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"essential tremor"

Franziska Hopfner, Dietrich Haubenberger, Wendy R Galpern, Katrina Gwinn, Ashlee Van't Veer, Samantha White, Kailash Bhatia, Charles H Adler, David Eidelberg, William Ondo, Glenn T Stebbins, Caroline M Tanner, Rick C Helmich, Fred A Lenz, Roy V Sillitoe, David Vaillancourt, Jerrold L Vitek, Elan D Louis, Holly A Shill, Matthew P Frosch, Tatiana Foroud, Gregor Kuhlenbäumer, Andrew Singleton, Claudia M Testa, Mark Hallett, Rodger Elble, Günther Deuschl
Essential tremor (ET) is a common cause of significant disability, but its etiologies and pathogenesis are poorly understood. Research has been hampered by the variable definition of ET and by non-standardized research approaches. The National Institute of Neurological Disorders and Stroke (USA) invited experts in ET and related fields to discuss current knowledge, controversies, and gaps in our understanding of ET and to develop recommendations for future research. Discussion focused on phenomenology and phenotypes, therapies and clinical trials, pathophysiology, pathology, and genetics...
October 4, 2016: Parkinsonism & related Disorders
Elisa Bruno, Alessandra Nicoletti, Graziella Quattrocchi, Graziella Filippini, Carlo Colosimo, Mario Zappia
BACKGROUND: Essential tremor is one of the most common movement disorders. Treatment primarily consists of pharmacological agents. While primidone and propranolol are well-established treatments in clinical practice, they may be ineffective in 25% to 55% of patients and can produce serious adverse events in a large percentage of them. For these reasons, it is worth evaluating the treatment alternatives for essential tremor. Some specialists have suggested that pregabalin could be a potentially useful agent, but there is uncertainty about its efficacy and safety...
October 20, 2016: Cochrane Database of Systematic Reviews
Joana Jesus-Ribeiro, António Freire, João Sargento-Freitas, Mário Sousa, Fernando Silva, Fradique Moreira, Maria João Cunha, Uwe Walter, Cristina Januário
BACKGROUND: The diagnosis of Parkinson's disease (PD) can sometimes be a challenge in the early stages of the disease. Both transcranial sonography (TCS) and DaTSCAN are recommended as auxiliary examinations for the differential diagnosis of PD; however, only few data exist regarding their diagnostic accuracy in the early stage of PD and essential tremor (ET). METHODS: We evaluated patients with clinically suspected diagnosis of PD at early stages (Hoehn and Yahr ≤2) or ET...
October 18, 2016: European Neurology
Adam M Nagy, Christopher M Tolleson
Deep brain stimulation (DBS) is a unique, functional neurosurgical therapy indicated for medication refractory movement disorders as well as some psychiatric diseases. Multicontact electrodes are placed in "deep" structures within the brain with targets varying depending on the surgical indication. An implanted programmable pulse generator supplies the electrodes with a chronic, high frequency electrical current that clinically mimics the effects of ablative lesioning techniques. DBS's efficacy has been well established for its movement disorder indications (Parkinson's disease, essential tremor, and dystonia)...
October 8, 2016: Brain Sciences
Vinod K Ravikumar, Allen L Ho, Jonathon J Parker, Elizabeth Erickson-DiRenzo, Casey H Halpern
Tremulous voice is characteristically associated with essential tremor, and is referred to as essential vocal tremor (EVT). Current estimates suggest that up to 40% of individuals diagnosed with essential tremor also present with EVT, which is associated with an impaired quality of life. Traditional EVT treatments have demonstrated limited success in long-term management of symptoms. However, voice tremor has been noted to decrease in patients receiving deep brain stimulation (DBS) with the targeting of thalamic nuclei...
October 10, 2016: Brain Sciences
Adolfo Ramirez-Zamora, Heather Smith, Vignessh Kumar, Julia Prusik, Sujoy Phookan, Julie G Pilitsis
BACKGROUND: Although thalamic deep brain stimulation (DBS) has been established as an effective therapy for refractory tremor in Parkinson's disease and essential tremor, reports investigating the efficacy of posterior subthalamic area (PSA) DBS for severe, debilitating tremors continue to emerge. However, questions regarding the optimal anatomical target, surgical approach, programming paradigms and effectiveness compared to other targets remain. OBJECTIVES: In this report, we aimed to review the current literature to assess different stereotactic techniques, anatomical considerations, adverse effects and stimulation settings in PSA DBS...
October 12, 2016: Stereotactic and Functional Neurosurgery
Sheng-Han Kuo, Jie Wang, William J Tate, Ming-Kai Pan, Geoffrey C Kelly, Jesus Gutierrez, Etty P Cortes, Jean-Paul G Vonsattel, Elan D Louis, Phyllis L Faust
Early onset and late onset essential tremor (ET) cases differ in several respects. Whether they differ with respect to cerebellar pathologic changes remains to be determined. We quantified a broad range of postmortem features (Purkinje cell (PC) counts, PC axonal torpedoes and associated axonal changes, heterotopic PCs, and hairy basket ratings) in 30 ET cases with age of tremor onset <50 years, 30 ET cases with age of tremor onset ≥50 years, and 30 controls (total n = 90). We also used two alternative age of onset cut-points (<40 vs...
October 10, 2016: Cerebellum
S V Vasichkin, O S Levin
AIM: To study gait disorders and postural instability in patients with essential tremor (ET). MATERIAL AND METHODS: Forty patients with ET, aged from 29 to 82 years, (mean 64.2±13.0) were examined. Tandem walk, tremor, stability and stabilometry were studied. RESULTS AND CONCLUSION: A half of the patients had gait disorders and postural instability. Though these disorders were mild to moderate, they caused significant subjective discomfort and influenced quality of life...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Hongwei Wu, Xingjiao Lu, Zhidong Cen, Fei Xie, Xiaosheng Zheng, You Chen, Wei Luo
Recently, Funayama et al. identified CHCHD2 as a novel causative gene of Parkinson disease (PD). However, the relationship between CHCHD2 and essential tremor (ET) patients was still unknown. Genetic analysis of CHCHD2 gene was conducted in 60 probands of ET families with autosomal dominant inheritance and 90 healthy controls in Chinese population. No pathogenic CHCHD2 mutation was found in ET patients. However, we identified one rare variant, c.5C>T, a reported risk variant for sporadic PD in Japanese populations, and examined the frequency of three common variants...
October 4, 2016: Neuroscience Letters
Julián Benito-León, Ángela Domingo-Santos
BACKGROUND: Orthostatic tremor (OT) remains among the most intriguing and poorly understood of movement disorders. Compared to Parkinson's disease or even essential tremor, there are very few articles addressing more basic science issues. In this review, we will discuss the findings of main case series on OT, including data on etiology, pathophysiology, diagnostic approach, treatment strategies, and outcome. METHODS: Data for this review were identified by searching PUBMED (January 1966 to August 2016) for the terms "orthostatic tremor" or "shaky leg syndrome," which yielded 219 entries...
2016: Tremor and Other Hyperkinetic Movements
Richard B Dewey, Padraig E O'Suilleabhain, Manjit Sanghera, Neepa Patel, Pravin Khemani, Laura H Lacritz, Shilpa Chitnis, Louis A Whitworth, Richard B Dewey
OBJECTIVE: To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. METHODS: We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. RESULTS: The result of this quality improvement process was the development of a neuromodulation network...
2016: PloS One
Fabiana C C Hirata, João R Sato, Gilson Vieira, Leandro T Lucato, Claudia C Leite, Edson Bor-Seng-Shu, Bruno F Pastorello, Maria C G Otaduy, Khallil T Chaim, Kenia R Campanholo, Natalia P Novaes, Luciano Magalhães Melo, Márcia R Gonçalves, Felipe Barjud Pereira do Nascimento, Manoel Jacobsen Teixeira, Egberto Reis Barbosa, Edson Amaro, Ellison Fernando Cardoso
OBJECTIVES: Our goal was to estimate the diagnostic accuracy of substantia nigra fractional anisotropy (SN-FA) for Parkinson's disease (PD) diagnosis in a sample similar to the clinical setting, including patients with essential tremor (ET) and healthy controls (HC). We also performed a systematic review and meta-analysis to estimate mean change in SN-FA induced by PD and its diagnostic accuracy. METHODS: Our sample consisted of 135 subjects: 72 PD, 21 ET and 42 HC...
October 5, 2016: European Radiology
Sheng-Han Kuo, Chi-Ying Lin, Jie Wang, Peter A Sims, Ming-Kai Pan, Jyun-You Liou, Danielle Lee, William J Tate, Geoffrey C Kelly, Elan D Louis, Phyllis L Faust
Changes in climbing fiber-Purkinje cell (CF-PC) synaptic connections have been found in the essential tremor (ET) cerebellum, and these changes are correlated with tremor severity. Whether these postmortem changes are specific to ET remains to be investigated. We assessed CF-PC synaptic pathology in the postmortem cerebellum across a range of degenerative movement disorders [10 Parkinson's disease (PD) cases, 10 multiple system atrophy (MSA) cases, 10 spinocerebellar ataxia type 1 (SCA1) cases, and 20 ET cases] and 25 controls...
October 4, 2016: Acta Neuropathologica
Nan-Ying Yu, Arend W A Van Gemmert, Shao-Hsia Chang
No abstract text is available yet for this article.
October 3, 2016: Behavior Research Methods
Maria Salsone, Rita Nistico', Basilio Vescio, Fabiana Novellino, Maurizio Morelli, Angela Lupo, Gennarina Arabia, Aldo Quattrone
OBJECTIVE: To investigate heart rate variability (HRV) in patients with Essential Tremor (ET) in comparison with patients with Parkinson's Disease (PD). METHODS: This is a cross sectional control study including 10 patients with ET, 10 patients with PD and 10 age-sex-matched controls. In patients and controls, we measured the components of HRV analysis in the frequency domain during a daytime period of 12-h. Selected HRV variables were low-frequency (LF) and high-frequency (HF), conventionally considered to be influenced by the sympathetic system and the parasympathetic system respectively...
September 28, 2016: Parkinsonism & related Disorders
Michael T Barbe, Jeremy Franklin, Daria Kraus, Paul Reker, Till A Dembek, Niels Allert, Jochen Wirths, Jürgen Voges, Lars Timmermann, Veerle Visser-Vandewalle
BACKGROUND: Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus is effective in medication refractory essential tremor (ET). In recent years, evidence has accumulated that the region ventral to the VIM, the posterior subthalamic area (PSA), might be an equally or even more effective target for electrode implantation. However, this evidence is primarily based on case series, cross-sectional observations, and retrospective data. METHODS/DESIGN: A prospective crossover pilot study investigating the effects of PSA stimulation in medication refractory ET patients was designed...
September 29, 2016: Trials
Jordan Vielotte
OBJECTIVE: Hypermetric tremors, i.e. of cerebellar origin (essential tremor, cerebellar stroke or tumor, multiple sclerosis, hereditary spinocerebellar ataxias), directly relate to iterative hypermetria by delayed antagonist correction at each movement and cause significant functional and social difficulties. Botulinum toxin injections (BoNT) can reduce the amplitude of any tremor, but at the expense of muscle weakening when the injection is performed on both agonists and antagonists contributing to tremor...
September 2016: Annals of Physical and Rehabilitation Medicine
Martin M Reich, Joachim Brumberg, Nicolò G Pozzi, Giorgio Marotta, Jonas Roothans, Mattias Åström, Thomas Musacchio, Leonardo Lopiano, Michele Lanotte, Ralph Lehrke, Andreas K Buck, Jens Volkmann, Ioannis U Isaias
Thalamic deep brain stimulation is a mainstay treatment for severe and drug-refractory essential tremor, but postoperative management may be complicated in some patients by a progressive cerebellar syndrome including gait ataxia, dysmetria, worsening of intention tremor and dysarthria. Typically, this syndrome manifests several months after an initially effective therapy and necessitates frequent adjustments in stimulation parameters. There is an ongoing debate as to whether progressive ataxia reflects a delayed therapeutic failure due to disease progression or an adverse effect related to repeated increases of stimulation intensity...
September 21, 2016: Brain: a Journal of Neurology
Alexandre Gironell, Juan Marin-Lahoz
BACKGROUND: T-type calcium channel activation has been postulated to underlie rhythmicity in the olivo-cerebellar system that is implicated in ET. Ethosuximide reduces T-type calcium currents and can suppress tremor in two animal models of ET. We explored the effects of ethosuximide in subjects with ET in an open-label trial using both clinical scales and accelerometric recordings measures. We initially planned to conduct the trial with 15 patients, but due to lack of efficacy and a high incidence of adverse effects, the trial was stopped after seven patients had participated...
2016: Tremor and Other Hyperkinetic Movements
Jie Wang, Geoffrey C Kelly, William J Tate, Yong-Shi Li, Michelle Lee, Jesus Gutierrez, Elan D Louis, Phyllis L Faust, Sheng-Han Kuo
BACKGROUND: Genome-wide association studies have revealed a link between essential tremor (ET) and the gene SLC1A2, which encodes excitatory amino acid transporter type 2 (EAAT2). We explored EAAT biology in ET by quantifying EAAT2 and EAAT1 levels in the cerebellar dentate nucleus, and expanded our prior analysis of EAAT2 levels in the cerebellar cortex. OBJECTIVE: To quantify EAAT2 and EAAT1 levels in the cerebellar dentate nucleus and cerebellar cortex of ET cases vs...
September 6, 2016: Parkinsonism & related Disorders
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