{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T21:47:21Z","timestamp":1789163241952,"version":"build-2803163510"},"reference-count":85,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T00:00:00Z","timestamp":1602460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Tremor is an important and common symptom in patients with multiple sclerosis (MS). It constituted one of the three core features of MS triad described by Charcot in the last century. Tremor could have a drastic impact on patients\u2019 quality of life. This paper provides an overview of tremor in MS and future perspectives with a particular emphasis on its epidemiology (prevalence: 25\u201358%), clinical characteristics (i.e., large amplitude 2.5\u20137 Hz predominantly postural or intention tremor vs. exaggerated physiological tremor vs. pseudo-rhythmic activity arising from cerebellar dysfunction vs. psychogenic tremor), pathophysiological mechanisms (potential implication of cerebellum, cerebello-thalamo-cortical pathways, basal ganglia, and brainstem), assessment modalities (e.g., tremor rating scales, Stewart\u2013Holmes maneuver, visual tracking, digitized spirography and accelerometric techniques, accelerometry\u2013electromyography coupling), and therapeutic options (i.e., including pharmacological agents, botulinum toxin A injections; deep brain stimulation or thalamotomy reserved for severe, disabling, or pharmaco-resistant tremors). Some suggestions are provided to help overcome the unmet needs and guide future therapeutic and diagnostic studies in this complex disorder.<\/jats:p>","DOI":"10.3390\/brainsci10100722","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T09:22:43Z","timestamp":1602580963000},"page":"722","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Tremor in Multiple Sclerosis\u2014An Overview and Future Perspectives"],"prefix":"10.3390","volume":"10","author":[{"given":"Karim","family":"Makhoul","sequence":"first","affiliation":[{"name":"Neurology Division, Lebanese American University Medical Center Rizk Hospital, Beirut 113288, Lebanon"},{"name":"Gilbert and Rose Mary Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rechdi","family":"Ahdab","sequence":"additional","affiliation":[{"name":"Neurology Division, Lebanese American University Medical Center Rizk Hospital, Beirut 113288, Lebanon"},{"name":"Gilbert and Rose Mary Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon"},{"name":"Hamidy Medical Center, Tripoli 1300, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naji","family":"Riachi","sequence":"additional","affiliation":[{"name":"Neurology Division, Lebanese American University Medical Center Rizk Hospital, Beirut 113288, Lebanon"},{"name":"Gilbert and Rose Mary Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0880-8608","authenticated-orcid":false,"given":"Moussa","family":"Chalah","sequence":"additional","affiliation":[{"name":"Service de Physiologie-Explorations Fonctionnelles, Henri Mondor Hospital, AP-HP, 94010 Cr\u00e9teil, France"},{"name":"EA 4391, Excitabilit\u00e9 Nerveuse et Th\u00e9rapeutique, Universit\u00e9 Paris-Est-Cr\u00e9teil, 94010 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0188-1957","authenticated-orcid":false,"given":"Samar","family":"Ayache","sequence":"additional","affiliation":[{"name":"Service de Physiologie-Explorations Fonctionnelles, Henri Mondor Hospital, AP-HP, 94010 Cr\u00e9teil, France"},{"name":"EA 4391, Excitabilit\u00e9 Nerveuse et Th\u00e9rapeutique, Universit\u00e9 Paris-Est-Cr\u00e9teil, 94010 Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/S1474-4422(10)70064-8","article-title":"The changing demographic pattern of multiple sclerosis epidemiology","volume":"9","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_2","unstructured":"Charcot, J.M. 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