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[The new tremor classification of the International Parkinson and Movement Disorder Society : Update on frequent tremors].

Tremor is one of the most frequent movement disorders. The recently published new classification of the Movement Disorder Society separates the clinical description of tremor syndromes as so-called axis 1 symptom constellations from the etiologies of tremor (axis 2). The same tremor syndromes can therefore be combined with different causes and vice versa. The terminology used in this classification is precisely defined and thereby also the necessary language for medical communication. Frequent tremor syndromes, such as enhanced physiologic tremor, dystonic and parkinsonian tremor as well as fo…

Differential effects of propranolol on head and upper limb tremor in patients with essential tremor and dystonia.

Propranolol is used as the first-line treatment in essential tremor and it has also been proposed as a treatment for tremor in dystonia. However, several issues remain uncertain. For example, it is still not clear whether propranolol exerts a beneficial effect on head tremor. Moreover, no studies have investigated whether the effect of propranolol on head and upper limb tremor in essential tremor differs from that in dystonia. We aimed to assess the effects of propranolol on tremor in different body parts in essential tremor and in patients with tremor and dystonia. Twenty-nine patients with h…

Resetting tremor by single and paired transcranial magnetic stimulation in Parkinson's disease and essential tremor.

OBJECTIVE: The pathogenesis of tremor in Parkinson's disease (PD) and essential tremor (ET) is not fully understood. This study tested the role of primary motor cortex (M1), supplementary motor area (SMA) and cerebellar cortex on PD and ET tremor by single- and paired-pulse transcranial magnetic stimulation (TMS). METHODS: Ten PD patients with resting tremor, six of them also with postural tremor, and ten ET patients with postural tremor were studied. Randomized single- and paired-pulse TMS with an interstimulus interval of 100 ms were delivered over M1, SMA and cerebellum. TMS effects were e…

Validity of a screening question for head tremor: an analysis of four essential tremor case samples.

BACKGROUND: The goal of this study was to assess the validity of a screening question for head tremor in essential tremor (ET). There are no published data on this topic, and the knowledge will guide future epidemiological investigations of this disorder. METHODS: These analyses utilized four distinct patient samples: a population-based study in northern Manhattan, a study of the environmental epidemiology of ET, a genetics study, and a brain repository. Sensitivity was the proportion of ET cases with head tremor on examination who self-reported head tremor. RESULTS: The sensitivity of the s…

Postural and Intention Tremors: A Detailed Clinical Study of Essential Tremor vs. Parkinson's Disease.

BACKGROUND: An estimated 30-50% of essential tremor (ET) diagnoses are incorrect, and the true diagnosis in those patients is often Parkinson's disease (PD) or other tremor disorders. There are general statements about the tremor in these ET and PD, but published data on the more subtle characteristics of tremor are surprisingly limited. Postural tremor may occur in both disorders, adding to the difficulty. There are several anecdotal impressions regarding specific features of postural tremor in ET vs. PD, including joint distribution (e.g., phalanges, metacarpal-phalangeal joints, wrist), tre…

Muscle loading as a method to isolate the underlying tremor components in essential tremor and Parkinson's disease.

Tremor is clinically evaluated and classified on the basis of its response to limb posture (resting, postural, and kinetic tremor), but the mechanisms underlying this powerful influence remain unclear and no satisfactory method exists to identify or quantify underlying tremor subtypes. Postural change is closely linked to changes in gravitational load. We therefore assessed the effect of changes in muscle load on essential tremor (ET) and parkinsonian tremor (PT) independently of postural change. A motor accurately delivered a series of constant (0.2-1.2 Nm) flexion and extension torques about…

Risk of action tremor in relatives of tremor-dominant and postural instability gait disorder PD.

BACKGROUND: Action tremor may be more prevalent in relatives of patients with Parkinson's disease (PD) than in relatives of control subjects. This tremor could represent mild PD or essential tremor. An estimate of the risk of this condition in families of patients with PD is important when studying the genetics of PD. OBJECTIVE: S: To determine the risk of action tremor in first-degree relatives of probands with tremor-dominant PD (TD-PD) and postural instability gait disorder PD (PIGD-PD) compared with first-degree relatives of control probands. METHODS: PD and control probands participated…

Coherence between low-frequency activation of the motor cortex and tremor in patients with essential tremor.

BACKGROUND: In healthy people, rhythmic activation of the motor cortex in the 15-30 Hz frequency range accompanies and contributes to voluntarily-generated postural contractions of contralateral muscle. In patients with Parkinson's disease, an abnormal low-frequency activation of the motor areas of the cortex occurs and has been directly linked to the characteristic 3-6 Hz rest tremor of this disease. We therefore investigated whether the motor cortex is involved in the transmission of the rhythmic motor drive responsible for generating essential tremor. METHODS: Non-invasive recordings of ac…

Stimulation of the ventral intermediate thalamic nucleus in tremor dominated Parkinson's disease and essential tremor.

Based on Benabid's experimental and clinical findings that low-frequency (50 Hz) electrical stimulation of the ventral intermediate thalamic nucleus may increase tremor, while higher frequencies (> 100 Hz) lead to suppression of the tremor, we implanted a stimulation electrode in 33 thalami among 27 patients. Six patients were implanted bilaterally. 23 suffered from Parkinson's disease, 4 from essential tremor. All patients had a drug-resistant tremor. The Vim target was calculated based on stereotactic ventriculography. An intra-operative neurophysiological target control was performed on all…

Identification of essential tremor and dystonic tremor using Graph Convolutional Networks with multiple connectivity patterns.

INTRODUCTION: As a deep learning algorithm, Graph convolutional network (GCN) can efficiently process graph-structured data to identify salient brain regions and brain connectivity patterns. We combine GCNs with a multi-connection pattern (MCGCN) to identify salient brain regions implicated in Essential Tremor (ET) and Dystonic Tremor (DT), aiming to explore the underlying neuropathological mechanisms of these conditions. METHODS: Rs-fMRI data were collected from 55 ET patients, 51 DT patients, and 52 healthy controls (HCs). BOLD time series from each subject were extracted and functional con…

OnabotulinumtoxinA treatment for MS-tremor modifies fMRI tremor response in central sensory-motor integration areas.

BACKGROUND: Treatment of tremor in MS is an unmet need. OnabotulinumtoxinA (BoNT-A) has shown promising results; however, little is known regarding its effects on the brain. The clinical presentation of tremor MS is shown to depend on subcortical neural damage and cortical neural plasticity. This study aimed to identify effects of onabotulinumtoxinA (BoNT-A) on brain activation in MS and upper-limb tremor using functional MRI. METHODS: Forty-three MS participants with tremor were randomized to receive intramuscular injections of placebo (n = 22) or BoNT-A (n = 21). Tremor was quantified using…

Transcutaneous Afferent Patterned Stimulation Therapy Reduces Hand Tremor for One Hour in Essential Tremor Patients.

Essential tremor (ET) patients often experience hand tremor that impairs daily activities. Non-invasive electrical stimulation of median and radial nerves in the wrist using a recently developed therapy called transcutaneous afferent patterned stimulation (TAPS) has been shown to provide symptomatic tremor relief in ET patients and improve patients' ability to perform functional tasks, but the duration of tremor reduction is unknown. In this single-arm, open-label study, fifteen ET patients performed four hand tremor-specific tasks (postural hold, spiral drawing, finger-to-nose reach, and pour…

Resistance Training Reduces Force Tremor and Improves Manual Dexterity in Older Individuals With Essential Tremor.

Although symptoms of Essential Tremor (ET) are typically controlled with medication, it is of interest to explore additional therapies to assist with functionality. The purpose of this study was to determine if a generalized upper limb resistance training (RT) program improves manual dexterity and reduces force tremor in older individuals with ET. Ten Essential Tremor and 9 controls were recruited into a dual group, pretest-posttest intervention study. Participants performed 6 weeks of upper-limb RT, and battery of manual dexterity and isometric force tremor assessments were performed before a…

Comparison of motor and non-motor features between essential tremor and tremor dominant Parkinson's disease.

BACKGROUND: Differential diagnosis of tremor disorders, including essential tremor (ET) and Parkinson's disease-tremor dominant type (PD-TDT), requires further investigation. Therefore, the current study aimed to compare non-motor and tremor features in order to differentiate between ET and PD-TDT. METHODS: Twenty-eight patients with classic ET and 24 patients with typical PD-TDT were retrospectively enrolled in a multi-stage investigation process. Tremor features including surface electromyogram (EMG) were analyzed in detail. For non-motor symptom analyses, the global cognition test, frontal…

Tolerance and tremor rebound following long-term chronic thalamic stimulation for Parkinsonian and essential tremor.

Fifty-eight patients, 36 with essential tremor (ET) and 22 with Parkinson's disease (PD), received deep brain stimulation (DBS) in the thalamic ventral intermediate (Vim) nucleus. The mean follow-up was 17 months for ET and 21 months for PD patients. Stimulation parameters were adjusted as needed, at various intervals after surgery. Results were assessed using routine clinical evaluation and established outcome scales. All patients needed incremental increase in stimulation parameters at various intervals during the first 6-12 months after surgery. The mean voltage 1 week postoperatively was 1…

The Washington Heights-Inwood Genetic Study of Essential Tremor: methodologic issues in essential-tremor research.

Essential tremor (ET) is the most prevalent movement disorder. It is unknown to what extent ET clusters within families, and the role of genetic susceptibility in etiology of ET has not been adequately investigated at the population level. The problem is largely methodological, with few well-designed studies. The Washington Height-Inwood Genetic Study of ET, begun in 1955, is designed to investigate the genetics of ET using a methodology that has not been applied to ET research to date. Part of the design includes a new set of clinical and electrophysiological diagnostic criteria for ET; the p…

Ботулинумитоксины для обработки треморов.

Тремор, осцилляционное расстройство движения, часто встречается в клинической практике при установлении различных этических норм, таких, как основной трёмор и болезнь Паркинсона. Несмотря на высокую распространенность этой практики, возможности лечения являются несколько ограниченными. Лекарства от оральных заболеваний зачастую неэффективны или ограничены побочными эффектами, а другие виды лечения, такие, как глубокая стимуляция мозга, являются более инвазивными и дорогостоящими. Инъекции ботулинового токсина (BONT) являются хорошо зарекомендовавшей себя терапией при лечении дистонии, однако е

Совпадение в аннотации оригинала
Tremor, an oscillatory movement disorder, is commonly encountered in clinical practice in the setting of a variety of etiologies, such as essential tremor and Parkinson's disease. Despite its high prevalence, treatment options are somewhat limited. Oral medications are often ineffective or limited by side effects, and other treatments, such as deep brain sti…