scholarly journals Essential tremor—the most common movement disorder in older people

2006 ◽  
Vol 35 (4) ◽  
pp. 344-349 ◽  
Author(s):  
Bhomraj Thanvi ◽  
Nelson Lo ◽  
Tom Robinson
Keyword(s):  
Older People ◽  
Movement Disorder ◽  
Essential Tremor

scholarly journals Research on Characteristics of Essential Tremor in the Latvian Population / Esenciālā Tremora Īpatnību Izpēte Latvijas Populācijā

2015 ◽  
Vol 69 (5) ◽  
pp. 259-264
Author(s):  
Ligita Smeltere ◽  
Elvīra Smeltere
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Movement Disorder ◽  
Essential Tremor ◽  
Severe Form ◽  
Progressive Development ◽  
Kinetic Tremor

Abstract Essential tremor (ET) is a common movement disorder, characterised by symptoms such as bilateral postural and kinetic tremor with prevalent manifestation in hands. The disease has chronic progressive development. In the case of continuous severe form it may resemble Parkinson’s disease (PD) and sometimes comorbidity with PD is possible. Although both diseases have different pathogenesis and treatment, some tremor characteristics for both are similar, thus causing difficulties and mistakes in diagnosing. The aim of the research was to determine ET characteristics within the Latvian population to identify possible causes for making mistakes.

scholarly journals Modeling mechanisms of tremor reduction for essential tremor using symmetric biphasic DBS

2019 ◽  
Author(s):  
Shane Lee ◽  
Wael F Asaad ◽  
Stephanie R Jones
Keyword(s):  
Deep Brain Stimulation ◽  
Side Effects ◽  
Movement Disorder ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Future Studies ◽  
Tremor Frequency ◽  
Ventral Intermediate Nucleus ◽  
Different Shapes ◽  
Deep Brain

AbstractEssential tremor (ET) is the most common movement disorder, in which the primary symptom is a prominent, involuntary 4–10 Hz movement. For severe, medication refractory cases, deep brain stimulation (DBS) targeting the ventral intermediate nucleus of the thalamus (VIM) can be an effective treatment for cessation of tremor and is thought to work in part by disrupting tremor frequency oscillations (TFOs) in VIM. However, DBS is not universally effective and may be further disrupting cerebellar-mediated activity in the VIM. Here, we applied biophysically detailed computational modeling to investigate whether the efficacy of DBS is affected by the mechanism of generation of TFOs or by the pattern of stimulation. We simulated the effects of DBS using standard, asymmetric pulses as well as biphasic, symmetric pulses to understand biophysical mechanisms of how DBS disrupts TFOs generated either extrinsically or intrinsically. The model results suggested that the efficacy of DBS in the VIM is affected by the mechanism of generation of TFOs. Symmetric biphasic DBS reduced TFOs more than standard DBS in both networks, and these effects were stronger in the intrinsic network. For intrinsic tremor frequency activity, symmetric biphasic DBS was more effective at reducing TFOs. Simulated non-tremor signals were also transmitted during symmetric biphasic DBS, suggesting that this type of DBS may help to reduce side effects caused by disruption of the cerebellothalamocortical pathway. Biophysical details in the model provided a mechanistic interpretation of the cellular and network dynamics contributing to these effects that can be empirically tested in future studies.Significance StatementEssential tremor (ET) is a common movement disorder, whose primary symptom is an involuntary rhythmic movement of the limbs or head. An area of the human tha-lamus demonstrates electrical activity that oscillates at the frequencies of tremor, and deep brain stimulation (DBS) in this area can reduce tremor. It is not fully understood how DBS affects tremor frequency activity in the thalamus, and studying different patterns of DBS stimulation may help to clarify these mechanisms. We created a computational model of different shapes of DBS and studied how they reduce different hypothesized generators of tremor frequency activity. A greater understanding of how DBS affects the thalamus may lead to improved treatments to reduce tremor and alleviate side effects in patients with ET.

Tremors

2016 ◽  
Author(s):  
Alfonso Fasano ◽  
Günther Deuschl
Keyword(s):  
Movement Disorder ◽  
Essential Tremor ◽  
Involuntary Movement ◽  
The Body ◽  
Drug Induced ◽  
Parkinsonian Tremor ◽  
Dystonic Tremor ◽  
Physiologic Tremor ◽  
Disease Definition ◽  
Holmes Tremor

Tremor is the most common movement disorder and denotes a rhythmic and involuntary movement of one or several regions of the body. This review covers disease definition, essential tremor, enhanced physiologic tremor, parkinsonian tremor, dystonic tremor, orthostatic tremor, cerebellar tremor, Holmes tremor, neuropathic tremor, palatal tremor, drug-induced and toxic tremors, functional tremor, rare tremor syndromes, tremorlike conditions, and treatment of tremor. Figures show action tremor assessment, the central nervous system circuits of tremor, magnetic resonance imaging findings in specific tremor conditions, general management of tremor patients, an algorithm for the treatment of parkinsonian tremor, and an algorithm for the treatment of dystonic tremor and primary writing tremor. Tables list types of tremor according to the condition of activation, tremor conditions in newborns and during childhood, clinical features of the most common tremor syndromes, motor signs other than tremor and nonmotor features of essential tremor patients, Movement Disorder Society consensus criteria for the diagnosis of essential tremor, genetic and environmental causes of essential tremor, causes of enhanced physiologic tremor, drugs and toxins known to cause tremor, paroxysmal tremors, pseudorhythmic myoclonus in the differential diagnosis of tremor, and pharmacologic management of essential tremor. Key words: essential tremor, movement disorder, pathologic tremor, physiologic tremor, tremor This review contains 6 highly rendered figures, 7 videos, 11 tables, and 163 references.

Agreement among movement disorder specialists on the clinical diagnosis of essential tremor

1997 ◽  
Vol 12 (6) ◽  
pp. 973-976 ◽  
Author(s):  
Sylvain Chouinard ◽  
Elan D. Louis ◽  
Stanley Fahn
Keyword(s):  
Movement Disorder ◽  
Essential Tremor ◽  
Clinical Diagnosis

scholarly journals “Old” and emerging Therapies of Human Tremor

2010 ◽  
Vol 2 ◽  
pp. CMT.S2999 ◽  
Author(s):  
G. Grimaldi ◽  
M. Manto
Keyword(s):  
Deep Brain Stimulation ◽  
Movement Disorder ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Daily Practice ◽  
Pharmacological Therapy ◽  
Review Article ◽  
Pharmacological Agents ◽  
Emerging Therapies ◽  
Deep Brain

Tremor is the most common movement disorder encountered during daily practice. Most forms of tremor are currently managed with drugs. However, the response of tremor to pharmacotherapy is variable and a combination of agents is often required. Surgery is considered when the response is not sufficient. In particular deep brain stimulation (DBS) is now playing a key-role, especially for refractory Parkinson's disease. DBS is also a well established therapy for essential tremor resistant to pharmacological therapy. New therapies are emerging, not only in the field of pharmacological agents, but also in the domain of bioengineering. They are presented in this review article.

scholarly journals Pharmacotherapy of Essential Tremor

2013 ◽  
Vol 5 ◽  
pp. JCNSD.S6561 ◽  
Author(s):  
Peter Hedera ◽  
FrantišEk Cibulčík ◽  
Thomas L. Davis
Keyword(s):  
Adverse Effect ◽  
Molecular Modeling ◽  
Movement Disorder ◽  
Essential Tremor ◽  
Clinical Observation ◽  
Treatment Algorithm ◽  
Invasive Therapy ◽  
Therapeutic Trials

Essential tremor (ET) is a common movement disorder but its pathogenesis remains poorly understood. This has limited the development of effective pharmacotherapy. The current therapeutic armamentaria for ET represent the product of careful clinical observation rather than targeted molecular modeling. Here we review their pharmacokinetics, metabolism, dosing, and adverse effect profiles and propose a treatment algorithm. We also discuss the concept of medically refractory tremor, as therapeutic trials should be limited unless invasive therapy is contraindicated or not desired by patients.

scholarly journals Biophysical modeling of VIM to assess contributions of oscillatory activity to essential tremor

2018 ◽  
Author(s):  
Shane Lee ◽  
David J Segar ◽  
Wael F Asaad ◽  
Stephanie R Jones
Keyword(s):  
Computational Model ◽  
Movement Disorder ◽  
Essential Tremor ◽  
Treatment Strategies ◽  
Thalamic Reticular Nucleus ◽  
Oscillatory Activity ◽  
Reticular Nucleus ◽  
Biophysical Modeling ◽  
Tremor Frequency ◽  
A Site

AbstractEssential tremor (ET) is the most common movement disorder, in which the primary symptom is a prominent, involuntary 4–10 Hz rhythmic movement. The presence of tremor frequency oscillations (TFOs) in the ventral intermediate nucleus of the thalamus (VIM) is well-established, but it is often assumed that it is driven by cerebellar tremor frequency activity, while the role of intrinsic oscillatory activity in VIM is not clear. An improved understanding of the mechanisms of tremor and non-tremor frequency activity in VIM is critical to the development of improved pharmacological and neuromodulatory therapies. Starting from a canonical model of thalamus, we developed a biophysically-principled computational model of tremor field activity in the VIM, coupled with the thalamic reticular nucleus (TRN). We simulated TFOs in the model generated either by extrinsic tremor-periodic drive or intrinsic VIM-TRN interaction to understand whether these networks exhibited distinct biophysical properties, which may impact the efficacy of pharmacological or stimulation treatment for TFOs. Extrinsic and intrinsic TFOs in the model depended on T-type Ca2+channels in different ways. Each also depended on GABA modulation in a site- and type-specific manner. These results suggested that efficacy of pharmacological manipulations may depend upon the mechanisms generating TFOs in VIM. Simulated non-tremor-related motor activity from cerebellum decreased extrinsic but increased intrinsic TFOs. Our results suggest that both mechanisms may be important to understand the emergence and cessation of TFOs in VIM and lead to experimentally testable predictions on how to modulate tremor frequency activity to improve treatment strategies for ET.Significance StatementEssential Tremor (ET) is a movement disorder in which the primary symptom is a prominent, involuntary, and rhythmic shaking, often of the hands. Electrical activity in many areas of the brain exhibit rhythmicity related to the patient’s tremor. One such area resides in a structure called the thalamus, but it is not fully known what gives rise to tremor-related activity. We created a computational model of this activity, which suggested how to differentiate tremor mechanisms and how these differences may contribute to other impairments in ET. Knowledge of the biophysical mechanisms contributing to tremor can ultimately lead to improvements in treatments to alleviate symptoms of ET.

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