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See Muthuraman et al. (doi:10.1093/aww164) for a scientific commentary on this article.
The pathophysiology of orthostatic tremor is unclear. Using neuroimaging to investigate the cerebellar motor pathways in patients, Gallea et al. reveal anatomo-functional changes in the cerebellar vermis, lateral cerebellum and supplementary motor area. Repetitive transcranial cerebellar stimulation reduces the amplitude of the tremor frequency peak and modifies cerebello-cortical connectivity.
