,"is_corresponding":true}],"reference_count":63,"raw_metadata":null,"created_at":"2026-07-18T21:13:43.728351Z","pmid":"32175656","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}