WorldWideScience

Sample records for head tremor part

  1. Tremor

    Science.gov (United States)

    Tremors are unintentional trembling or shaking movements in one or more parts of your body. Most tremors occur in the hands. You can also have arm, head, face, vocal cord, trunk, and leg tremors. Tremors are most common in middle-aged and ...

  2. Intention tremor after head injury

    International Nuclear Information System (INIS)

    Iwadate, Yasuo; Saeki, Naokatsu; Namba, Hiroki; Odaki, Masaru; Oka, Nobuo.

    1989-01-01

    Eight cases of intention tremor as a late complication of head injury were investigated. The patients ranged in age from 3 to 24 years. All received severe head injuries and lapsed into coma immediately afterward (Glasgow Coma Scale scores ≤8). Six patients exhibited decerebration or decortication. Hemiparesis was present in six cases and oculomotor nerve palsy in four. In the chronic stage, all patients displayed some degree of impairment of higher cortical function and five had dysarthria and/or ataxia. Initial computed tomography (CT) scans within 3 hours after the injury were obtained in five cases, of which four showed a hemorrhagic lesion in the midbrain or its surroundings. Other CT findings were diffuse cerebral swelling (four cases), intraventricular hemorrhage (three), and multiple hemorrhagic lesions (two). In the chronic stage, generalized cortical atrophy or ventricular enlargement was noted in five cases. These clinical features and CT findings indicate diffuse brain damage as well as midbrain damage and may reflect shearing injury. (author)

  3. Defining Dystonic Tremor

    OpenAIRE

    Elble, Rodger J

    2013-01-01

    A strong association between dystonia and tremor has been known for more than a century. Two forms of tremor in dystonia are currently recognized: 1) dystonic tremor, which is tremor produced by dystonic muscle contraction and 2) tremor associated with dystonia, which is tremor in a body part that is not dystonic, but there is dystonia elsewhere. Both forms of tremor in dystonia frequently resemble essential tremor or another pure tremor syndrome (e.g., isolated head and voice tremors and tas...

  4. Tremor in dystonia.

    Science.gov (United States)

    Pandey, Sanjay; Sarma, Neelav

    2016-08-01

    Tremor has been recognized as an important clinical feature in dystonia. Tremor in dystonia may occur in the body part affected by dystonia known as dystonic tremor or unaffected body regions known as tremor associated with dystonia. The most common type of tremor seen in dystonia patients is postural and kinetic which may be mistaken for familial essential tremor. Similarly familial essential tremor patients may have associated dystonia leading to diagnostic uncertainties. The pathogenesis of tremor in dystonia remains speculative, but its neurophysiological features are similar to dystonia which helps in differentiating it from essential tremor patients. Treatment of tremor in dystonia depends upon the site of involvement. Dystonic hand tremor is treated with oral pharmacological therapy and dystonic head, jaw and voice tremor is treated with injection botulinum toxin. Neurosurgical interventions such as deep brain stimulation and lesion surgery should be an option in patients not responding to the pharmacological treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Approach to a tremor patient

    Science.gov (United States)

    Sharma, Soumya; Pandey, Sanjay

    2016-01-01

    Tremors are commonly encountered in clinical practice and are the most common movement disorders seen. It is defined as a rhythmic, involuntary oscillatory movement of a body part around one or more joints. In the majority of the population, tremor tends to be mild. They have varying etiology; hence, classifying them appropriately helps in identifying the underlying cause. Clinically, tremor is classified as occurring at rest or action. They can also be classified based on their frequency, amplitude, and body part involved. Parkinsonian tremor is the most common cause of rest tremor. Essential tremor (ET) and enhanced physiological tremor are the most common causes of action tremor. Isolated head tremor is more likely to be dystonic rather than ET. Isolated voice tremor could be considered to be a spectrum of ET. Psychogenic tremor is not a diagnosis of exclusion; rather, demonstration of various clinical signs is needed to establish the diagnosis. Severity of tremor and response to treatment can be assessed using clinical rating scales as well as using electrophysiological measurements. The treatment of tremor is symptomatic. Medications are effective in half the cases of essential hand tremor and in refractory patients; deep brain stimulation is an alternative therapy. Midline tremors benefit from botulinum toxin injections. It is also the treatment of choice in dystonic tremor and primary writing tremor. PMID:27994349

  6. Tremor: Tremor:

    OpenAIRE

    Georgiev, Dejan; Kragelj, Veronika; Pirtošek, Zvezdan; Ribarič, Samo

    2012-01-01

    Tremor is one of the most common disorders in the population of patients diagnosed with movement disorders. In the literature we find several classifications and different types of tremors. Each tremor type has its own characteristics. The most frequently used and widely accepted tremor classification divides tremors according to clinical appearance. First, they are roughly divided into resting tremor and action tremor. Action tremor is then subdivided into postural, kinetic, intention, task ...

  7. Tremor

    Science.gov (United States)

    ... and down or closing and opening the eyes. Intention tremor is produced with purposeful movement toward a ... by any movement such as holding a heavy book or a dumbbell in the same position. top ...

  8. Dystonia and Tremor: The Clinical Syndromes with Isolated Tremor

    Directory of Open Access Journals (Sweden)

    Alberto Albanese

    2016-04-01

    Full Text Available Background: Dystonia and tremor share many commonalities. Isolated tremor is part of the phenomenological spectrum of isolated dystonia and of essential tremor. The occurrence of subtle features of dystonia may allow one to differentiate dystonic tremor from essential tremor. Diagnostic uncertainty is enhanced when no features of dystonia are found in patients with a tremor syndrome, raising the question whether the observed phenomenology is an incomplete form of dystonia. Methods: Known forms of syndromes with isolated tremor are reviewed. Diagnostic uncertainties between tremor and dystonia are put into perspective. Results: The following isolated tremor syndromes are reviewed: essential tremor, head tremor, voice tremor, jaw tremor, and upper-limb tremor. Their varied phenomenology is analyzed and appraised in the light of a possible relationship with dystonia. Discussion: Clinicians making a diagnosis of isolated tremor should remain vigilant for the detection of features of dystonia. This is in keeping with the recent view that isolated tremor may be an incomplete phenomenology of dystonia.

  9. Dystonia and Tremor: The Clinical Syndromes with Isolated Tremor

    Science.gov (United States)

    Albanese, Alberto; Sorbo, Francesca Del

    2016-01-01

    Background Dystonia and tremor share many commonalities. Isolated tremor is part of the phenomenological spectrum of isolated dystonia and of essential tremor. The occurrence of subtle features of dystonia may allow one to differentiate dystonic tremor from essential tremor. Diagnostic uncertainty is enhanced when no features of dystonia are found in patients with a tremor syndrome, raising the question whether the observed phenomenology is an incomplete form of dystonia. Methods Known forms of syndromes with isolated tremor are reviewed. Diagnostic uncertainties between tremor and dystonia are put into perspective. Results The following isolated tremor syndromes are reviewed: essential tremor, head tremor, voice tremor, jaw tremor, and upper-limb tremor. Their varied phenomenology is analyzed and appraised in the light of a possible relationship with dystonia. Discussion Clinicians making a diagnosis of isolated tremor should remain vigilant for the detection of features of dystonia. This is in keeping with the recent view that isolated tremor may be an incomplete phenomenology of dystonia. PMID:27152246

  10. Tremor

    Science.gov (United States)

    ... clothes with Velcro fasteners or using button hooks Cooking or eating with utensils that have a larger handle Using a sippy cup to drink Wearing slip-on shoes and using shoehorns When to Contact a Medical Professional Call your provider if your tremor: Is worse ...

  11. Effect of propranolol in head tremor: quantitative study following single-dose and sustained drug administration.

    Science.gov (United States)

    Calzetti, S; Sasso, E; Negrotti, A; Baratti, M; Fava, R

    1992-12-01

    The effect of the beta-adrenoceptor antagonist propranolol has been investigated in nine patients suffering from isolated (six patients) or prominent (three patients) essential tremor of the head. In a double-blind, placebo-controlled study the tremorolytic efficacy of propranolol has been assessed by a quantitative accelerometric method after a single oral dose (120 mg) and following 2 weeks of sustained treatment with two different dosage regimens of the drug (120 and 240 mg daily). As compared with placebo, a significant reduction in tremor magnitude was found following a single oral dose but not on sustained administration of the beta-blocker at either dosage. The results suggest that the efficacy of sustained propranolol on isolated or prominent essential head tremor is less predictable and satisfactory than expected on the basis of the single-dose response, as compared with hand tremor.

  12. Rest tremor in idiopathic adult-onset dystonia.

    Science.gov (United States)

    Gigante, A F; Berardelli, A; Defazio, G

    2016-05-01

    Tremor in dystonia has been described as a postural or kinetic abnormality. In recent series, however, patients with idiopathic adult-onset dystonia also displayed rest tremor. The frequency and distribution of rest tremor were studied in a cohort of 173 consecutive Italian patients affected by various forms of idiopathic adult-onset dystonia attending our movement disorder clinic over 8 months. Examination revealed tremor in 59/173 patients (34%): 12 patients had head tremor, 34 patients had arm tremor, whilst 13 patients presented tremor in both sites. Head tremor was postural in all patients, whereas arm tremor was postural/kinetic in 28 patients, only at rest in one and both postural/kinetic and at rest in 18 patients. Patients with tremor were more likely to have segmental/multifocal dystonia. Patients who had rest tremor (either alone or associated with action tremor) had a higher age at dystonia onset and a greater frequency of dystonic arm involvement than patients with action tremor alone or without tremor. Both action and rest tremor are part of the tremor spectrum of adult-onset dystonia and are more frequently encountered in segmental/multifocal dystonia. The higher age at dystonia onset and the greater frequency of arm dystonia in patients with rest tremor may have pathophysiological implications and may account, at least in part, for the previous lack of identification of rest tremor as one possible type of tremor present in dystonia. © 2016 EAN.

  13. The course of cervical dystonia with head tremor during botulinum toxin type A treatment

    Directory of Open Access Journals (Sweden)

    A. N. Korenko

    2017-01-01

    Full Text Available Objective: to evaluate the efficacy and safety of botulinum toxin type A (BTA injections into the neck muscles to reduce dystonic postures, head tremor, and pain syndrome in patients with cervical dystonia (CD within the first 8 cycles of treatment.Patients and methods. The investigation included 76 patients (26 (34% men and 50 (66% women with CD and dystonic head tremor, who were given BTA injections into the neck muscles for the first time. All the 76 patients received at least one cycle of BTA therapy. At the same type, 18 of these patients received 4 cycles of injections and 36 patients had 8 cycles. Injections were given when the symptoms of CD recurred or increased and the patient needed to be retreated. The interval between the injection cycles was arbitrary, but not less than 12 weeks. The doses of BTA agents per treatment cycle were as follows: Dysport was 400 to 1000 U, xeomin was 50 to 300 U, and Botox 200 to 300 U. The symptoms of CD were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS and the Tsui scale before the first injection of BTA and injection cycles 4 and 8; the presence or absence of head tremor was recorded.Results. The TWSTRS severity of CD symptoms decreased from 38 [36; 41] to 30 [27; 33] scores by injection cycle 4 (p < 0.001 and to 26 [23; 27] scores by cycle 8 (p<0.01. The Tsui severity of CD reduced from 9.3 [9; 10] to 7.2 [7; 8] scores by injection cycle 4 (p<0.001 and to 6.7 [6; 7] scores by cycle 8. The Tsui tremor scores decreased from 1.9 [1.6; 2.1] to 1.4 [1.1; 1.6] scores by injection cycle 4 and to 1.1 [0.9;1.4] scores by cycle 8 (p<0.01. Tremor completely disappeared in 6 (11% of patients by injection cycle 4 and in 6 (18% patients by cycle 8. According to Section 3 of the TWSTRS, pain intensity was reduced from 9.9 [8.9; 11.0] to 5.0 [3.3; 6.6] scores by injection cycle 4 (p<0.001 and to 2.1 [0.7; 3.6] scores by cycle 8 (p < 0.01; pain regressed completely in 12 (41

  14. Features of treatment of cervical dystonia associated with head tremor with botulinum toxin type A drugs under electro myographic control

    Directory of Open Access Journals (Sweden)

    A. N. Korenko

    2016-01-01

    Full Text Available The study was aimed to evaluate the efficacy and safety of injections of botulinum toxin typeA (BTA in the neck muscles under electromyographic control and without it to reduce head tremor, muscle tone and dystonic postures, as well as pain in patients with cervical dystonia (CD. 49 patients with CD and dystonic head tremor who received injections of BTA were examined. 33 (67 % patients received Dysport in an average dose of 695 (627; 762 units, 15 (31 % patients received Xeomin in an average dose of 262 (227; 297 units and 1 (2 % patient received 300 units of Botox. 16 (33 % patients received injections under EMGcontrol. The level of symptoms of CD and tremor before and 4 weeks after the treatment were measured by the TWSTRS and Tsui scales. Evaluation of the treatment efficacy was carried out using the patientreported Clinical Global Improvement (CGI scale, and the presence or absence of head tremor after injection was also recorded. The TWSTRS score decreased from 39 (36, 42 to 24 (21, 26, the TZUI score decreased from 9.8 (9, 10 to 4.9 (4, 6 in 4 weeks after injection (p <0.001. The level of tremor measured by Tsui scale decreased from 2.1 (1.7, 2.4 and 0.7 points (0,5; 0,9 (p <0.001. In 24 (49 % cases, complete disappearance of tremor was noted in 4 weeks after injection. Complete regression of tremor was observed significantly more frequently in patients with torticollis who received injections with EMG-control in 10(71 % cases vs. 8(32 % without it (p <0.05. 28(57 % patients noted moderate or significant improvement on the CGI scale. Pain decreased from 5.4 (3.9, 6.9 points to 2.4 (1.3, 3.6 (p <0.001 according to section 3 of TWSTRS scale, pain completely regressed in 15 (52 % patients. BTA injections are highly effective and safe treatment of CD symptoms such as dystonic posture, pain and dystonic tremor. BTA injections in the neck muscles under EMGcontrol can improve outcome in patients with torticollis associated with

  15. Functional tremor.

    Science.gov (United States)

    Schwingenschuh, P; Deuschl, G

    2016-01-01

    Functional tremor is the commonest reported functional movement disorder. A confident clinical diagnosis of functional tremor is often possible based on the following "positive" criteria: a sudden tremor onset, unusual disease course, often with fluctuations or remissions, distractibility of the tremor if attention is removed from the affected body part, tremor entrainment, tremor variability, and a coactivation sign. Many patients show excessive exhaustion during examination. Other somatizations may be revealed in the medical history and patients may show additional functional neurologic symptoms and signs. In cases where the clinical diagnosis remains challenging, providing a "laboratory-supported" level of certainty aids an early positive diagnosis. In rare cases, in which the distinction from Parkinson's disease is difficult, dopamine transporter single-photon emission computed tomography (DAT-SPECT) can be indicated. © 2016 Elsevier B.V. All rights reserved.

  16. Head and Arm Tremor in X-linked Spinal and Bulbar Muscular Atrophy

    Directory of Open Access Journals (Sweden)

    Irene Aicua

    2014-10-01

    Full Text Available Background: X‐linked spinal and bulbar muscular atrophy (SBMA is a rare adult‐onset neuronopathy. Although tremor is known to occur in this disease, the number of reported cases of SBMA with tremor is rare, and the number with videotaped documentation is exceedingly rare. Our aim was to describe/document the characteristic signs of tremor in spinal and bulbar muscular atrophy.Case Report: We report a case of a 58‐year‐old male with a positive family history of tremor. On examination, the patient had jaw and hand tremors but he also exhibited gynecomastia, progressive bulbar paresis, and wasting and weakness primarily in the proximal limb muscles. The laboratory tests revealed an elevated creatine phosphokinase. Genetic testing was positive for X‐SBMA, with 42 CAG repeats.Discussion: Essential tremor is one of the most common movement disorders, yet it is important for clinicians to be aware of the presence of other distinguishing features that point to alternative diagnoses. The presence of action tremor associated with muscle atrophy and gynecomastia should lead to a suspicion of SBMA.

  17. Dystonia and Tremor: The Clinical Syndromes with Isolated Tremor

    OpenAIRE

    Albanese, Alberto; Sorbo, Francesca Del

    2016-01-01

    Background: Dystonia and tremor share many commonalities. Isolated tremor is part of the phenomenological spectrum of isolated dystonia and of essential tremor. The occurrence of subtle features of dystonia may allow one to differentiate dystonic tremor from essential tremor. Diagnostic uncertainty is enhanced when no features of dystonia are found in patients with a tremor syndrome, raising the question whether the observed phenomenology is an incomplete form of dystonia. Methods: Known form...

  18. Clinical phenotype and genetic mutation of one case with head tremor and cerebellar atrophy

    Directory of Open Access Journals (Sweden)

    Kun-ming XIE

    2017-07-01

    Full Text Available Objective To make the diagnosis for a patient presented with head tremor and cerebellar atrophy by integrating clinical features and accessory examination with genetic testing and to explore the interpretation of genetic testing results.  Methods A 30-year-old male patient's medical information, clinical pheontype, family history and accessory examinations were collected. The next?generation sequencing (NGS of exons in 3994 causative genes of Mendelian inheritance diseases and the family tree verification were carried out. China Human Phenotype Ontology (CHPO, Phenomizer, Ensembl and Online Mendelian Inheritance in Man (OMIM database were used to interpret the genetic test results.  Results The patient carried heterozygous mutation of spinocerebellar ataxia type 19 (SCA19 related KCND3 gene c.1057A > G (p. Ser353Gly, but his parents did not carry this mutation. The patient also carried heterozygous mutation of parkinsonism type 20 (PARK20 related SYNJ1 gene c.4436C > T (p.Thr1479Ile which was also seen in his mother. Phenotypic similarity analysis showed the patient's phenotype was correspond with the phenotype of SCA19, and the variation locus of KCND3 gene c.1057A > G was highly conservative with homologous gene in different species.  Conclusions By means of the integration of clinical phenotype with the result of genetic test, KCND3 gene c.1057A > G (p.Ser353Gly carried in the patient is the pathogenic mutation. DOI: 10.3969/j.issn.1672-6731.2017.07.007

  19. Superselective Thalamotomy in the Most Lateral Part of the Ventralis Intermedius Nucleus for Controlling Essential and Parkinsonian Tremor.

    Science.gov (United States)

    Hirato, Masafumi; Miyagishima, Takaaki; Takahashi, Akio; Yoshimoto, Yuhei

    2018-01-01

    The minimum and essential thalamic areas for reducing tremor were investigated in cases treated by superselective thalamotomy in the most lateral part of the ventralis intermedius nucleus (mlp-VIM). Stereotactic superselective VIM thalamotomy with depth microrecording was performed in 21 patients with essential tremor (ET) and 15 patients with tremor-dominant Parkinson disease (PD). A very small and narrow (axial plane) therapeutic lesion was formed as a square on the sagittal plane and inverse V on the axial plane in the mlp-VIM, which covered the kinesthetic response area topographically related to tremor. Patients with ET were followed up for 4.7 ± 3.0 years and patients with PD for 7.9 ± 3.9 years. Almost complete tremor control was achieved in all patients immediately after surgery and continued for up to 8 years. A few adverse events were recognized but disappeared within 1 month without 1 patient with thalamic hemorrhage. The medial border of the therapeutic lesion was significantly more lateral in both patients with ET and patients with PD than the calculated standard target point and was in patients with PD than in patients with ET. The mean width was only about 2.4 mm. The individual differences of the adequate location of the therapeutic lesion were significantly greater in the ET than in the PD group. The important area for reducing tremor was small and narrow and was located in the mlp-VIM, where the proprioceptive ascending signals from the tremor-dominant body part are conducted. Superselective thalamotomy in the mlp-VIM was safe and effective for the long-term in patients with ET and PD. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Tremor entities and their classification: an update.

    Science.gov (United States)

    Gövert, Felix; Deuschl, Günther

    2015-08-01

    This review focuses on important new findings in the field of tremor and illustrates the consequences for the current definition and classification of tremor. Since 1998 when the consensus criteria for tremor were proposed, new variants of tremors and new diagnostic methods were discovered that have changed particularly the concepts of essential tremor and dystonic tremor. Accumulating evidence exists that essential tremor is not a single entity rather different conditions that share the common symptom action tremor without other major abnormalities. Tremor is a common feature in patients with adult-onset focal dystonia and may involve several different body parts and forms of tremor. Recent advances, in particular, in the field of genetics, suggest that dystonic tremor may even be present without overt dystonia. Monosymptomatic asymmetric rest and postural tremor has been further delineated, and apart from tremor-dominant Parkinson's disease, there are several rare conditions including rest and action tremor with normal dopamine transporter imaging (scans without evidence of dopaminergic deficit) and essential tremor with tremor at rest. Increasing knowledge in the last decades changed the view on tremors and highlights several caveats in the current tremor classification. Given the ambiguous assignment between tremor phenomenology and tremor etiology, a more cautious definition of tremors on the basis of clinical assessment data is needed.

  1. Essential Tremor

    Science.gov (United States)

    ... Treatment There is no definitive cure for essential tremor. Symptomatic drug therapy may include propranolol or other beta blockers and primidone, an anticonvulsant drug. Eliminating tremor "triggers" ...

  2. Volcanic tremor masks its seismogenic source: Results from a study of noneruptive tremor recorded at Mount St. Helens, Washington

    Science.gov (United States)

    Denlinger, Roger P.; Moran, Seth C.

    2014-01-01

    On 2 October 2004, a significant noneruptive tremor episode occurred during the buildup to the 2004–2008 eruption of Mount St. Helens (Washington). This episode was remarkable both because no explosion followed, and because seismicity abruptly stopped following the episode. This sequence motivated us to consider a model for volcanic tremor that does not involve energetic gas release from magma but does involve movement of conduit magma through extension on its way toward the surface. We found that the tremor signal was composed entirely of Love and Rayleigh waves and that its spectral bandwidth increased and decreased with signal amplitude, with broader bandwidth signals containing both higher and lower frequencies. Our modeling results demonstrate that the forces giving rise to this tremor were largely normal to conduit walls, generating hybrid head waves along conduit walls that are coupled to internally reflected waves. Together these form a crucial part of conduit resonance, giving tremor wavefields that are largely a function of waveguide geometry and velocity. We find that the mechanism of tremor generation fundamentally masks the nature of the seismogenic source giving rise to resonance. Thus multiple models can be invoked to explain volcanic tremor, requiring that information from other sources (such as visual observations, geodesy, geology, and gas geochemistry) be used to constrain source models. With concurrent GPS and field data supporting rapid rise of magma, we infer that tremor resulted from drag of nearly solid magma along rough conduit walls as magma was forced toward the surface.

  3. Essential tremor

    Science.gov (United States)

    ... such as: Smoking and smokeless tobacco Overactive thyroid ( hyperthyroidism ) Suddenly stopping alcohol after drinking a lot for ... from the medicines used to treat your tremor Prevention Alcoholic beverages in small quantities may decrease tremors. ...

  4. Diagnosis and Treatment of Common Forms of Tremor

    Science.gov (United States)

    Puschmann, Andreas; Wszolek, Zbigniew K.

    2014-01-01

    Tremor is the most common movement disorder presenting to an outpatient neurology practice and is defined as a rhythmical, involuntary oscillatory movement of a body part. The authors review the clinical examination, classification, and diagnosis of tremor. The pathophysiology of the more common forms of tremor is outlined, and treatment options are discussed. Essential tremor is characterized primarily by postural and action tremors, may be a neurodegenerative disorder with pathologic changes in the cerebellum, and can be treated with a wide range of pharmacologic and nonpharmacologic methods. Tremor at rest is typical for Parkinson’s disease, but may arise independently of a dopaminergic deficit. Enhanced physiologic tremor, intention tremor, and dystonic tremor are discussed. Further differential diagnoses described in this review include drug- or toxin-induced tremor, neuropathic tremor, psychogenic tremor, orthostatic tremor, palatal tremor, tremor in Wilson’s disease, and tremor secondary to cerebral lesions, such as Holmes’ tremor (midbrain tremor). An individualized approach to treatment of tremor patients is important, taking into account the degree of disability, including social embarrassment, which the tremor causes in the patient’s life. PMID:21321834

  5. Essential Tremor Is More Than a Tremor

    Science.gov (United States)

    ... Giving Options Donate Prev Next IETF > About Essential Tremor > Video Video Click to share on Facebook (Opens ... Click to print (Opens in new window) Essential Tremor is More Than a Tremor Providing a voice ...

  6. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available ... Giving Options Donate Prev Next IETF > About Essential Tremor > Video Video Click to share on Facebook (Opens ... Click to print (Opens in new window) Essential Tremor is More Than a Tremor Providing a voice ...

  7. Neural computational modeling reveals a major role of corticospinal gating of central oscillations in the generation of essential tremor

    Directory of Open Access Journals (Sweden)

    Hong-en Qu

    2017-01-01

    Full Text Available Essential tremor, also referred to as familial tremor, is an autosomal dominant genetic disease and the most common movement disorder. It typically involves a postural and motor tremor of the hands, head or other part of the body. Essential tremor is driven by a central oscillation signal in the brain. However, the corticospinal mechanisms involved in the generation of essential tremor are unclear. Therefore, in this study, we used a neural computational model that includes both monosynaptic and multisynaptic corticospinal pathways interacting with a propriospinal neuronal network. A virtual arm model is driven by the central oscillation signal to simulate tremor activity behavior. Cortical descending commands are classified as alpha or gamma through monosynaptic or multisynaptic corticospinal pathways, which converge respectively on alpha or gamma motoneurons in the spinal cord. Several scenarios are evaluated based on the central oscillation signal passing down to the spinal motoneurons via each descending pathway. The simulated behaviors are compared with clinical essential tremor characteristics to identify the corticospinal pathways responsible for transmitting the central oscillation signal. A propriospinal neuron with strong cortical inhibition performs a gating function in the generation of essential tremor. Our results indicate that the propriospinal neuronal network is essential for relaying the central oscillation signal and the production of essential tremor.

  8. Neural computational modeling reveals a major role of corticospinal gating of central oscillations in the generation of essential tremor.

    Science.gov (United States)

    Qu, Hong-En; Niu, Chuanxin M; Li, Si; Hao, Man-Zhao; Hu, Zi-Xiang; Xie, Qing; Lan, Ning

    2017-12-01

    Essential tremor, also referred to as familial tremor, is an autosomal dominant genetic disease and the most common movement disorder. It typically involves a postural and motor tremor of the hands, head or other part of the body. Essential tremor is driven by a central oscillation signal in the brain. However, the corticospinal mechanisms involved in the generation of essential tremor are unclear. Therefore, in this study, we used a neural computational model that includes both monosynaptic and multisynaptic corticospinal pathways interacting with a propriospinal neuronal network. A virtual arm model is driven by the central oscillation signal to simulate tremor activity behavior. Cortical descending commands are classified as alpha or gamma through monosynaptic or multisynaptic corticospinal pathways, which converge respectively on alpha or gamma motoneurons in the spinal cord. Several scenarios are evaluated based on the central oscillation signal passing down to the spinal motoneurons via each descending pathway. The simulated behaviors are compared with clinical essential tremor characteristics to identify the corticospinal pathways responsible for transmitting the central oscillation signal. A propriospinal neuron with strong cortical inhibition performs a gating function in the generation of essential tremor. Our results indicate that the propriospinal neuronal network is essential for relaying the central oscillation signal and the production of essential tremor.

  9. Tremor in neurodegenerative ataxias, Huntington disease and tic disorder.

    Science.gov (United States)

    Rudzińska, M; Krawczyk, M; Wójcik-Pędziwiatr, M; Szczudlik, A; Tomaszewski, T

    2013-01-01

    Tremor is the most prevalent movement disorder, defined as rhythmic oscillations of a body part, caused by alternating or synchronic contractions of agonistic or antagonistic muscles. The aim of the study was to assess prevalence and to characterize parameters of tremor accompanying de-generative ataxias, Huntington disease (HD) and tic disorders in comparison with a control group. Forty-three patients with degenerative ataxias, 28 with HD and 26 with tic disorders together with 51 healthy controls were included in the study. For each participant, clinical and instrumental assessment (accelerometer, electromyography [EMG], graphic tablet) of hand tremor was performed. Frequency and severity of tremor were assessed in three positions: at rest (rest tremor), with hands extended (postural tremor), during the 'finger-to-nose' test and during Archimedes spiral drawing (kinetic tremor). Based on the mass load test, the type of tremor was determined as essential tremor type or enhanced physiological tremor type. The incidence of tremor in the accelerometry in patients with degenerative ataxia (50%) significantly differs from controls (10%) (p = 0.001). The dominant tremor was postural, low-intense, with 7-Hz frequency, essential tremor (23%) or other tremor type (23%), while enhanced physiological tremor was the least frequent (2%). Tremor in patients with HD and tic disorders was found in 10% and 20% of patients, respectively, similarly to the control group. Tremor was mild, postural and of essential tremor type, less frequently of enhanced physiological tremor type. No correlation between severity of tremor and severity of disease was found. The prevalence of tremor is considerably higher among patients with degenerative ataxias compared with HD, tic disorder and the control group. The most common type of tremor accompanying ataxias, HD and tic disorders is essential tremor type.

  10. Thalamic Deep Brain Stimulation for Essential Tremor Also Reduces Voice Tremor.

    Science.gov (United States)

    Kundu, Bornali; Schrock, Lauren; Davis, Tyler; House, Paul A

    2017-12-12

    Voice tremor is a common feature of essential tremor (ET) that is difficult to treat medically and significantly affects quality of life. Deep brain stimulation (DBS) of the ventral intermediate nucleus (Vim) of the thalamus is effective in improving contralateral distal limb tremor and has been shown in limited studies to affect voice tremor. Our objective was to retrospectively evaluate whether Vim-DBS used to treat patients with essential motor tremor also effectively treated underlying concurrent voice tremor and assess whether particular lead locations were favorable for treating vocal tremor. In this retrospective cohort study, patients had unilateral or bilateral lead placement and were monitored for up to 12 months. We used the Fahn-Tolosa-Marin (FTM) subscore to assess vocal tremor. Changes in vocal tremor before and after stimulation and over several sessions were assessed. Of the 77 patients who met the inclusion criteria and were treated for essential tremor, 20 (26%) patients had vocal tremor prior to stimulation. Active Vim-DBS decreased the amplitude of voice tremor by 80% (p centroid of stimulation showed that Vim thalamic stimulation that is more anterior on average yielded better voice tremor control, significantly so on the left side (p < 0.05). Additionally, there was improvement in head, tongue, and face tremor scores (p < 0.05). Unilateral and bilateral Vim-DBS targeted to treat the motor component of essential tremor also dramatically decreased the amplitude of voice tremor in this group of patients, suggesting a potential benefit of this treatment for affected patients. © 2017 International Neuromodulation Society.

  11. Medical and surgical treatment of tremors.

    Science.gov (United States)

    Schneider, Susanne A; Deuschl, Günther

    2015-02-01

    Tremor is a hyperkinetic movement disorder characterized by rhythmic oscillations of one or more body parts. Disease severity ranges from mild to severe with various degrees of impact on quality of life. Essential tremor and parkinsonian tremor are the most common etiologic subtypes. Treatment may be challenging; although several drugs are available, response may be unsatisfactory. For some tremor forms, controlled data are scarce or completely missing and treatment is often based on anecdotal evidence. In this article, we review the current literature on tremor treatment, with a focus on common forms. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Unusual Forehead Tremor in Four Patients with Essential Tremor

    OpenAIRE

    Gascón-Bayarri, Jordi; Campdelacreu, Jaume; Calopa, Màtil; Jaumà, Serge; Bau, Laura; Povedano, Mònica; Montero, Jordi

    2012-01-01

    Forehead tremor has only been reported in two patients with essential tremor, one with rhythmic tremor and the other with dystonic tremor. We report 4 new patients with essential tremor who present a 4–6 Hz frontal tremor registered by electromyography and unusual features like frontal tremor preceding limb tremor or unilateral involvement. Frontal tremor is present in some patients with essential tremor, sometimes preceding limb tremor. Treatment with botulinum toxin may be useful.

  13. Unusual Forehead Tremor in Four Patients with Essential Tremor

    Directory of Open Access Journals (Sweden)

    Jordi Gascón-Bayarri

    2012-01-01

    Full Text Available Forehead tremor has only been reported in two patients with essential tremor, one with rhythmic tremor and the other with dystonic tremor. We report 4 new patients with essential tremor who present a 4–6 Hz frontal tremor registered by electromyography and unusual features like frontal tremor preceding limb tremor or unilateral involvement. Frontal tremor is present in some patients with essential tremor, sometimes preceding limb tremor. Treatment with botulinum toxin may be useful.

  14. Tectonic tremor

    Science.gov (United States)

    Shelly, David R.

    2016-01-01

    Tectonic, non-volcanic tremor is a weak vibration of ground, which cannot be felt by humans but can be detected by sensitive seismometers. It is defined empirically as a low-amplitude, extended duration seismic signal associated with the deep portion (∼20–40 km depth) of some major faults. It is typically observed most clearly in the frequency range of 2–8 Hz and is depleted in energy at higher frequencies relative to regular earthquakes.

  15. UK semiconductor tracker parts head for CERN

    CERN Multimedia

    Holland, Colin

    2005-01-01

    The last of the 4 barrels that make up the central part of the Semiconductor Tracker (SCT), the heart of the biggest physics collaboration in the world have left Oxford for its new home at the European Particle Physics Laboratory, CERN, near Geneva

  16. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available Home About the IETF Volunteer For Healthcare Providers Giving Options Donate Prev Next IETF > About Essential Tremor > ... Mild Hereditary Tremor No Big Deal Raving Fan Home About the IETF Volunteer For Healthcare Providers Giving ...

  17. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available ... More Than a Tremor Providing a voice for people with essential tremor means also reaching out to ... six-minute video tells the stories of six people living with ET. It goes beyond diagnosis and ...

  18. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available Home About the IETF Volunteer For Healthcare Providers Giving Options Donate Prev Next IETF > About Essential Tremor > ... for Grants Relevant to Essential Tremor IETF Champion Home About the IETF Volunteer For Healthcare Providers Giving ...

  19. Unusual Wrist Tremor: Unilateral Isometric Tremor?

    Directory of Open Access Journals (Sweden)

    Theresa A. Zesiewicz

    2014-01-01

    Full Text Available Background: Tremors may be difficult to classify.Case Report: An 83‐year‐old male presented with an unusual left wrist tremor. The tremor could be reproducibly elicited by making a fist or carrying a weighted object (e.g., a shopping bag, bottle of water of approximately 1 lb or more, and it intensified with heavier weights. The tremor was difficult to classify, although it shared features with isometric tremor.Discussion: This specific presentation of tremor has not been reported previously. We hope that the detailed description we provide will aid other neurologists who encounter this or similar tremors in their clinics.

  20. Statistical properties of mine tremor aftershocks

    CSIR Research Space (South Africa)

    Kgarume, TE

    2010-02-01

    Full Text Available Mine tremors and their aftershocks pose a risk to mine workers in the deep gold mines of South Africa. The statistical properties of mine-tremor aftershocks were investigated as part of an endeavour to assess the hazard and manage the risk. Data...

  1. Tremors and Klinefelter's Syndrome

    Directory of Open Access Journals (Sweden)

    Marcie L. Rabin

    2015-06-01

    Full Text Available Background: Klinefelter’s syndrome (KS has been associated with tremor, but reports on tremor phenomenology and treatment are limited. Case Reports: Patient 1 is a 17‐year‐old male with a dystonic tremor treated with deep brain stimulation (DBS. Patient 2 is a 57‐year‐old male with a predominant left hand resting tremor and dystonic features. Discussion: Our cases suggest that the tremor in patients with KS may be dystonic in nature. Patient 1 is also the third reported case of successful treatment with DBS. These cases have implications for elucidating the underlying neurobiological mechanism of tremor and identifying treatment options.

  2. Tremor in the elderly

    DEFF Research Database (Denmark)

    Deuschl, Günther; Petersen, Inge; Lorenz, Delia

    2015-01-01

    Isolated tremor in the elderly is commonly diagnosed as essential tremor (ET). The prevalence of tremor increases steeply with increasing age, whereas hereditary tremor is becoming less common. Moreover, late-manifesting tremor seems to be associated with dementia and earlier mortality. We...... hypothesize that different entities underlie tremor in the elderly. Two thousand four hundred forty-eight subjects from the Longitudinal Study of Aging Danish Twins older than 70 y answered screening questions for ET in 2001. Two thousan fifty-six (84%) participants drew Archimedes spirals to measure...

  3. The phenomenology of parkinsonian tremor.

    Science.gov (United States)

    Deuschl, Günther; Papengut, Frank; Hellriegel, Helge

    2012-01-01

    The definition of Parkinsonian tremor covers all different forms occurring in Parkinson's disease. The most common form is rest tremor, labelled as typical Parkinsonian tremor. Other variants cover also postural and action tremors. Data support the notion that suppression of rest tremor may be more specific for PD tremors. Several differential diagnoses like rest tremor in ET, dystonic tremor, psychogenic tremor and Holmes' tremor may be misinterpreted as PD-tremor. Tests and clinical clues to separate them are presented. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Treatment of Essential Tremor

    Science.gov (United States)

    ... for PATIENTS and their FAMILIES TREATMENT OF ESSENTIAL TREMOR This fact sheet is provided to help you understand which therapies help treat essential tremor. Neurologists from the American Academy of Neurology are ...

  5. Lessons from (triggered) tremor

    Science.gov (United States)

    Gomberg, Joan

    2010-01-01

    I test a “clock-advance” model that implies triggered tremor is ambient tremor that occurs at a sped-up rate as a result of loading from passing seismic waves. This proposed model predicts that triggering probability is proportional to the product of the ambient tremor rate and a function describing the efficacy of the triggering wave to initiate a tremor event. Using data mostly from Cascadia, I have compared qualitatively a suite of teleseismic waves that did and did not trigger tremor with ambient tremor rates. Many of the observations are consistent with the model if the efficacy of the triggering wave depends on wave amplitude. One triggered tremor observation clearly violates the clock-advance model. The model prediction that larger triggering waves result in larger triggered tremor signals also appears inconsistent with the measurements. I conclude that the tremor source process is a more complex system than that described by the clock-advance model predictions tested. Results of this and previous studies also demonstrate that (1) conditions suitable for tremor generation exist in many tectonic environments, but, within each, only occur at particular spots whose locations change with time; (2) any fluid flow must be restricted to less than a meter; (3) the degree to which delayed failure and secondary triggering occurs is likely insignificant; and 4) both shear and dilatational deformations may trigger tremor. Triggered and ambient tremor rates correlate more strongly with stress than stressing rate, suggesting tremor sources result from time-dependent weakening processes rather than simple Coulomb failure.

  6. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available ... About the IETF Volunteer For Healthcare Providers Giving Options Donate Prev Next IETF > About Essential Tremor > Video ... About the IETF Volunteer For Healthcare Providers Giving Options Donate Privacy Policy Contact Us Send to Email ...

  7. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available ... living with ET. It goes beyond diagnosis and treatments, to explore the emotional and psychosocial aspects of ... FDA Clearance for Cala ONE Wrist Device Neuromodulation Therapy Gives Relief From Hand Tremor IETF Accepting Proposals ...

  8. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available ... Tremor > Video Video Click to share on Facebook (Opens in new window) Click to share on Twitter (Opens in new window) Click to share on Google+ (Opens in new window) Click to email this to ...

  9. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available ... Essential Tremor > Video Video Click to share on Facebook (Opens in new window) Click to share on ... IETF Volunteer For Healthcare Providers Giving Options Donate Privacy Policy Contact Us Send to Email Address Your ...

  10. Essential Tremor Is More Than a Tremor

    Medline Plus

    Full Text Available Home About the IETF Volunteer For Healthcare Providers Giving Options Donate Prev Next IETF > About Essential Tremor > Video Video Click to share on Facebook (Opens in new window) Click ...

  11. Rhythmic finger tapping reveals cerebellar dysfunction in essential tremor.

    Science.gov (United States)

    Buijink, A W G; Broersma, M; van der Stouwe, A M M; van Wingen, G A; Groot, P F C; Speelman, J D; Maurits, N M; van Rootselaar, A F

    2015-04-01

    Cerebellar circuits are hypothesized to play a central role in the pathogenesis of essential tremor. Rhythmic finger tapping is known to strongly engage the cerebellar motor circuitry. We characterize cerebellar and, more specifically, dentate nucleus function, and neural correlates of cerebellar output in essential tremor during rhythmic finger tapping employing functional MRI. Thirty-one propranolol-sensitive essential tremor patients with upper limb tremor and 29 healthy controls were measured. T2*-weighted EPI sequences were acquired. The task consisted of alternating rest and finger tapping blocks. A whole-brain and region-of-interest analysis was performed, the latter focusing on the cerebellar cortex, dentate nucleus and inferior olive nucleus. Activations were also related to tremor severity. In patients, dentate activation correlated positively with tremor severity as measured by the tremor rating scale part A. Patients had reduced activation in widespread cerebellar cortical regions, and additionally in the inferior olive nucleus, and parietal and frontal cortex, compared to controls. The increase in dentate activation with tremor severity supports involvement of the dentate nucleus in essential tremor. Cortical and cerebellar changes during a motor timing task in essential tremor might point to widespread changes in cerebellar output in essential tremor. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Genetics Home Reference: essential tremor

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions Essential tremor Essential tremor Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Essential tremor is a movement disorder that causes involuntary, rhythmic ...

  13. The nature of tremor circuits in parkinsonian and essential tremor

    Science.gov (United States)

    Cagnan, Hayriye; Little, Simon; Foltynie, Thomas; Limousin, Patricia; Zrinzo, Ludvic; Hariz, Marwan; Cheeran, Binith; Fitzgerald, James; Green, Alexander L.; Aziz, Tipu

    2014-01-01

    Tremor is a cardinal feature of Parkinson’s disease and essential tremor, the two most common movement disorders. Yet, the mechanisms underlying tremor generation remain largely unknown. We hypothesized that driving deep brain stimulation electrodes at a frequency closely matching the patient’s own tremor frequency should interact with neural activity responsible for tremor, and that the effect of stimulation on tremor should reveal the role of different deep brain stimulation targets in tremor generation. Moreover, tremor responses to stimulation might reveal pathophysiological differences between parkinsonian and essential tremor circuits. Accordingly, we stimulated 15 patients with Parkinson’s disease with either thalamic or subthalamic electrodes (13 male and two female patients, age: 50–77 years) and 10 patients with essential tremor with thalamic electrodes (nine male and one female patients, age: 34–74 years). Stimulation at near-to tremor frequency entrained tremor in all three patient groups (ventrolateral thalamic stimulation in Parkinson’s disease, P = 0.0078, subthalamic stimulation in Parkinson’s disease, P = 0.0312; ventrolateral thalamic stimulation in essential tremor, P = 0.0137; two-tailed paired Wilcoxon signed-rank tests). However, only ventrolateral thalamic stimulation in essential tremor modulated postural tremor amplitude according to the timing of stimulation pulses with respect to the tremor cycle (e.g. P = 0.0002 for tremor amplification, two-tailed Wilcoxon rank sum test). Parkinsonian rest and essential postural tremor severity (i.e. tremor amplitude) differed in their relative tolerance to spontaneous changes in tremor frequency when stimulation was not applied. Specifically, the amplitude of parkinsonian rest tremor remained unchanged despite spontaneous changes in tremor frequency, whereas that of essential postural tremor reduced when tremor frequency departed from median values. Based on these results we conclude that

  14. Report covering examination of parts from downhole steam generators. [Combustor head and sleeve parts

    Energy Technology Data Exchange (ETDEWEB)

    Pettit, F. S.; Meier, G. H.

    1983-08-01

    Combustor head and sleeve parts were examined by using optical and scanning electron metallography after use in oxygen/diesel and air/diesel downhole steam generators. The degradation of the different alloy components is described in terms of reactions with oxygen, sulfur and carbon in the presence of cyclic stresses, all generated by the combustion process. Recommendations are presented for component materials (alloys and coatings) to extend component lives in the downhole steam generators. 9 references, 22 figures, 3 tables.

  15. Obstructed pancreaticojejunostomy partly explains exocrine insufficiency after pancreatic head resection.

    Science.gov (United States)

    Nordback, Isto; Parviainen, Mickael; Piironen, Anneli; Räty, Sari; Sand, Juhani

    2007-02-01

    The majority of patients with long-term survival after pancreatic head resection suffer from pancreatic exocrine insufficiency. The objective of this study was to investigate whether this is due to glandular malfunction or obstructed pancreaticojejunal anastomosis. Twenty-six patients (10 M, 16 F, mean age 61 years, range 34-81 years) were re-examined a median of 52 months (range 3-76 months) after pancreatic head resection and end-to-end invaginated pancreaticojejunostomy. Pancreatic exocrine function was measured by fecal elastase-1 assay. The size of the pancreatic remnant, glandular secretion and the flow through the anastomosis were analyzed with secretin-stimulated dynamic magnetic resonance pancreatography (D-MRP). All patients had pancreatic exocrine insufficiency, 24 (92%) of them having severe insufficiency. Eighteen patients (69%) reported moderate to severe diarrhea. Lowest fecal elastase-1 concentrations were associated with the initial diagnosis of chronic pancreatitis or ductal adenocarcinoma, suggesting preoperative primary or secondary chronic pancreatitis as important determinants. The size of the remnant gland did not correlate with the fecal elastase-1 concentrations. D-MRP failed in three patients. Severe glandular malfunctions were found in 7 (30%) of the 23 successful D-MRP examinations. The anastomosis was totally obstructed in 5 patients (22%) or partially obstructed in 6 (26%) but remained perfectly open in 5 patients (22%). The five patients with perfect anastomoses had the highest measured median fecal elastase-1 activity. Although late diarrhea and pancreatic exocrine insufficiency may be partly induced already by the disease treated with resection, at least half may be explained by obstructed anastomosis. To obtain better late functional results, improvements may be required in the surgical techniques.

  16. Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society.

    Science.gov (United States)

    Bhatia, Kailash P; Bain, Peter; Bajaj, Nin; Elble, Rodger J; Hallett, Mark; Louis, Elan D; Raethjen, Jan; Stamelou, Maria; Testa, Claudia M; Deuschl, Guenther

    2018-01-01

    Consensus criteria for classifying tremor disorders were published by the International Parkinson and Movement Disorder Society in 1998. Subsequent advances with regard to essential tremor, tremor associated with dystonia, and other monosymptomatic and indeterminate tremors make a significant revision necessary. Convene an international panel of experienced investigators to review the definition and classification of tremor. Computerized MEDLINE searches in January 2013 and 2015 were conducted using a combination of text words and MeSH terms: "tremor", "tremor disorders", "essential tremor", "dystonic tremor", and "classification" limited to human studies. Agreement was obtained using consensus development methodology during four in-person meetings, two teleconferences, and numerous manuscript reviews. Tremor is defined as an involuntary, rhythmic, oscillatory movement of a body part and is classified along two axes: Axis 1-clinical characteristics, including historical features (age at onset, family history, and temporal evolution), tremor characteristics (body distribution, activation condition), associated signs (systemic, neurological), and laboratory tests (electrophysiology, imaging); and Axis 2-etiology (acquired, genetic, or idiopathic). Tremor syndromes, consisting of either isolated tremor or tremor combined with other clinical features, are defined within Axis 1. This classification scheme retains the currently accepted tremor syndromes, including essential tremor, and provides a framework for defining new syndromes. This approach should be particularly useful in elucidating isolated tremor syndromes and syndromes consisting of tremor and other signs of uncertain significance. Consistently defined Axis 1 syndromes are needed to facilitate the elucidation of specific etiologies in Axis 2. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  17. Stereotactic neurosurgery for tremor

    NARCIS (Netherlands)

    Speelman, Johannes D.; Schuurman, Richard; de Bie, Rob M. A.; Esselink, Rianne A. J.; Bosch, D. Andries

    2002-01-01

    The role of the motor thalamus as surgical target in stereotactic neurosurgery for different kinds of tremor is discussed. For tremor in Parkinson's disease. the subthalamic nucleus becomes more and more often the surgical target, because this target also gives relief of other and more

  18. Backprojection of volcanic tremor

    Science.gov (United States)

    Haney, Matthew M.

    2014-01-01

    Backprojection has become a powerful tool for imaging the rupture process of global earthquakes. We demonstrate the ability of backprojection to illuminate and track volcanic sources as well. We apply the method to the seismic network from Okmok Volcano, Alaska, at the time of an escalation in tremor during the 2008 eruption. Although we are able to focus the wavefield close to the location of the active cone, the network array response lacks sufficient resolution to reveal kilometer-scale changes in tremor location. By deconvolving the response in successive backprojection images, we enhance resolution and find that the tremor source moved toward an intracaldera lake prior to its escalation. The increased tremor therefore resulted from magma-water interaction, in agreement with the overall phreatomagmatic character of the eruption. Imaging of eruption tremor shows that time reversal methods, such as backprojection, can provide new insights into the temporal evolution of volcanic sources.

  19. The state of head injury biomechanics: past, present, and future part 2: physical experimentation.

    Science.gov (United States)

    Goldsmith, Werner; Monson, Kenneth L

    2005-01-01

    This presentation is the continuation of the article published in Critical Reviews of Biomedical Engineering, 29(5-6), 2001. That issue contained topics dealing with components and geometry of the human head, classification of head injuries, some early experimental studies, and tolerance considerations. It then dealt with head motion and load characterization, investigations during the period from 1939 to 1966, injury causation and early modeling efforts, the 1966 Head Injury Conference and its sequels, mechanical properties of solid tissues, fluid characterization, and early investigation of the mechanical properties of cranial materials. It continued with a description of the systematic investigations of solid cranial components and structural properties since 1966, fetal cranial properties, analytical head modeling, and numerical solutions of head injury. The paper concluded with experimental dynamic loading of human living and cadaver heads, dynamic loading of surrogate heads, and head injury mechanics. This portion of the paper describes physical head injury experimentation involving animals, primarily primates, human cadavers, volunteers, and inanimate physical models. In order to address the entire domain of head injury biomechanics in the two-part survey, it was intended that this information be supplemented by discussions of head injury tolerance and criteria, automotive and sports safety considerations, and the design of protective equipment, but Professor Goldsmith passed away before these sections could be completed. It is nevertheless anticipated that this attenuated installment will provide, in conjunction with the first part of the survey, a valuable resource for students and practitioners of head injury biomechanics.

  20. Multiple Resting-State Networks Are Associated With Tremors and Cognitive Features in Essential Tremor.

    Science.gov (United States)

    Fang, Weidong; Chen, Huiyue; Wang, Hansheng; Zhang, Han; Liu, Mengqi; Puneet, Munankami; Lv, Fajin; Cheng, Oumei; Wang, Xuefeng; Lu, Xiurong; Luo, Tianyou

    2015-12-01

    The heterogeneous clinical features of essential tremor indicate that the dysfunctions of this syndrome are not confined to motor networks, but extend to nonmotor networks. Currently, these neural network dysfunctions in essential tremor remain unclear. In this study, independent component analysis of resting-state functional MRI was used to study these neural network mechanisms. Thirty-five essential tremor patients and 35 matched healthy controls with clinical and neuropsychological tests were included, and eight resting-state networks were identified. After considering the structure and head-motion factors and testing the reliability of the selected resting-state networks, we assessed the functional connectivity changes within or between resting-state networks. Finally, image-behavior correlation analysis was performed. Compared to healthy controls, essential tremor patients displayed increased functional connectivity in the sensorimotor and salience networks and decreased functional connectivity in the cerebellum network. Additionally, increased functional network connectivity was observed between anterior and posterior default mode networks, and a decreased functional network connectivity was noted between the cerebellum network and the sensorimotor and posterior default mode networks. Importantly, the functional connectivity changes within and between these resting-state networks were correlated with the tremor severity and total cognitive scores of essential tremor patients. The findings of this study provide the first evidence that functional connectivity changes within and between multiple resting-state networks are associated with tremors and cognitive features of essential tremor, and this work demonstrates a potential approach for identifying the underlying neural network mechanisms of this syndrome. © 2015 International Parkinson and Movement Disorder Society.

  1. Streaking tremor in Cascadia

    Science.gov (United States)

    Vidale, J. E.; Ghosh, A.; Sweet, J. R.; Creager, K. C.; Wech, A.; Houston, H.

    2009-12-01

    Details of tremor deep in subduction zones is damnably difficult to glimpse because of the lack of crisp initial arrivals, low waveform coherence, uncertain focal mechanisms, and the probability of simultaneous activity across extended regions. Yet such details hold out the best hope to illuminate the unknown mechanisms underlying episodic tremor and slip. Attacking this problem with brute force, we pointed a small, very dense seismic array down at the migration path of a good-sized episodic tremor and slip (ETS) event. In detail, it was an 84-element, 1300-m-aperture temporary seismic array in northern Washington, and the migration path of the May 2008 ETS event was 30-40 km directly underneath. Our beamforming technique tracked the time, incident angle, and azimuth of tremor radiation in unprecedented detail. We located the tremor by assuming it occurs on the subduction interface, estimated relative tremor moment released by each detected tremor window, and mapped it on the interface [Ghosh et al., GRL, 2009]. Fortunately for our ability to image it, the tremor generally appears to emanate from small regions, and we were surprised by how steadily the regions migrated with time. For the first time in Cascadia, we found convergence-parallel transient streaks of tremor migrating at velocities of several tens of km/hr, with movement in both up- and down-dip directions. Similar patterns have been seen in Japan [Shelly, G3, 2007]. This is in contrast to the long-term along-strike marching of tremor at 10 km/day. These streaks tend to propagate steadily and often repeat the same track on the interface multiple times. They light up persistent moment patches on the interface by a combination of increased amplitude and longer residence time within the patches. The up- and down-dip migration dominates the 2 days of tremor most clearly imaged by our array. The tendency of the streaks to fill in bands is the subject of the presentation of Ghosh et al. here. The physical

  2. Tremor - self-care

    Science.gov (United States)

    ... in your day-to-day: Buy clothes with Velcro fasteners instead of buttons or hooks. Cook or ... your tremor. Some of these medicines have side effects. Tell your provider if you have these symptoms ...

  3. How to treat tremor.

    Science.gov (United States)

    Rektor, Ivan; Rektorová, Irena; Suchý, Václav

    2004-05-01

    This paper presents an example of 18(th) century medical thinking. The author, Dr Georg Ernst Stahl (1659-1734) was the founder of the phlogiston theory in the field of chemistry, a medical professor, and a court physician in Saxony and Prussia. His description includes a definition of tremor, the internal and external causes of tremor, the types of tremor, the diagnostic and prognostic signs, and the treatment. From a present (contemporary) point of view, some compounds that were then used in treatment may have had a limited therapeutic effect on some kinds of tremor. Protopin has an anticholinergic and GABA-ergic effect, and rhoeadin (tetrahydrobenzazepin) may have had an effect similar to that of neuroleptics. Nevertheless, it is not clear whether the recommended quantity of these compounds was sufficient for a clinical effect. Most of the prescribed drugs could only have had a placebo effect.

  4. Educational paper Abusive Head Trauma Part II: Radiological aspects

    NARCIS (Netherlands)

    Sieswerda-Hoogendoorn, Tessa; Boos, Stephen; Spivack, Betty; Bilo, Rob A. C.; van Rijn, Rick R.

    2012-01-01

    Abusive head trauma (AHT) is a relatively common cause of neurotrauma in young children. Radiology plays an important role in establishing a diagnosis and assessing a prognosis. Computed tomography (CT), followed by magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI), is the

  5. Coherence analysis differentiates between cortical myoclonic tremor and essential tremor

    NARCIS (Netherlands)

    van Rootselaar, AF; Maurits, NM; Koelman, JHTM; van der Hoeven, JH; Bour, LJ; Leenders, KL; Brown, P; Tijssen, MAJ

    Familial cortical myoclonic tremor with epilepsy (FCMTE) is characterized by a distal kinetic tremor, infrequent epileptic attacks, and autosomal dominant inheritance. The tremor is thought to originate from the motor cortex. In our patient group, a premovement cortical spike Could not be

  6. An autocorrelation method to detect low frequency earthquakes within tremor

    Science.gov (United States)

    Brown, J.R.; Beroza, G.C.; Shelly, D.R.

    2008-01-01

    Recent studies have shown that deep tremor in the Nankai Trough under western Shikoku consists of a swarm of low frequency earthquakes (LFEs) that occur as slow shear slip on the down-dip extension of the primary seismogenic zone of the plate interface. The similarity of tremor in other locations suggests a similar mechanism, but the absence of cataloged low frequency earthquakes prevents a similar analysis. In this study, we develop a method for identifying LFEs within tremor. The method employs a matched-filter algorithm, similar to the technique used to infer that tremor in parts of Shikoku is comprised of LFEs; however, in this case we do not assume the origin times or locations of any LFEs a priori. We search for LFEs using the running autocorrelation of tremor waveforms for 6 Hi-Net stations in the vicinity of the tremor source. Time lags showing strong similarity in the autocorrelation represent either repeats, or near repeats, of LFEs within the tremor. We test the method on an hour of Hi-Net recordings of tremor and demonstrates that it extracts both known and previously unidentified LFEs. Once identified, we cross correlate waveforms to measure relative arrival times and locate the LFEs. The results are able to explain most of the tremor as a swarm of LFEs and the locations of newly identified events appear to fill a gap in the spatial distribution of known LFEs. This method should allow us to extend the analysis of Shelly et al. (2007a) to parts of the Nankai Trough in Shikoku that have sparse LFE coverage, and may also allow us to extend our analysis to other regions that experience deep tremor, but where LFEs have not yet been identified. Copyright 2008 by the American Geophysical Union.

  7. Range dependent characteristics in the head-related transfer functions of a bat-head cast: part 1. Monaural characteristics

    International Nuclear Information System (INIS)

    Kim, S; Allen, R; Rowan, D

    2012-01-01

    Knowledge of biological sonar systems has revolutionized many aspects of sonar engineering and further advances will benefit from more detailed understanding of their underlying acoustical processes. The anatomically diverse, complex and dynamic heads and ears of bats are known to be important for echolocation although their range-dependent properties are not well understood, particularly across the wide frequency range of some bats' vocalizations. The aim of this and a companion paper Kim et al (2012 Bioinspir. Biomim.) is to investigate bat-head acoustics as a function of bat-target distance, based on measurements up to 100 kHz and more robust examination of hardware characteristics in measurements than previously reported, using a cast of a bat head. In this first paper, we consider the spectral features at either ear (i.e. monaural head-related transfer functions). The results show, for example, that there is both higher magnitude and a stronger effect of distance at close range at relatively low frequencies. This might explain, at least in part, why bats adopt a strategy of changing the frequency range of their vocalizations while approaching a target. There is also potential advantage in the design of bio-inspired receivers of using range-dependent HRTFs and utilizing their distinguished frequency characteristics over the distance. (paper)

  8. How typical are 'typical' tremor characteristics? : Sensitivity and specificity of five tremor phenomena

    NARCIS (Netherlands)

    van der Stouwe, A. M. M.; Elting, J. W.; van der Hoeven, J. H.; van Laar, T.; Leenders, K. L.; Maurits, N. M.; Tijssen, M. Aj.

    Introduction: Distinguishing between different tremor disorders can be challenging. Some tremor disorders are thought to have typical tremor characteristics: the current study aims to provide sensitivity and specificity for five 'typical' tremor phenomena. Methods: Retrospectively, we examined 210

  9. [Clinical subtypes of essential tremor and their electrophysiological and pharmacological differences].

    Science.gov (United States)

    Koguchi, Y; Nakajima, M; Kawamura, M; Hirayama, K

    1995-02-01

    We divided 19 patients with essential tremor into two subtypes according to clinical characteristics of the tremor. Ten patients had pure postural tremor distributed in the hand(s), head, and face (group A). Nine patients had tremor extending to the voice or leg(s), associated with resting tremor and/or hyperkinesie volitionnelle of the hand(s) (group B). Their ages, the age of onset, and the duration of illness were not different between the two groups. Electrophysiologically, the tremor of group A patients had higher frequencies than that of group B patients, and had synchronized activities for antagonistic muscles. Four of group B patients had reciprocal antagonistic activities of the tremor. Inactive phase of tremor induced by an electrically-evoked muscle twitch was invariably within the range of the physiological silent period for group A patients, and prolonged beyond the range for four of group B patients. Pharmacologically, 78% of group A patients responded well to beta-blocker, which was effective for 25% of group B patients. Sixty per cent of beta-blocker-resistant group B patients responded well to phenobarbital. In conclusion, a peripheral mechanism, presumably beta-adrenergic drive, is important for the tremor in group A patients, while central pathogenic mechanisms are more important for the tremor of group B patients.

  10. Mechanical analysis of a ceramic head being part of a modular hip prosthesis

    International Nuclear Information System (INIS)

    Ravagli, Ermenegildo

    1998-04-01

    This report still pursues the aim of carrying out a systematic mechanical analysis of a ceramic head being part of a modular hip prosthesis, in order to characterize it exhaustively, i.e. to assess its performances and some of its main specifications. Here in particular the aim is to locate the stress of the head when it undergoes the load transferred by the stem, presuming that the stem-head mating is not perfect, but there is a conical error called of the 2. type, to which corresponds a stem summit angle smaller than the one in the head hole. This conical error changes considerably the head stress and therefore this study is considered decisive for a later correct assessment of its resistance to breaking. This study is performed in the frame of the STRIDE-CETMA Project, which is aimed at founding and developing a Centre for technologically advanced materials in Brindisi (Italy) Technology Park [it

  11. Educational paper: Abusive Head Trauma part I. Clinical aspects.

    Science.gov (United States)

    Sieswerda-Hoogendoorn, Tessa; Boos, Stephen; Spivack, Betty; Bilo, Rob A C; van Rijn, Rick R

    2012-03-01

    Abusive Head Trauma (AHT) refers to the combination of findings formerly described as shaken baby syndrome. Although these findings can be caused by shaking, it has become clear that in many cases there may have been impact trauma as well. Therefore a less specific term has been adopted by the American Academy of Pediatrics. AHT is a relatively common cause of childhood neurotrauma with an estimated incidence of 14-40 cases per 100,000 children under the age of 1 year. About 15-23% of these children die within hours or days after the incident. Studies among AHT survivors demonstrate that approximately one-third of the children are severely disabled, one-third of them are moderately disabled and one-third have no or only mild symptoms. Other publications suggest that neurological problems can occur after a symptom-free interval and that half of these children have IQs below the 10th percentile. Clinical findings are depending on the definitions used, but AHT should be considered in all children with neurological signs and symptoms especially if no or only mild trauma is described. Subdural haematomas are the most reported finding. The only feature that has been identified discriminating AHT from accidental injury is apnoea. AHT should be approached with a structured approach, as in any other (potentially lethal) disease. The clinician can only establish this diagnosis if he/she has knowledge of the signs and symptoms of AHT, risk factors, the differential diagnosis and which additional investigations to perform, the more so since parents seldom will describe the true state of affairs spontaneously.

  12. The many roads to tremor.

    Science.gov (United States)

    Brittain, John-Stuart; Brown, Peter

    2013-12-01

    Tremor represents one of the most prominent examples of aberrant synchronisation within the human motor system, and Essential Tremor (ET) is by far the most common tremor disorder. Yet, even within ET there is considerable variation, and patients may have contrasting amounts of postural and intention tremor. Recently, Pedrosa et al. (2013) challenged tremor circuits in a cohort of patients presenting with ET, by applying low-frequency deep brain stimulation within thalamus. This interventional approach provided strong evidence that distinct (yet possibly overlapping) neural substrates are responsible for postural and intention tremor in ET. Intention tremor, and not postural tremor, was exacerbated by low frequency stimulation, and the effect was localised in the region of the ventrolateral thalamus in such a way as to implicate cerebello-thalamic pathways. These results, taken in conjunction with the contemporary literature, reveal that pathological changes exaggerate oscillatory synchrony in selective components of an extensive and distributed motor network, and that synchronisation within these networks is further regulated according to motor state. Through a combination of pathological and more dynamic physiological factors, activity then spills out into the periphery in the form of tremor. The findings of Pedrosa et al. (2013) are timely as they coincide with an emerging notion that tremor may result through selective dysregulation within a broader tremorgenic network. © 2013.

  13. Median Filtering Methods for Non-volcanic Tremor Detection

    Science.gov (United States)

    Damiao, L. G.; Nadeau, R. M.; Dreger, D. S.; Luna, B.; Zhang, H.

    2016-12-01

    Various properties of median filtering over time and space are used to address challenges posed by the Non-volcanic tremor detection problem. As part of a "Big-Data" effort to characterize the spatial and temporal distribution of ambient tremor throughout the Northern San Andreas Fault system, continuous seismic data from multiple seismic networks with contrasting operational characteristics and distributed over a variety of regions are being used. Automated median filtering methods that are flexible enough to work consistently with these data are required. Tremor is characterized by a low-amplitude, long-duration signal-train whose shape is coherent at multiple stations distributed over a large area. There are no consistent phase arrivals or mechanisms in a given tremor's signal and even the durations and shapes among different tremors vary considerably. A myriad of masquerading noise, anthropogenic and natural-event signals must also be discriminated in order to obtain accurate tremor detections. We present here results of the median methods applied to data from four regions of the San Andreas Fault system in northern California (Geysers Geothermal Field, Napa, Bitterwater and Parkfield) to illustrate the ability of the methods to detect tremor under diverse conditions.

  14. Dystonia Associated with Idiopathic Slow Orthostatic Tremor

    Directory of Open Access Journals (Sweden)

    Christopher Kobylecki

    2016-02-01

    Full Text Available Background: We aimed to characterize the clinical and electrophysiological features of patients with slow orthostatic tremor.Case Report: The clinical and neurophysiological data of patients referred for lower limb tremor on standing were reviewed. Patients with symptomatic or primary orthostatic tremor were excluded. Eight patients were identified with idiopathic slow 4–8 Hz orthostatic tremor, which was associated with tremor and dystonia in cervical and upper limb musculature. Coherence analysis in two patients showed findings different to those seen in primary orthostatic tremor.Discussion: Slow orthostatic tremor may be associated with dystonia and dystonic tremor.

  15. Thalamic physiology of intentional essential tremor is more like cerebellar tremor than postural essential tremor

    OpenAIRE

    Zakaria, R; Lenz, FA; Hua, S; Avin, BH; Liu, CC; Mari, Z

    2013-01-01

    The neuronal physiological correlates of clinical heterogeneity in human essential tremor are unknown. We now test the hypothesis that thalamic neuronal and EMG activities during intention essential tremor are similar to those of the intention tremor which is characteristic of cerebellar lesions. Thalamic neuronal firing was studied in a cerebellar relay nucleus (ventral intermediate, Vim) and in a pallidal relay nucleus (ventral oral posterior, Vop) during stereotactic surgery for the treatm...

  16. Tracing tremor: Neural correlates of essential tremor and its treatment

    NARCIS (Netherlands)

    Buijink, A.W.G.

    2016-01-01

    This thesis focusses on the neural correlates and treatment of the neurological movement disorder essential tremor (ET). ET, one of the most common movement disorders in clinical neurology, is characterized by an action and intention tremor of mainly the hands, hampering daily life activities.

  17. Gliding and Quasi-harmonic Tremor Behaviour of Raung Volcano: November 2014 Crisis Period Case Study

    Directory of Open Access Journals (Sweden)

    Vico Luthfi Ipmawan

    2018-01-01

    Full Text Available DOI: 10.17014/ijog.5.1.13-21The seismic activity of Raung Volcano was raised on 11 November 2014. As many as 1709 tremors were recorded followed by continuous tremors appearing in late November 2014. Quasi-harmonic and gliding tremors appeared in a spectrogram on 12 November 2014. The quasi-harmonic tremors refer to tremors that have no fully harmonic form in spectrum. The gliding harmonic tremors refer to harmonic tremors that have frequency jumps with either positive or negative increment. After signal restitution processing, the Maximum Entropy Spectral Analysis (MESA method was applied in Raung recordings resulting the spectrum and the spectrogram of tremors. The quasi-harmonic tremors have the monotonic spectrum in its head and centre segment, and the harmonic one in its tails. There are twenty-four spectrums that show frequency changes between the monotonic and harmonic. The similarity between the fundamental frequency range of the monotonic and harmonic ones suggests that both signals are excited from a common resonator. The alternating of monotonic and harmonic respectively over this period is qualitatively similar with Julian’s synthetic time series about the nonlinear oscillator model. It is suggested that Raung Volcano magma pressure is sizeable to make a chaotic vibration. A pressure increasing in Raung magmatic conduit causes the increasing of P-wave velocity and makes a positive gliding frequency.

  18. Tremor in the Elderly: Essential and Aging-Related Tremor

    Science.gov (United States)

    Deuschl, Günthe; Petersen, Inge; Lorenz, Delia; Christensen, Kaare

    2016-01-01

    Isolated tremor in the elderly is commonly diagnosed as essential tremor (ET). The prevalence of tremor increases steeply with increasing age, whereas hereditary tremor is becoming less common. Moreover, late-manifesting tremor seems to be associated with dementia and earlier mortality. We hypothesize that different entities underlie tremor in the elderly. Two thousand four hundred forty-eight subjects from the Longitudinal Study of Aging Danish Twins older than 70 y answered screening questions for ET in 2001. Two thousan fifty-six (84%) participants drew Archimedes spirals to measure their tremor severity, and classical aging phenotypes were assessed. A subgroup of 276 individuals fulfilling either screening criteria for ET or being controls were personally assessed. Medications and mortality data are available. The spiral score increased with age. The spiral score correlated with tremor severity. For the whole cohort, mortality was significantly correlated with the spiral score, and higher spiral scores were associated with lower physical and cognitive functioning. Multivariate analysis identified higher spiral scores as an independent risk factor for mortality. In contrast, the ET patients did not show an increased but rather a lower mortality rate although it was not statistically significant. Consistent with a slower than normal aging, they were also physically and cognitively better functioning than controls. Because incident tremors beyond 70 y of age show worse aging parameters and mortality than controls and ET, we propose to label it ‘aging-related tremor’ (ART). This tremor starts later in life and is accompanied by subtle signs of aging both cognitively and physically. More detailed clinical features and pathogenesis warrant further assessment. PMID:26095699

  19. Surgery for Dystonia and Tremor.

    Science.gov (United States)

    Crowell, Jason L; Shah, Binit B

    2016-03-01

    Surgical procedures for dystonia and tremor have evolved over the past few decades, and our understanding of risk, benefit, and predictive factors has increased substantially in that time. Deep brain stimulation (DBS) is the most utilized surgical treatment for dystonia and tremor, though lesioning remains an effective option in appropriate patients. Dystonic syndromes that have shown a substantial reduction in severity secondary to DBS are isolated dystonia, including generalized, cervical, and segmental, as well as acquired dystonia such as tardive dystonia. Essential tremor is quite amenable to DBS, though the response of other forms of postural and kinetic tremor is not nearly as robust or consistent based on available evidence. Regarding targeting, DBS lead placement in the globus pallidus internus has shown marked efficacy in dystonia reduction. The subthalamic nucleus is an emerging target, and increasing evidence suggests that this may be a viable target in dystonia as well. The ventralis intermedius nucleus of the thalamus is the preferred target for essential tremor, though targeting the subthalamic zone/caudal zona incerta has shown promise and may emerge as another option in essential tremor and possibly other tremor disorders. In the carefully selected patient, DBS and lesioning procedures are relatively safe and effective for the management of dystonia and tremor.

  20. Development of the two-part pattern during regeneration of the head in hydra

    DEFF Research Database (Denmark)

    Bode, Matthias; Awad, T A; Koizumi, O

    1988-01-01

    The head of a hydra is composed of two parts, a domed hypostome with a mouth at the top and a ring of tentacles below. When animals are decapitated a new head regenerates. During the process of regeneration the apical tip passes through a transient stage in which it exhibits tentacle......-like characteristics before becoming a hypostome. This was determined from markers which appeared before morphogenesis took place. The first was a monoclonal antibody, TS-19, that specifically binds to the ectodermal epithelial cells of the tentacles. The second was an antiserum against the peptide Arg......-Phe-amide (RFamide), which in the head of hydra is specific to the sensory cells of the hypostomal apex and the ganglion cells of the lower hypostome and tentacles. The TS-19 expression and the ganglion cells with RFamide-like immunoreactivity (RLI) arose first at the apex and spread radially. Once the tentacles...

  1. Is tremor related to celiac disease?

    Science.gov (United States)

    Ameghino, Lucia; Rossi, Malco Damian; Cerquetti, Daniel; Merello, Marcelo

    2017-06-14

    Neurological features in celiac disease (CD) are not rare (5%-36%), but tremor is scarcely described. Subjects with CD and healthy controls completed an online survey using WHIGET tremor rating scale. One thousand five hundred and twelve subjects completed the survey, finally 674 CD patients and 290 healthy subjects were included. A higher prevalence of tremor in CD patients was observed in comparison to controls (28% vs 14%, P tremor in CD patients with and without tremor was 25% and 20% ( P = 0.2), while in the control group it was 41% and 10% ( P tremor showed a higher frequency of family history of tremor when compared to CD patients with tremor (41.5% vs 24.6%, P = 0.03). The results suggested that tremor in CD might be more frequent and possibly related to the disease itself and not due to associated essential tremor.

  2. Parts : valitsus ei saa kukkuda heade kavatsuste pärast / Juhan Parts ; interv. Rasmus Kagge

    Index Scriptorium Estoniae

    Parts, Juhan, 1966-

    2005-01-01

    Ilmunud ka: Pärnu Postimees 16. märts, lk. 7. Peaminister Juhan Parts selgitab olukorda valitsuses, võimalikust umbusalduse avaldamisest justiitsminister Ken-Marti Vaherile, võimuliidu püsimajäämise tingimustest

  3. Treatment of essential tremor with arotinolol.

    Science.gov (United States)

    Kuroda, Y; Kakigi, R; Shibasaki, H

    1988-04-01

    We investigated the effect of arotinolol, a new peripherally acting beta-adrenergic blocker, in 15 patients with essential tremor. The patients received 30 mg per day of arotinolol for 8 weeks. Accelerometer readings showed a significant reduction in amplitude of postural tremor after treatment. Action tremor also improved to essentially the same degree as postural tremor. The present findings support the view that the therapeutic effect of beta-blockers in essential tremor is mediated by peripheral beta-adrenergic receptors.

  4. Intermittent cortical involvement in the preservation of tremor in essential tremor

    NARCIS (Netherlands)

    Sharifi, Sarvi; Luft, Frauke; Verhagen, Rens; Heida, Tjitske; Speelman, Johannes D.; Bour, Lo J.; van Rootselaar, Anne-Fleur

    2017-01-01

    Cortical involvement in essential tremor, an involuntary action tremor supposedly of subcortical origin, is uncertain. Conflicting results of corticomuscular coherence studies in essential tremor suggest an intermittent corticomuscular coupling. On the basis of the literature, we hypothesized that

  5. Role of altered cerebello-thalamo-cortical network in the neurobiology of essential tremor

    Energy Technology Data Exchange (ETDEWEB)

    Lenka, Abhishek; Bhalsing, Ketaki Swapnil; Jhunjhunwala, Ketan [National Institute of Mental Health and Neurosciences, Department of Neurology, Bangalore, Karnataka (India); National Institute of Mental Health and Neurosciences, Department of Clinical Neurosciences, Bangalore, Karnataka (India); Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn [National Institute of Mental Health and Neurosciences, Department of Neuroimaging and Interventional Radiology, Bangalore, Karnataka (India); Naduthota, Rajini M.; Yadav, Ravi; Pal, Pramod Kumar [National Institute of Mental Health and Neurosciences, Department of Neurology, Bangalore, Karnataka (India)

    2017-02-15

    Essential tremor (ET) is the most common movement disorder among adults. Although ET has been recognized as a mono-symptomatic benign illness, reports of non-motor symptoms and non-tremor motor symptoms have increased its clinical heterogeneity. The neural correlates of ET are not clearly understood. The aim of this study was to understand the neurobiology of ET using resting state fMRI. Resting state functional MR images of 30 patients with ET and 30 age- and gender-matched healthy controls were obtained. The functional connectivity of the two groups was compared using whole-brain seed-to-voxel-based analysis. The ET group had decreased connectivity of several cortical regions especially of the primary motor cortex and the primary somatosensory cortex with several right cerebellar lobules compared to the controls. The thalamus on both hemispheres had increased connectivity with multiple posterior cerebellar lobules and vermis. Connectivity of several right cerebellar seeds with the cortical and thalamic seeds had significant correlation with an overall score of Fahn-Tolosa-Marin tremor rating scale (FTM-TRS) as well as the subscores for head tremor and limb tremor. Seed-to-voxel resting state connectivity analysis revealed significant alterations in the cerebello-thalamo-cortical network in patients with ET. These alterations correlated with the overall FTM scores as well as the subscores for limb tremor and head tremor in patients with ET. These results further support the previous evidence of cerebellar pathology in ET. (orig.)

  6. Role of altered cerebello-thalamo-cortical network in the neurobiology of essential tremor

    International Nuclear Information System (INIS)

    Lenka, Abhishek; Bhalsing, Ketaki Swapnil; Jhunjhunwala, Ketan; Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn; Naduthota, Rajini M.; Yadav, Ravi; Pal, Pramod Kumar

    2017-01-01

    Essential tremor (ET) is the most common movement disorder among adults. Although ET has been recognized as a mono-symptomatic benign illness, reports of non-motor symptoms and non-tremor motor symptoms have increased its clinical heterogeneity. The neural correlates of ET are not clearly understood. The aim of this study was to understand the neurobiology of ET using resting state fMRI. Resting state functional MR images of 30 patients with ET and 30 age- and gender-matched healthy controls were obtained. The functional connectivity of the two groups was compared using whole-brain seed-to-voxel-based analysis. The ET group had decreased connectivity of several cortical regions especially of the primary motor cortex and the primary somatosensory cortex with several right cerebellar lobules compared to the controls. The thalamus on both hemispheres had increased connectivity with multiple posterior cerebellar lobules and vermis. Connectivity of several right cerebellar seeds with the cortical and thalamic seeds had significant correlation with an overall score of Fahn-Tolosa-Marin tremor rating scale (FTM-TRS) as well as the subscores for head tremor and limb tremor. Seed-to-voxel resting state connectivity analysis revealed significant alterations in the cerebello-thalamo-cortical network in patients with ET. These alterations correlated with the overall FTM scores as well as the subscores for limb tremor and head tremor in patients with ET. These results further support the previous evidence of cerebellar pathology in ET. (orig.)

  7. Re-Emergent Tremor of Parkinson's Disease Masquerading as Essential Tremor

    Directory of Open Access Journals (Sweden)

    Sarah Morgan

    2016-03-01

    Full Text Available Background: The re-emergent tremor of Parkinson’s disease (PD is generally recognized as a postural tremor. Phenomenology Shown: A PD patient with a re-emergent tremor occurring during a task (spiral drawing, which on the surface produced a tremor that resembled that of essential tremor (ET. Educational Value: Researchers and clinicians should be aware of features of this re-emergent tremor to help distinguish it from that of ET.

  8. Slip rate and tremor genesis in Cascadia

    Science.gov (United States)

    Wech, Aaron G.; Bartlow, Noel M.

    2014-01-01

    At many plate boundaries, conditions in the transition zone between seismogenic and stable slip produce slow earthquakes. In the Cascadia subduction zone, these events are consistently observed as slow, aseismic slip on the plate interface accompanied by persistent tectonic tremor. However, not all slow slip at other plate boundaries coincides spatially and temporally with tremor, leaving the physics of tremor genesis poorly understood. Here we analyze seismic, geodetic, and strainmeter data in Cascadia to observe for the first time a large, tremor-generating slow earthquake change from tremor-genic to silent and back again. The tremor falls silent at reduced slip speeds when the migrating slip front pauses as it loads the stronger adjacent fault segment to failure. The finding suggests that rheology and slip-speed-regulated stressing rate control tremor genesis, and the same section of fault can slip both with and without detectable tremor, limiting tremor's use as a proxy for slip.

  9. Characterizing Orthostatic Tremor Using a Smartphone Application.

    Science.gov (United States)

    Balachandar, Arjun; Fasano, Alfonso

    2017-01-01

    Orthostatic tremor is one of the few tremor conditions requiring an electromyogram for definitive diagnosis since leg tremor might not be visible to the naked eye. An iOS application (iSeismometer, ObjectGraph LLC, New York) using an Apple iPhone 5 (Cupertino, CA, USA) inserted into the patient's sock detected a tremor with a frequency of 16.4 Hz on both legs. The rapid and straightforward accelerometer-based recordings accomplished in this patient demonstrate the ease with which quantitative analysis of orthostatic tremor can be conducted and, importantly, demonstrates the potential application of this approach in the assessment of any lower limb tremor.

  10. Time-Reversal Study of the Hemet (CA) Tremor Source

    Science.gov (United States)

    Larmat, C. S.; Johnson, P. A.; Guyer, R. A.

    2010-12-01

    Since its first observation by Nadeau & Dolenc (2005) and Gomberg et al. (2008), tremor along the San Andreas fault system is thought to be a probe into the frictional state of the deep part of the fault (e.g. Shelly et al., 2007). Tremor is associated with slow, otherwise deep, aseismic slip events that may be triggered by faint signals such as passing waves from remote earthquakes or solid Earth tides.Well resolved tremor source location is key to constrain frictional models of the fault. However, tremor source location is challenging because of the high-frequency and highly-scattered nature of tremor signal characterized by the lack of isolated phase arrivals. Time Reversal (TR) methods are emerging as a useful tool for location. The unique requirement is a good velocity model for the different time-reversed phases to arrive coherently onto the source point. We present results of location for a tremor source near the town of Hemet, CA, which was triggered by the 2002 M 7.9 Denali Fault earthquake (Gomberg et al., 2008) and by the 2009 M 6.9 Gulf of California earthquake. We performed TR in a volume model of 88 (N-S) x 70 (W-E) x 60 km (Z) using the full-wave 3D wave-propagation package SPECFEM3D (Komatitsch et al., 2002). The results for the 2009 episode indicate a deep source (at about 22km) which is about 4km SW the fault surface scarp. We perform STA/SLA and correlation analysis in order to have independent confirmation of the Hemet tremor source. We gratefully acknowledge the support of the U. S. Department of Energy through the LANL/LDRD Program for this work.

  11. Three-part head-splitting proximal humerus fracture through a unicameral bone cyst.

    Science.gov (United States)

    Younghein, John A; Eskander, Mark S; DeAngelis, Nicola A; Wixted, John J

    2012-06-01

    Unicameral bone cysts are rare in adults and are most often found incidentally on radiographs. However, they can persist from the adolescent period and may be present in locations that predispose to or exacerbate fractures.This article describes a case of a healthy 40-year-old woman who sustained a proximal humerus trauma that involved a large unicameral bone cyst, resulting in a 3-part head-splitting fracture. The epiphyseal location of the cyst contributed to the severity and extent of the fracture that resulted from a simple fall. Given the age of the patient, open reduction and internal fixation with a locking plate and lag screws was performed. The patient chose open reduction and internal fixation to preserve a hemiarthroplasty procedure in case of future revision. Successful humeral head reconstruction was achieved, and the patient fully recovered. One year postoperatively, the patient underwent arthroscopic debridement to alleviate subjective stiffness and decreased range of motion.Multipart head-splitting fractures require complex repair strategies. The gold standard for the treatment of these injuries is hemiarthroplasty. However, the decision process is difficult in a young patient given the average survival of autoplastic prostheses and the added difficulty of later revision. The current case demonstrates the complexity of decision making resulting from a rare injury in a young, healthy patient and shows that open reduction and internal fixation can provide acceptable reconstruction in such situations. Copyright 2012, SLACK Incorporated.

  12. The Clinical Evaluation of Parkinson's Tremor

    NARCIS (Netherlands)

    Zach, H.; Dirkx, M.; Bloem, B.R.; Helmich, R.C.

    2015-01-01

    Parkinson's disease harbours many different tremors that differ in distribution, frequency, and context in which they occur. A good clinical tremor assessment is important for weighing up possible differential diagnoses of Parkinson's disease, but also to measure the severity of the tremor as a

  13. Possible deep fault slip preceding the 2004 Parkfield earthquake, inferred from detailed observations of tectonic tremor

    Science.gov (United States)

    Shelly, David R.

    2009-01-01

    Earthquake predictability depends, in part, on the degree to which sudden slip is preceded by slow aseismic slip. Recently, observations of deep tremor have enabled inferences of deep slow slip even when detection by other means is not possible, but these data are limited to certain areas and mostly the last decade. The region near Parkfield, California, provides a unique convergence of several years of high-quality tremor data bracketing a moderate earthquake, the 2004 magnitude 6.0 event. Here, I present detailed observations of tectonic tremor from mid-2001 through 2008 that indicate deep fault slip both before and after the Parkfield earthquake that cannot be detected with surface geodetic instruments. While there is no obvious short-term precursor, I find unidirectional tremor migration accompanied by elevated tremor rates in the 3 months prior to the earthquake, which suggests accelerated creep on the fault ∼16 km beneath the eventual earthquake hypocenter.

  14. Polypyrrole Actuators for Tremor Suppression

    DEFF Research Database (Denmark)

    Skaarup, Steen; Mogensen, Naja; Bay, Lasse

    2003-01-01

    Neurological tremor affecting limbs can be divided into at least 6 different types with frequencies ranging from 2 to about 20 Hz. In order to alleviate the symptoms by suppressing the tremor, sensing and actuation systems able to perform at these frequencies are needed. Electroactive polymers...... exemplify 'soft actuator' technology that may be especially suitable for use in conjunction with human limbs. The electrochemical and mechanical properties of polypyrrole dodecyl benzene sulphonate actuator films have been studied with this application in mind. The results show that the time constants...

  15. Internal tremor in Parkinson's disease, multiple sclerosis, and essential tremor.

    Science.gov (United States)

    Cochrane, Graham D; Rizvi, Syed; Abrantes, Ana; Crabtree, Brigid; Cahill, Jonathan; Friedman, Joseph H

    2015-10-01

    Internal tremor (IT) is a poorly recognized symptom that has been described in Parkinson's disease (PD). Described as a feeling of tremor in the extremities or trunk without actual movement, ITs are not debilitating but can be bothersome to patients. The origin of the sensation is unknown., and ITs may be prevalent in other diseases than PD. The present study sought to expand knowledge about IT by confirming their presence in PD, and determining their prevalence in Multiple Sclerosis (MS), and Essential Tremor (ET). A survey was developed in order to determine the prevalence of IT in PD, MS, and ET and to learn what associations with various disease characteristics were present. The survey was administered to 89 consecutive PD, 70 MS, and 11 ET patients. ITs were found to be a prevalent symptom in all three disorders (32.6% of PD, 35.9% of MS, and 54.5% of ET subjects reported experiencing ITs). ITs were found to be associated both with the subjects' perceived levels of anxiety and the presence of visible tremors. ITs appear to be a common symptom in all three disorders studied. These results need to be confirmed and compared to appropriate control populations. Copyright © 2015. Published by Elsevier Ltd.

  16. Range dependent characteristics in the head-related transfer functions of a bat-head cast: part 2. Binaural characteristics

    International Nuclear Information System (INIS)

    Kim, S; Allen, R; Rowan, D

    2012-01-01

    Further innovations in bio-inspired engineering based on biosonar systems, such as bats, may arise from more detailed understanding of the underlying acoustic processes. This includes the range-dependent properties of bat heads and ears, particularly at the higher frequencies of bat vocalizations. In a companion paper Kim et al (2012 Bioinspir. Biomim.), range-dependent head-related transfer functions of a bat head cast were investigated up to 100 kHz at either ear (i.e. monaural features). The current paper extends this to consider range-dependent spectral and temporal disparities between the two ears (i.e. binaural features), using experimental data and a spherical model of a bat head to provide insights into the physical basis for these features. It was found that binaural temporal and high-frequency binaural spectral features are approximately independent of distance, having the effect of decreasing their angular resolution at close range. In contrast, low-frequency binaural spectral features are strongly distance-dependent, such that angular sensitivity can be maintained by lowering the frequency of the echolocation emission at close range. Together with the companion paper Kim et al, we speculate that distance-dependent low-frequency monaural and binaural features at short range might help explain why some species of bats that drop the frequency of their calls on target approach while approaching a target. This also provides an impetus for the design of effective emissions in sonar engineering applied to similar tasks. (paper)

  17. Neural correlates of dystonic tremor: A multimodal study of voice tremor in spasmodic dysphonia

    Science.gov (United States)

    Kirke, Diana N.; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

    2016-01-01

    Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous, as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions. PMID:26843004

  18. Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia.

    Science.gov (United States)

    Kirke, Diana N; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

    2017-02-01

    Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions.

  19. Study of medicines’ market for the treatment of seborrheic dermatitis of the pilar part of head

    Directory of Open Access Journals (Sweden)

    V. A. Solodovnik

    2018-03-01

    Full Text Available Modern arsenal of medicines and cosmetics used for the therapy of seborrheic dermatitis of the pilar part of head is various enough. Today pharmaceutical market keeps developing and constitutes a complex system that causes the necessity of its investigation and forming the informational base concerning the dynamics of assortment, prices and availability of medicines. The aim of work is forming the informational file about medicines and cosmetics which are used in treatment of seborrheic dermatitis of the pilar part of head and advisability substantiation of the creation of new medication with Octopirox on the base of marketing analysis. Materials and methods. As informative materials we used: the State register of medications of Ukraine; reference book of medications «Compendium on-line»; internet resources on the search of medications in the pharmacies of Ukraine “GeoApteka” and “Tabletki.ua”. A marketing method, monitoring methods, logical generalization, groupment and graphic methods were applied in-process of research. Results. Complex marketing evaluation of the Ukrainian pharmaceutical market of medications used for the therapy of seborrheic dermatitis of the pilar part of head was carried out taking into account heterogeneous structure in two trends: medicines and cosmetics. Conclusion. Modern arsenal of medicines was organized in two trends: segment of medicines consists of 26 medications of D01A subgroup “Antifungals for topical use” and D11A subgroup “Other dermatologic medications”; “КС” segment has 71 cosmetics (cosmetics with Octopirox prevail – 12 propositions. In form of making, the liquids prevail – shampoo, tonics, solutions, serums. All tools concerning “Order of dispensing” are available without a prescription but before their using the doctor's advice taking into account individuality of each patient is needed. The analyzable market segment is characterized by the deficiency of combined drugs

  20. [Speech-related tremor of lips: a focal task-specific tremor].

    Science.gov (United States)

    Morita, Shuhei; Takagi, Rieko; Miwa, Hideto; Kondo, Tomoyoshi

    2002-04-01

    We report a 66-year-old Japanese woman in whom tremor of lips appeared during speech. Her past and family histories were unremarkable. On neurological examination, there was no abnormal finding except the lip tremor. Results of laboratory findings were all within normal levels. Her MRI and EEG were normal. Surface EMG studies revealed that regular grouped discharges at a frequency of about 4-5 Hz appeared in the orbicularis oris muscle only during voluntary speaking. The tremor was not observed under conditions of a purposeless phonation or a vocalization of a simple word, suggesting that the tremor was not a vocal tremor but a task-specific tremor related to speaking. Administration of a beta-blocker and consumption of small amount of alcohol could effectively improve the tremor, possibly suggesting that this type of tremor might be a clinical variant of essential tremor.

  1. Sonography, CT and MR in soft part growths in the head and neck region

    International Nuclear Information System (INIS)

    Brinkmann, G.; Brix, F.; Beigel, A.

    1990-01-01

    14 patients with a space-occupying growth in the head and neck region were examined via sonography, CT and MR to explore and demonstrate by means of a prospective comparative study the possibilities offered by these three imaging methods. Stages are best diagnosed by means of sonography; the leading role of this method is undisputed. To clarify sonographically unclear findings and especially in pre-surgery planning, MR offers advantages over CT on account of the high soft-part contrast and multiplanar visualisation. However, it is impossible or very difficult to differentiate abscesses and lymphadenitides from malignant growths with these three methods solely on the basis of image-morphological criteria. (orig.) [de

  2. Resistor mesh model of a spherical head: part 2: a review of applications to cortical mapping.

    Science.gov (United States)

    Chauveau, N; Morucci, J P; Franceries, X; Celsis, P; Rigaud, B

    2005-11-01

    A resistor mesh model (RMM) has been validated with reference to the analytical model by consideration of a set of four dipoles close to the cortex. The application of the RMM to scalp potential interpolation was detailed in Part 1. Using the RMM and the same four dipoles, the different methods of cortical mapping were compared and have shown the potentiality of this RMM for obtaining current and potential cortical distributions. The lead-field matrices are well-adapted tools, but the use of a square matrix of high dimension does not permit the inverse solution to be improved in the presence of noise, as a regularisation technique is necessary with noisy data. With the RMM, the transfer matrix and the cortical imaging technique proved to be easy to implement. Further development of the RMM will include application to more realistic head models with more accurate conductivities.

  3. Harmaline Tremor: Underlying Mechanisms in a Potential Animal Model of Essential Tremor

    Directory of Open Access Journals (Sweden)

    Adrian Handforth

    2012-09-01

    Full Text Available Background: Harmaline and harmine are tremorigenic β-carbolines that, on administration to experimental animals, induce an acute postural and kinetic tremor of axial and truncal musculature. This drug-induced action tremor has been proposed as a model of essential tremor. Here we review what is known about harmaline tremor.Methods: Using the terms harmaline and harmine on PubMed, we searched for papers describing the effects of these β-carbolines on mammalian tissue, animals, or humans.Results: Investigations over four decades have shown that harmaline induces rhythmic burst-firing activity in the medial and dorsal accessory inferior olivary nuclei that is transmitted via climbing fibers to Purkinje cells and to the deep cerebellar nuclei, then to brainstem and spinal cord motoneurons. The critical structures required for tremor expression are the inferior olive, climbing fibers, and the deep cerebellar nuclei; Purkinje cells are not required. Enhanced synaptic norepinephrine or blockade of ionic glutamate receptors suppresses tremor, whereas enhanced synaptic serotonin exacerbates tremor. Benzodiazepines and muscimol suppress tremor. Alcohol suppresses harmaline tremor but exacerbates harmaline-associated neural damage. Recent investigations on the mechanism of harmaline tremor have focused on the T-type calcium channel.Discussion: Like essential tremor, harmaline tremor involves the cerebellum, and classic medications for essential tremor have been found to suppress harmaline tremor, leading to utilization of the harmaline model for preclinical testing of antitremor drugs. Limitations are that the model is acute, unlike essential tremor, and only approximately half of the drugs reported to suppress harmaline tremor are subsequently found to suppress tremor in clinical trials.

  4. Using Portable Transducers to Measure Tremor Severity

    Directory of Open Access Journals (Sweden)

    Rodger Elble

    2016-05-01

    Full Text Available Background: Portable motion transducers, suitable for measuring tremor, are now available at a reasonable cost. The use of these transducers requires knowledge of their limitations and data analysis. The purpose of this review is to provide a practical overview and example software for using portable motion transducers in the quantification of tremor. Methods: Medline was searched via PubMed.gov in December 2015 using the Boolean expression “tremor AND (accelerometer OR accelerometry OR gyroscope OR inertial measurement unit OR digitizing tablet OR transducer.” Abstracts of 419 papers dating back to 1964 were reviewed for relevant portable transducers and methods of tremor analysis, and 105 papers written in English were reviewed in detail. Results: Accelerometers, gyroscopes, and digitizing tablets are used most commonly, but few are sold for the purpose of measuring tremor. Consequently, most software for tremor analysis is developed by the user. Wearable transducers are capable of recording tremor continuously, in the absence of a clinician. Tremor amplitude, frequency, and occurrence (percentage of time with tremor can be computed. Tremor amplitude and occurrence correlate strongly with clinical ratings of tremor severity. Discussion: Transducers provide measurements of tremor amplitude that are objective, precise, and valid, but the precision and accuracy of transducers are mitigated by natural variability in tremor amplitude. This variability is so great that the minimum detectable change in amplitude, exceeding random variability, is comparable for scales and transducers. Research is needed to determine the feasibility of detecting smaller change using averaged data from continuous long-term recordings with wearable transducers.

  5. Olfaction and essential tremor Olfato no tremor essencial

    Directory of Open Access Journals (Sweden)

    Lucas Barasnevicius Quagliato

    2009-03-01

    Full Text Available OBJECTIVE: To characterize the olfactory identification in 40 essential tremor (ET patients, with the University of Pennsylvania 12 Smell Identification Test (UPSIT, to correlate UPSIT scores to clinical and epidemiological data and to compare it to 89 aged matched controls. METHOD: Patients were assessed using ET Clinical Scale of Evaluation and UPSIT. RESULTS: In patients with ET, the UPSIT medium score was 9.10, similar to the control group (9.11, which was also observed in all age groups. ET severity did not correlate to UPSIT scores. CONCLUSION: This study demonstrated normality of olfactory identification on ET, qualifying UPSIT to be an important tool on tremor differential diagnosis of undetermined origin.OBJETIVO: Caracterizar a identificação olfatória em 40 pacientes com tremor essencial, através do Teste de Identificação de 12 Cheiros da Universidade de Pensilvânia (TICUP, correlacioná-la aos dados clínicos e epidemiológicos e compará-la com 89 indivíduos normais. MÉTODO: Os pacientes foram avaliados com a Escala Clínica de Avaliação do TE e com o TICUP. RESULTADOS: A média de acertos no TICUP nos pacientes com TE foi 9,10, semelhante à do grupo controle (9,11, sendo isso observado em todas as faixas etárias. A gravidade do TE não se correlacionou com o resultado do TICUP. CONCLUSÃO: Este estudo demonstrou normalidade da identificação olfatória no TE, qualificando o TICUP como ferramenta importante no diagnóstico diferencial dos tremores de causa indeterminada.

  6. Numerical Simulation and Validation of a High Head Model Francis Turbine at Part Load Operating Condition

    Science.gov (United States)

    Goyal, Rahul; Trivedi, Chirag; Kumar Gandhi, Bhupendra; Cervantes, Michel J.

    2017-07-01

    Hydraulic turbines are operated over an extended operating range to meet the real time electricity demand. Turbines operated at part load have flow parameters not matching the designed ones. This results in unstable flow conditions in the runner and draft tube developing low frequency and high amplitude pressure pulsations. The unsteady pressure pulsations affect the dynamic stability of the turbine and cause additional fatigue. The work presented in this paper discusses the flow field investigation of a high head model Francis turbine at part load: 50% of the rated load. Numerical simulation of the complete turbine has been performed. Unsteady pressure pulsations in the vaneless space, runner, and draft tube are investigated and validated with available experimental data. Detailed analysis of the rotor stator interaction and draft tube flow field are performed and discussed. The analysis shows the presence of a rotating vortex rope in the draft tube at the frequency of 0.3 times of the runner rotational frequency. The frequency of the vortex rope precession, which causes severe fluctuations and vibrations in the draft tube, is predicted within 3.9% of the experimental measured value. The vortex rope results pressure pulsations propagating in the system whose frequency is also perceive in the runner and upstream the runner.

  7. Differential Diagnosis of Parkinson Disease, Essential Tremor, and Enhanced Physiological Tremor with the Tremor Analysis of EMG

    Directory of Open Access Journals (Sweden)

    Jie Zhang

    2017-01-01

    Full Text Available We investigate the differential diagnostic value of tremor analysis of EMG on Parkinson’s disease (PD, essential tremor (ET, and enhanced physiological tremor (EPT. Clinical data from 25 patients with PD, 20 patients with ET, and 20 patients with EPT were collected. The tremor frequency and muscle contraction pattern of the resting, posture, and 500 g and 1000 g overload were recorded. The frequency of PD tremor was 4–6 Hz, and the frequency of ET was also in this range; the frequency of EPT is 6–12 hz having some overlap with PD. The muscle contraction patterns of the ET and EPT group were mainly synchronous contraction, and the muscle contraction mode of the PD group was mainly alternating contraction. Having tremor latency from rest to postural position and having changes in tremor amplitude after mental concentration in PD might distinguish ET. Tremor analysis of EMG was able to distinguish PD from ET and EPT by varying the tremor frequency and muscle contraction pattern. It can also differentiate between PD and ET by the latency and concentration effect and ET and EPT by weight load effect.

  8. Characterizing Orthostatic Tremor Using a Smartphone Application

    Directory of Open Access Journals (Sweden)

    Arjun Balachandar

    2017-07-01

    Full Text Available Background: Orthostatic tremor is one of the few tremor conditions requiring an electromyogram for definitive diagnosis since leg tremor might not be visible to the naked eye.Phenomenology Shown: An iOS application (iSeismometer, ObjectGraph LLC, New York using an Apple iPhone 5 (Cupertino, CA, USA inserted into the patient’s sock detected a tremor with a frequency of 16.4 Hz on both legs.Educational Value: The rapid and straightforward accelerometer-based recordings accomplished in this patient demonstrate the ease with which quantitative analysis of orthostatic tremor can be conducted and, importantly, demonstrates the potential application of this approach in the assessment of any lower limb tremor

  9. Control of lithium tremor with propranolol.

    Science.gov (United States)

    Lapierre, Y D

    1976-04-03

    Lithium tremor is an irregular, nonrhythmic tremor of the distal extremities, variable in both intensity and frequency. It is clinically differentiated from essential tremor and tremors due to anxiety and neuroleptics. The pathophysiologic mechanisms are hypothesized to be of perpheral origin. Five patients were successfully treated with propranolol. In general, the dosage of propranolol must be individually adjusted and is usually from 30 to 40 mg daily in divided doses. This blocker of beta-adrenergic receptors remains effective with long-term administration and increases in dosage are not required.

  10. Differences in striatal dopamine transporter density between tremor dominant and non-tremor Parkinson's disease

    International Nuclear Information System (INIS)

    Kaasinen, Valtteri; Kinos, Maija; Joutsa, Juho; Seppaenen, Marko; Noponen, Tommi

    2014-01-01

    Parkinson's disease (PD) can manifest with a tremor-dominant or a non-tremor (akinetic-rigid) phenotype. Although the tremor-dominant subtype may show a better prognosis, there is limited information on the phenotypic differences regarding the level of striatal dopamine transmission. The present study investigated striatal dopamine transporter (DAT) binding characteristics in a large sample of patients with and without tremor. [ 123 I]FP-CIT SPECT scans of 231 patients with a clinical diagnosis of PD and abnormal FP-CIT binding (157 with tremor, 74 without tremor) and 230 control patients with normal FP-CIT binding (148 with tremor, 82 without tremor) were analysed using an automated region-of-interest analysis of the scans (BRASS). Specific striatal binding ratios were compared between phenotypes and groups using age, sex, and symptom duration, predominant side of symptoms, dopaminergic medications and scanner as covariates. Patients with PD had 28.1 - 65.0 % lower binding in all striatal regions compared to controls (p < 0.001). The mean FP-CIT caudate nucleus uptake and the left caudate nucleus uptake were higher in PD patients with tremor than in PD patients without tremor (mean 9.0 % higher, left 10.5 % higher; p < 0.05), whereas there were no differences between tremor and non-tremor control patients. No significant effects of tremor on DAT binding were observed in the anterior or posterior putamen. The motor phenotype is associated with the extent of caudate dopamine terminal loss in PD, as dopamine function is relatively more preserved in tremor patients. Symptom type is related to caudate dopamine function only in association with Parkinsonian dopaminergic degeneration, not in intact dopamine systems in patients with non-PD tremor. (orig.)

  11. Seismic wave triggering of nonvolcanic tremor, episodic tremor and slip, and earthquakes on Vancouver Island

    Science.gov (United States)

    Rubinstein, Justin L.; Gomberg, Joan; Vidale, John E.; Wech, Aaron G.; Kao, Honn; Creager, Kenneth C.; Rogers, Garry

    2009-02-01

    We explore the physical conditions that enable triggering of nonvolcanic tremor and earthquakes by considering local seismic activity on Vancouver Island, British Columbia during and immediately after the arrival of large-amplitude seismic waves from 30 teleseismic and 17 regional or local earthquakes. We identify tremor triggered by four of the teleseismic earthquakes. The close temporal and spatial proximity of triggered tremor to ambient tremor and aseismic slip indicates that when a fault is close to or undergoing failure, it is particularly susceptible to triggering of further events. The amplitude of the triggering waves also influences the likelihood of triggering both tremor and earthquakes such that large amplitude waves triggered tremor in the absence of detectable aseismic slip or ambient tremor. Tremor and energy radiated from regional/local earthquakes share the same frequency passband so that tremor cannot be identified during these smaller, more frequent events. We confidently identify triggered local earthquakes following only one teleseism, that with the largest amplitude, and four regional or local events that generated vigorous aftershock sequences in their immediate vicinity. Earthquakes tend to be triggered in regions different from tremor and with high ambient seismicity rates. We also note an interesting possible correlation between large teleseismic events and episodic tremor and slip (ETS) episodes, whereby ETS events that are "late" and have built up more stress than normal are susceptible to triggering by the slight nudge of the shaking from a large, distant event, while ETS events that are "early" or "on time" are not.

  12. Triggered tremor sweet spots in Alaska

    Science.gov (United States)

    Gomberg, Joan; Prejean, Stephanie

    2013-01-01

    To better understand what controls fault slip along plate boundaries, we have exploited the abundance of seismic and geodetic data available from the richly varied tectonic environments composing Alaska. A search for tremor triggered by 11 large earthquakes throughout all of seismically monitored Alaska reveals two tremor “sweet spots”—regions where large-amplitude seismic waves repeatedly triggered tremor between 2006 and 2012. The two sweet spots locate in very different tectonic environments—one just trenchward and between the Aleutian islands of Unalaska and Akutan and the other in central mainland Alaska. The Unalaska/Akutan spot corroborates previous evidence that the region is ripe for tremor, perhaps because it is located where plate-interface frictional properties transition between stick-slip and stably sliding in both the dip direction and laterally. The mainland sweet spot coincides with a region of complex and uncertain plate interactions, and where no slow slip events or major crustal faults have been noted previously. Analyses showed that larger triggering wave amplitudes, and perhaps lower frequencies (tremor. However, neither the maximum amplitude in the time domain or in a particular frequency band, nor the geometric relationship of the wavefield to the tremor source faults alone ensures a high probability of triggering. Triggered tremor at the two sweet spots also does not occur during slow slip events visually detectable in GPS data, although slow slip below the detection threshold may have facilitated tremor triggering.

  13. Treatment of lithium induced tremor with atenolol.

    Science.gov (United States)

    Davé, M

    1989-03-01

    This is the first report on the successful treatment of one patient with lithium induced tremor with hydrophilic atenolol, which is a relatively selective beta 1 adrenergic receptor blocker. Atenolol's advantages over lipophilic beta blockers in the treatment of lithium induced tremor are discussed.

  14. Holmes’ Tremor with Shoulder Pain Treated by Deep Brain Stimulation of Unilateral Ventral Intermediate Thalamic Nucleus and Globus Pallidus Internus

    Directory of Open Access Journals (Sweden)

    Sabri Aydın

    2017-05-01

    Full Text Available A 21-year-old male was admitted with severe right arm and hand tremors after a thalamic hemorrhage caused by a traffic accident. He was also suffering from agonizing pain in his right shoulder that manifested after the tremor. Neurologic examination revealed a disabling, severe, and irregular kinetic and postural tremor in the right arm during target-directed movements. There was also an irregular ipsilateral rest tremor and dystonic movements in the distal part of the right arm. The amplitude was moderate at rest and extremely high during kinetic and intentional movements. The patient underwent left globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. The patient improved by more than 80% as rated by the Fahn-Tolosa-Marin Tremor Rating Scale and Visual Analog Scale six months after surgery.

  15. Development of Tremor Suppression Control System Using Adaptive Filter and Its Application to Meal-assist Robot

    Science.gov (United States)

    Yano, Ken'ichi; Ohara, Eiichi; Horihata, Satoshi; Aoki, Takaaki; Nishimoto, Yutaka

    A robot that supports independent living by assisting with eating and other activities which use the operator's own hand would be helpful for people suffering from tremors of the hand or any other body part. The proposed system using adaptive filter estimates tremor frequencies with a time-varying property and individual differences online. In this study, the estimated frequency is used to adjusting the tremor suppression filter which insulates the voluntary motion signal from the sensor signal containing tremor components. These system are integrated into the control system of the Meal-Assist Robot. As a result, the developed system makes it possible for the person with a tremor to manipulate the supporting robot without causing operability to deteriorate and without hazards due to improper operation.

  16. Afterslip, tremor, and the Denali fault earthquake

    Science.gov (United States)

    Gomberg, Joan; Prejean, Stephanie; Ruppert, Natalia

    2012-01-01

    We tested the hypothesis that afterslip should be accompanied by tremor using observations of seismic and aseismic deformation surrounding the 2002 M 7.9 Denali fault, Alaska, earthquake (DFE). Afterslip happens more frequently than spontaneous slow slip and has been observed in a wider range of tectonic environments, and thus the existence or absence of tremor accompanying afterslip may provide new clues about tremor generation. We also searched for precursory tremor, as a proxy for posited accelerating slip leading to rupture. Our search yielded no tremor during the five days prior to the DFE or in several intervals in the three months after. This negative result and an array of other observations all may be explained by rupture penetrating below the presumed locked zone into the frictional transition zone. While not unique, such an explanation corroborates previous models of megathrust and transform earthquake ruptures that extend well into the transition zone.

  17. Locating non-volcanic tremor along the San Andreas Fault using a multiple array source imaging technique

    Science.gov (United States)

    Ryberg, T.; Haberland, C.H.; Fuis, G.S.; Ellsworth, W.L.; Shelly, D.R.

    2010-01-01

    Non-volcanic tremor (NVT) has been observed at several subduction zones and at the San Andreas Fault (SAF). Tremor locations are commonly derived by cross-correlating envelope-transformed seismic traces in combination with source-scanning techniques. Recently, they have also been located by using relative relocations with master events, that is low-frequency earthquakes that are part of the tremor; locations are derived by conventional traveltime-based methods. Here we present a method to locate the sources of NVT using an imaging approach for multiple array data. The performance of the method is checked with synthetic tests and the relocation of earthquakes. We also applied the method to tremor occurring near Cholame, California. A set of small-aperture arrays (i.e. an array consisting of arrays) installed around Cholame provided the data set for this study. We observed several tremor episodes and located tremor sources in the vicinity of SAF. During individual tremor episodes, we observed a systematic change of source location, indicating rapid migration of the tremor source along SAF. ?? 2010 The Authors Geophysical Journal International ?? 2010 RAS.

  18. Electrophysiologic characteristics of tremor in Parkinson?s disease and essential tremor

    Directory of Open Access Journals (Sweden)

    Ederson Cichaczewski

    2014-04-01

    Full Text Available Tremor in essential tremor (ET and Parkinson’s disease (PD usually present specific electrophysiologic profiles, however amplitude and frequency may have wide variations. Objective: To present the electrophysiologic findings in PD and ET. Method: Patients were assessed at rest, with posture and action. Seventeen patients with ET and 62 with PD were included. PD cases were clustered into three groups: predominant rest tremor; tremor with similar intensity at rest, posture and during kinetic task; and predominant kinetic tremor. Results: Patients with PD presented tremors with average frequency of 5.29±1.18 Hz at rest, 5.79±1.39 Hz with posture and 6.48±1.34 Hz with the kinetic task. Tremor in ET presented with an average frequency of 5.97±1.1 Hz at rest, 6.18±1 Hz with posture and 6.53±1.2 Hz with kinetic task. Seven (41.2% also showed rest tremor. Conclusion: The tremor analysis alone using the methodology described here, is not sufficient to differentiate tremor in ET and PD.

  19. Essential Tremor: A Neurodegenerative Disease?

    Directory of Open Access Journals (Sweden)

    Julian Benito-Leon

    2014-07-01

    Full Text Available Background: Essential tremor (ET is one of the most common neurological disorders among adults, and is the most common of the many tremor disorders. It has classically been viewed as a benign monosymptomatic condition, yet over the past decade, a growing body of evidence indicates that ET is a progressive condition that is clinically heterogeneous, as it may be associated with a spectrum of clinical features, with both motor and non‐motor elements. In this review, I will describe the most significant emerging milestones in research which, when taken together, suggest that ET is a neurodegenerative condition.Methods: A PubMed search conducted in June 2014 crossing the terms “essential tremor” (ET and “neurodegenerative” yielded 122 entries, 20 of which included the term “neurodegenerative” in the article title. This was supplemented by articles in the author's files that pertained to this topic.Results/Discussion: There is an open and active dialogue in the medical community as to whether ET is a neurodegenerative disease, with considerable evidence in favor of this. Specifically, ET is a progressive disorder of aging associated with neuronal loss (reduction in Purkinje cells as well as other post‐mortem changes that occur in traditional neurodegenerative disorders. Along with this, advanced neuroimaging techniques are now demonstrating distinct structural changes, several of which are consistent with neuronal loss, in patients with ET. However, further longitudinal clinical and neuroimaging longitudinal studies to assess progression are required.

  20. Beta 1 versus nonselective blockade in therapy of essential tremor.

    Science.gov (United States)

    Larsen, T A; Teräväinen, H

    1983-01-01

    The beta 1-selective blocker metoprolol was compared to propranolol and a placebo in a double-blind crossover trial in 24 patients with essential tremor. Both beta blockers suppressed the essential tremor, but metoprolol, which caused a mean reduction of 32.0% in tremor intensity from the base-line value, was less effective than propranolol, which reduced mean tremor intensity by 41.3%. Subjective benefit for their tremor was found by 15 of the patients taking propranolol and by one taking metoprolol. The tremor frequency was not affected. No serious side effects were observed. Metoprolol may offer an alternative for those essential tremor patients who cannot tolerate propranolol.

  1. Triggered creep as a possible mechanism for delayed dynamic triggering of tremor and earthquakes

    Science.gov (United States)

    Shelly, David R.; Peng, Zhigang; Hill, David P.; Aiken, Chastity

    2011-01-01

    The passage of radiating seismic waves generates transient stresses in the Earth's crust that can trigger slip on faults far away from the original earthquake source. The triggered fault slip is detectable in the form of earthquakes and seismic tremor. However, the significance of these triggered events remains controversial, in part because they often occur with some delay, long after the triggering stress has passed. Here we scrutinize the location and timing of tremor on the San Andreas fault between 2001 and 2010 in relation to distant earthquakes. We observe tremor on the San Andreas fault that is initiated by passing seismic waves, yet migrates along the fault at a much slower velocity than the radiating seismic waves. We suggest that the migrating tremor records triggered slow slip of the San Andreas fault as a propagating creep event. We find that the triggered tremor and fault creep can be initiated by distant earthquakes as small as magnitude 5.4 and can persist for several days after the seismic waves have passed. Our observations of prolonged tremor activity provide a clear example of the delayed dynamic triggering of seismic events. Fault creep has been shown to trigger earthquakes, and we therefore suggest that the dynamic triggering of prolonged fault creep could provide a mechanism for the delayed triggering of earthquakes. ?? 2011 Macmillan Publishers Limited. All rights reserved.

  2. Nontraumatic head and neck emergencies: a clinical approach. Part 1: cervicofacial swelling, dysphagia, and dyspnea.

    Science.gov (United States)

    Brea Álvarez, B; Tuñón Gómez, M; Esteban García, L; García Hidalgo, C Y; Ruiz Peralbo, R M

    2016-01-01

    Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons: first, they affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Various publications focus on nontraumatic emergencies of the head and neck from the viewpoints of anatomic location or of particular diseases. However, these are not the most helpful viewpoints for dealing with patients in the emergency department, who present with particular signs and symptoms. We propose an analysis starting from the four most common clinical presentations of patients who come to the emergency department for nontraumatic head and neck emergencies: cervical swelling, dysphagia, dyspnea, and loss of vision. Starting from these entities, we develop an approach to the radiologic management and diagnosis of these patients. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Bilateral Hypertrophic Olivary Degeneration and Holmes Tremor without Palatal Tremor: An Unusual Association

    Directory of Open Access Journals (Sweden)

    Carlos Cosentino

    2016-07-01

    Full Text Available Background: Lesions in the Guillain–Mollaret triangle or dentate-rubro-olivary pathway may lead to hypertrophic olivary degeneration (HOD, a secondary trans-synaptic degeneration of the inferior olivary nucleus. HOD is usually associated with palatal tremor and rarely with Holmes tremor. Bilateral HOD is a very unusual condition and very few cases are reported. Case Report: We report here two cases of bilateral HOD after two different vascular lesions located at the decussation of superior cerebellar peduncles, thus impairing both central tegmental tracts and interrupting bilaterally the dentate-rubral-olivary pathway. Interestingly, both developed bilateral Holmes tremor but not palatal tremor. Discussion: Lesions in some of the components in the Guillain–Mollaret triangle may develop Holmes tremor with HOD and without palatal tremor. Magnetic resonance imaging is an invaluable tool in these cases. Better understanding of the pathways in this loop is needed.

  4. [Disappearance of essential neck tremor after pontine base infarction].

    Science.gov (United States)

    Urushitani, M; Inoue, H; Kawamura, K; Kageyama, T; Fujisawa, M; Nishinaka, K; Udaka, F; Kameyama, M

    1996-08-01

    Mechanism of essential tremor remains unknown. Central oscillators, postulated in thalamus, inferior olive, and spinal cord are thought to be important to form rhythmicity, and finally to stimulate spinal or medullary motor cells, leading trembling muscle contraction, tremor. Among several subtypes of essential familial tremor, including hand tremor, neck tremor, and voice tremor, essential neck tremor is a common disorder, and its pathophysiology seems different from that of typical essential hand tremor, since patients with essential hand tremor are responsive to beta blocker, whereas those with neck tremor are usually not. We experienced a 41-year-old left handed woman with essential neck tremor in whom neck titubation disappeared shortly after pontine base infarct. She was our patient in the outpatient clinic with the diagnosis of essential neck tremor. The tremor developed when she was teenage, and has been localized in the neck muscles. Alcohol intake had apparently diminished it transiently. Her mother also had the tremor in her neck. She was admitted to our hospital with sudden onset of right-sided limb weakness and speech disturbance. Neurological examination showed right hemiparesis including the ipsilateral face, scanning speech, and cerebellar limb ataxia on the same side. In addition, there was no tremor in her neck. Brain MR imaging revealed a pontine base infarct at the level of middle pons, which was consistent with paramedian artery territory. The hemiparesis and speech disturbance improved almost completely after treatment, and her neck tremor has never occurred in one year follow-up. In our patient, efficacy of alcohol imply that essential neck tremor and hand tremor had same central nervous pathway including central oscillator in common, and descending cortical fibers is seemingly associated with diminishing patient's tremor. Pathophysiology of essential neck tremor was discussed with reviewing previous literature.

  5. HYPERTRANSLATION OF THE HEAD BACKWARDS - PART OF THE MECHANISM OF CERVICAL WHIPLASH INJURY

    NARCIS (Netherlands)

    PENNING, L

    Based upon a review of the literature, a theory is developed that in whiplash injury the primary mechanism of the trauma is not hyperretroflexion but hypertranslation of the head backwards. Thus a hyperanteflexion (not hyperretroflexion) of the upper cervical spine, probably especially of the

  6. Electrophysiologic Assessments of Involuntary Movements: Tremor and Myoclonus

    Directory of Open Access Journals (Sweden)

    Hyun-Dong Park

    2009-05-01

    Full Text Available Tremor is defined as a rhythmical, involuntary oscillatory movement of a body part. Although neurological examination reveals information regarding its frequency, regularity, amplitude, and activation conditions, the electrophysiological investigations help in confirming the tremor, in differentiating it from other hyperkinetic disorders like myoclonus, and may provide etiological clues. Accelerometer with surface electromyogram (EMG can be used to document the dominant frequency of a tremor, which may be useful as certain frequencies are more characteristic of specific etiologies than others hyperkinetic disorders. It may show rhythmic bursts, duration and activation pattern (alternating or synchronous. Myoclonus is a quick, involuntary movement. Electrophysiological studies may helpful in the evaluation of myoclonus, not only for confirming the clinical diagnosis but also for understanding the underlying physiological mechanisms. Electroencephalogram (EEG-EMG correlates can give us important information about myoclonus. Jerk-locked back-averaging and evoked potentials with recording of the long-latency, long-loop reflexes are currently available to study the pathophysiology of myoclonus.

  7. Autosomal dominant cortical tremor, myoclonus and epilepsy.

    Science.gov (United States)

    Striano, Pasquale; Zara, Federico

    2016-09-01

    The term 'cortical tremor' was first introduced by Ikeda and colleagues to indicate a postural and action-induced shivering movement of the hands which mimics essential tremor, but presents with the electrophysiological findings of cortical reflex myoclonus. The association between autosomal dominant cortical tremor, myoclonus and epilepsy (ADCME) was first recognized in Japanese families and is now increasingly reported worldwide, although it is described using different acronyms (BAFME, FAME, FEME, FCTE and others). The disease usually takes a benign course, although drug-resistant focal seizures or slight intellectual disability occur in some cases. Moreover, a worsening of cortical tremor and myoclonus is common in advanced age. Although not yet recognized by the International League Against Epilepsy (ILAE), this is a well-delineated epilepsy syndrome with remarkable features that clearly distinguishes it from other myoclonus epilepsies. Moreover, genetic studies of these families show heterogeneity and different susceptible chromosomal loci have been identified.

  8. Cataloging tremor at Kilauea Volcano, Hawaii

    Science.gov (United States)

    Thelen, W. A.; Wech, A.

    2013-12-01

    Tremor is a ubiquitous seismic feature on Kilauea volcano, which emanates from at least three distinct sources. At depth, intermittent tremor and earthquakes thought to be associated with the underlying plumbing system of Kilauea (Aki and Koyanagi, 1981) occurs approximately 40 km below and 40 km SW of the summit. At the summit of the volcano, nearly continuous tremor is recorded close to a persistently degassing lava lake, which has been present since 2008. Much of this tremor is correlated with spattering at the lake surface, but tremor also occurs in the absence of spattering, and was observed at the summit of the volcano prior to the appearance of the lava lake, predominately in association with inflation/deflation events. The third known source of tremor is in the area of Pu`u `O`o, a vent that has been active since 1983. The exact source location and depth is poorly constrained for each of these sources. Consistently tracking the occurrence and location of tremor in these areas through time will improve our understanding of the plumbing geometry beneath Kilauea volcano and help identify precursory patterns in tremor leading to changes in eruptive activity. The continuous and emergent nature of tremor precludes the use of traditional earthquake techniques for automatic detection and location of seismicity. We implement the method of Wech and Creager (2008) to both detect and localize tremor seismicity in the three regions described above. The technique uses an envelope cross-correlation method in 5-minute windows that maximizes tremor signal coherency among seismic stations. The catalog is currently being built in near-realtime, with plans to extend the analysis to the past as time and continuous data availability permits. This automated detection and localization method has relatively poor depth constraints due to the construction of the envelope function. Nevertheless, the epicenters distinguish activity among the different source regions and serve as

  9. What is This Thing Called Tremor?

    Science.gov (United States)

    Rubin, A. M.; Bostock, M. G.

    2017-12-01

    Tremor has many enigmatic attributes. The LFEs that comprise it have a dearth of large events, implying a characteristic scale. Bostock et al. (2015) found LFE duration beneath Vancouver Island to be nearly independent of magnitude. That duration ( 0.4 s), multiplied by a shear wave speed, defines a length scale far larger than the spatial separation between consecutive but non-colocated detections. If one LFE ruptures multiple brittle patches in a ductile matrix its propagation speed can be slowed to the extent that consecutive events don't overlap, but then why aren't there larger and smaller LFEs with larger and smaller durations? Perhaps there are. Tremor seismograms from Vancouver Island are often saturated with direct arrivals, by which we mean time lags between events shorter than typical event durations. Direct evidence of this, given the small coda amplitude of LFE stacks, is that seismograms at stations many kilometers apart often track each other wiggle for wiggle. We see this behavior over the full range tremor amplitudes, from close to the noise level on a tremor-free day to 10 times larger. If the LFE magnitude-frequency relation is time-independent, this factor of 10 implies that the LFE occurrence rate during loud tremor is 10^2=100 times that during quiet tremor (>250 LFEs per second). We investigate the implications of this by comparing observed seismograms to synthetics made from the superposition of "LFEs" that are Poissonian in time over a range of average rates. We find that provided the LFEs have a characteristic scale (whether exponential or power law), saturation completely obscures the moment-duration scaling of the contributing events; that is, the moment-duration scaling of LFEs may be identical to that of regular earthquakes. Nonetheless, there are subtle differences between our synthetics and real seismograms, remarkably independent of tremor amplitude, that remain to be explained. Foremost among these is a slightly greater affinity of

  10. Evaluation of precipitates used in strainer head loss testing. Part I. Chemically generated precipitates

    International Nuclear Information System (INIS)

    Bahn, Chi Bum; Kasza, Ken E.; Shack, William J.; Natesan, Ken; Klein, Paul

    2009-01-01

    The purpose of the current program was to evaluate the properties of chemical precipitates proposed by industry that have been used in sump strainer head loss testing. Specific precipitates that were evaluated included aluminum oxyhydroxide (AlOOH) and sodium aluminum silicate (SAS) prepared according to the procedures in WCAP-16530-NP, along with precipitates formed from injecting chemicals into the test loop according to the procedure used by one sump strainer test vendor for U.S. pressurized water reactors. The settling rates of the surrogate precipitates are strongly dependent on their particle size and are reasonably consistent with those expected from Stokes' Law or colloid aggregation models. Head loss tests showed that AlOOH and SAS surrogates are quite effective in increasing the head loss across a perforated pump inlet strainer that has an accumulated fibrous debris bed. The characteristics of aluminum hydroxide precipitate using sodium aluminate were dependent on whether it was formed in high-purity or ordinary tap water and whether excess silicate was present or not.

  11. Resistor mesh model of a spherical head: part 1: applications to scalp potential interpolation.

    Science.gov (United States)

    Chauveau, N; Morucci, J P; Franceries, X; Celsis, P; Rigaud, B

    2005-11-01

    A resistor mesh model (RMM) has been implemented to describe the electrical properties of the head and the configuration of the intracerebral current sources by simulation of forward and inverse problems in electroencephalogram/event related potential (EEG/ERP) studies. For this study, the RMM representing the three basic tissues of the human head (brain, skull and scalp) was superimposed on a spherical volume mimicking the head volume: it included 43 102 resistances and 14 123 nodes. The validation was performed with reference to the analytical model by consideration of a set of four dipoles close to the cortex. Using the RMM and the chosen dipoles, four distinct families of interpolation technique (nearest neighbour, polynomial, splines and lead fields) were tested and compared so that the scalp potentials could be recovered from the electrode potentials. The 3D spline interpolation and the inverse forward technique (IFT) gave the best results. The IFT is very easy to use when the lead-field matrix between scalp electrodes and cortex nodes has been calculated. By simple application of the Moore-Penrose pseudo inverse matrix to the electrode cap potentials, a set of current sources on the cortex is obtained. Then, the forward problem using these cortex sources renders all the scalp potentials.

  12. Modern molecular biomarkers of head and neck cancer. Part I. Epigenetic diagnostics and prognostics: Systematic review.

    Science.gov (United States)

    Juodzbalys, Gintaras; Kasradze, David; Cicciù, Marco; Sudeikis, Aurimas; Banys, Laurynas; Galindo-Moreno, Pablo; Guobis, Zygimantas

    2016-01-01

    Nearly half of the head and neck cancer cases are diagnosed in late stages. Traditional screening modalities have many disadvantages. The aim of the present article was to review the scientific literature about novel head and neck cancer diagnostics - epigenetic biomarkers. A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed database. Authors conducted the search of articles in English language published from 2004 to 2015. A total of thirty three relevant studies were included in the review. Fifteen of them concerned DNA methylation alterations, nine evaluation of abundancies in histone expressions and nine miRNA expression changes in HNC. Considerable number of epigenetic biomarkers have been identified in both tumor tissue and salivary samples. Genes with best diagnostic effectiveness rates and further studying prospects were: TIMP3, DCC, DAPK, CDH1, CCNA1, AIM1, MGMT, HIC1, PAX1, PAX5, ZIC4, p16, EDNRB, KIF1A, MINT31, CD44, RARβ , ECAD. Individual histone and miRNA alterations tend to be hnc specific. Prognostic values of separate biomarkers are ambiguous. No established standards for molecular assay of head and neck cancer was found in order to elude the paradoxical results and discrepancies in separate trials.

  13. Optimal digital filtering for tremor suppression.

    Science.gov (United States)

    Gonzalez, J G; Heredia, E A; Rahman, T; Barner, K E; Arce, G R

    2000-05-01

    Remote manually operated tasks such as those found in teleoperation, virtual reality, or joystick-based computer access, require the generation of an intermediate electrical signal which is transmitted to the controlled subsystem (robot arm, virtual environment, or a cursor in a computer screen). When human movements are distorted, for instance, by tremor, performance can be improved by digitally filtering the intermediate signal before it reaches the controlled device. This paper introduces a novel tremor filtering framework in which digital equalizers are optimally designed through pursuit tracking task experiments. Due to inherent properties of the man-machine system, the design of tremor suppression equalizers presents two serious problems: 1) performance criteria leading to optimizations that minimize mean-squared error are not efficient for tremor elimination and 2) movement signals show ill-conditioned autocorrelation matrices, which often result in useless or unstable solutions. To address these problems, a new performance indicator in the context of tremor is introduced, and the optimal equalizer according to this new criterion is developed. Ill-conditioning of the autocorrelation matrix is overcome using a novel method which we call pulled-optimization. Experiments performed with artificially induced vibrations and a subject with Parkinson's disease show significant improvement in performance. Additional results, along with MATLAB source code of the algorithms, and a customizable demo for PC joysticks, are available on the Internet at http:¿tremor-suppression.com.

  14. Psychogenic Tremor: A Video Guide to Its Distinguishing Features

    Directory of Open Access Journals (Sweden)

    Joseph Jankovic

    2014-08-01

    Full Text Available Background: Psychogenic tremor is the most common psychogenic movement disorder. It has characteristic clinical features that can help distinguish it from other tremor disorders. There is no diagnostic gold standard and the diagnosis is based primarily on clinical history and examination. Despite proposed diagnostic criteria, the diagnosis of psychogenic tremor can be challenging. While there are numerous studies evaluating psychogenic tremor in the literature, there are no publications that provide a video/visual guide that demonstrate the clinical characteristics of psychogenic tremor. Educating clinicians about psychogenic tremor will hopefully lead to earlier diagnosis and treatment. Methods: We selected videos from the database at the Parkinson's Disease Center and Movement Disorders Clinic at Baylor College of Medicine that illustrate classic findings supporting the diagnosis of psychogenic tremor.Results: We include 10 clinical vignettes with accompanying videos that highlight characteristic clinical signs of psychogenic tremor including distractibility, variability, entrainability, suggestibility, and coherence.Discussion: Psychogenic tremor should be considered in the differential diagnosis of patients presenting with tremor, particularly if it is of abrupt onset, intermittent, variable and not congruous with organic tremor. The diagnosis of psychogenic tremor, however, should not be simply based on exclusion of organic tremor, such as essential, parkinsonian, or cerebellar tremor, but on positive criteria demonstrating characteristic features. Early recognition and management are critical for good long-term outcome.

  15. Linking Essential Tremor to the Cerebellum-Animal Model Evidence.

    Science.gov (United States)

    Handforth, Adrian

    2016-06-01

    In this review, we hope to stimulate interest in animal models as opportunities to understand tremor mechanisms within the cerebellar system. We begin by considering the harmaline model of essential tremor (ET), which has ET-like anatomy and pharmacology. Harmaline induces the inferior olive (IO) to burst fire rhythmically, recruiting rhythmic activity in Purkinje cells (PCs) and deep cerebellar nuclei (DCN). This model has fostered the IO hypothesis of ET, which postulates that factors that promote excess IO, and hence PC complex spike synchrony, also promote tremor. In contrast, the PC hypothesis postulates that partial PC cell loss underlies tremor of ET. We describe models in which chronic partial PC loss is associated with tremor, such as the Weaver mouse, and others with PC loss that do not show tremor, such as the Purkinje cell degeneration mouse. We postulate that partial PC loss with tremor is associated with terminal axonal sprouting. We then discuss tremor that occurs with large lesions of the cerebellum in primates. This tremor has variable frequency and is an ataxic tremor not related to ET. Another tremor type that is not likely related to ET is tremor in mice with mutations that cause prolonged synaptic GABA action. This tremor is probably due to mistiming within cerebellar circuitry. In the final section, we catalog tremor models involving neurotransmitter and ion channel perturbations. Some appear to be related to the IO hypothesis of ET, while in others tremor may be ataxic or due to mistiming. In summary, we offer a tentative framework for classifying animal action tremor, such that various models may be considered potentially relevant to ET, subscribing to IO or PC hypotheses, or not likely relevant, as with mistiming or ataxic tremor. Considerable further research is needed to elucidate the mechanisms of tremor in animal models.

  16. Tremor recording and analysis as a tool for target localisation in thalamotomy and DBS for tremor

    NARCIS (Netherlands)

    Journee, HL; Hamoen, DJ; Staal, MJ; Sclabassi, R; Haaxma, R; Elands, A; Hummel, JJJ; Boom, H; Robinson, C; Rutten, W; Neuman, M; Wijkstra, H

    1997-01-01

    The objective of this work was to design and use a tremor and analysis system for stereotactic thalamotomy and thalamus stimulation (DBS). A notebook PC based system was developed. The tremor was measured by accelero-transducers or EMG. The method was used to confirm the definitive localization of

  17. Distinguishing the Central Drive to Tremor in Parkinson's Disease and Essential Tremor

    Science.gov (United States)

    Brittain, John-Stuart; Cagnan, Hayriye; Mehta, Arpan R.; Saifee, Tabish A.; Edwards, Mark J.

    2015-01-01

    Parkinson's disease (PD) and essential tremor (ET) are the two most common movement disorders. Both have been associated with similar patterns of network activation leading to the suggestion that they may result from similar network dysfunction, specifically involving the cerebellum. Here, we demonstrate that parkinsonian tremors and ETs result from distinct patterns of interactions between neural oscillators. These patterns are reflected in the tremors' derived frequency tolerance, a novel measure readily attainable from bedside accelerometry. Frequency tolerance characterizes the temporal evolution of tremor by quantifying the range of frequencies over which the tremor may be considered stable. We found that patients with PD (N = 24) and ET (N = 21) were separable based on their frequency tolerance, with PD associated with a broad range of stable frequencies whereas ET displayed characteristics consistent with a more finely tuned oscillatory drive. Furthermore, tremor was selectively entrained by transcranial alternating current stimulation applied over cerebellum. Narrow frequency tolerances predicted stronger entrainment of tremor by stimulation, providing good evidence that the cerebellum plays an important role in pacing those tremors. The different patterns of frequency tolerance could be captured with a simple model based on a broadly coupled set of neural oscillators for PD, but a more finely tuned set of oscillators in ET. Together, these results reveal a potential organizational principle of the human motor system, whose disruption in PD and ET dictates how patients respond to empirical, and potentially therapeutic, interventions that interact with their underlying pathophysiology. PMID:25589772

  18. Kinetic Tremor: Differences Between Smokers and Non-smokers

    OpenAIRE

    Louis, Elan D.

    2006-01-01

    Tremor is among the acute effects of nicotine exposure. Published studies have focused on smoking-related postural (static) hand tremor rather than kinetic tremor (tremor during hand use), and gender differences in smoking-related tremor have not been examined. In a group of adults who were sampled from a population (mean ± SD = 65.7 ± 11.5 years, range = 18 - 92 years), the investigator assessed whether the severity of postural and kinetic tremors differed in smokers versus non-smokers, and ...

  19. Insights into the causal relationship between slow slip and tectonic tremor in Guerrero, Mexico

    Science.gov (United States)

    Villafuerte, Carlos; Cruz-Atienza, Víctor M.

    2017-08-01

    Similar to other subduction zones, tectonic tremors (TTs) and slow-slip events (SSEs) take place in the deep segment of the plate interface in Guerrero, Mexico. However, their spatial correlation in this region is not as clear as the episodic tremor and slip observed in Cascadia and Japan. In this study we provide insights into the causal relationship between TTs and SSEs in Guerrero by analyzing the evolution of the deformation fields induced by the long-term 2006 SSE together with new locations of TTs and low-frequency earthquakes (LFEs). Unlike previous studies we find that the SSE slip rate modulates the TT and LFE activity in the whole tremor region. This means that the causal relationship between the SSE and the TT activity directly depends on the stressing rate history of the tremor asperities that is modulated by the surrounding slip rate. We estimated that the frictional strength of the asperities producing tremor downdip in the sweet spot is around 3.2 kPa, which is 2.3 times smaller than the corresponding value updip in the transient zone, partly explaining the overwhelming tremor activity of the sweet spot despite that the slow slip there is smaller. Based on the LFE occurrence-rate history during the interlong-term SSE period, we determined that the short-term SSEs in Guerrero take place further downdip (about 35 km) than previously estimated, with maximum slip of about 8 mm in the sweet spot. This new model features a continuum of slow slip extending across the entire tremor region of Guerrero.

  20. Source mechanism of volcanic tremor

    Energy Technology Data Exchange (ETDEWEB)

    Ferrick, M.G.; Qamar, A.; St. Lawrence, W.F.

    1982-10-10

    Low-frequency (<10 Hz) volcanic earthquakes originate at a wide range of depths and occur before, during, and after magmatic eruptions. The characteristics of these earthquakes suggest that they are not typical tectonic events. Physically analogous processes occur in hydraulic fracturing of rock formations, low-frequency icequakes in temperate glaciers, and autoresonance in hydroelectric power stations. We propose that unsteady fluid flow in volcanic conduits is the common source mechanism of low-frequency volcanic earthquakes (tremor). The fluid dynamic source mechanism explains low-frequency earthquakes of arbitrary duration, magnitude, and depth of origin, as unsteady flow is independent of physical properties of the fluid and conduit. Fluid transients occur in both low-viscosity gases and high-viscosity liquids. A fluid transient analysis can be formulated as generally as is warranted by knowledge of the composition and physical properties of the fluid, material properties, geometry and roughness of the conduit, and boundary conditions. To demonstrate the analytical potential of the fluid dynamic theory, we consider a single-phase fluid, a melt of Mount Hood andesite at 1250/sup 0/C, in which significant pressure and velocity variations occur only in the longitudinal direction. Further simplification of the conservation of mass and momentum equations presents an eigenvalue problem that is solved to determine the natural frequencies and associated damping of flow and pressure oscillations.

  1. Clinical Application of Cone-Beam Computed Tomography of the Rabbit Head: Part 1 - Normal Dentition

    Directory of Open Access Journals (Sweden)

    GG Comet Riggs

    2016-10-01

    Full Text Available Domestic rabbits (Oryctolagus cuniculus are increasingly popular as household pets; therefore, veterinarians need to be familiar with the most common diseases afflicting rabbits including dental diseases. Diagnostic approaches for dental disease include gross oral examination, endoscopic oral examination, skull radiography, and computed tomography (CT. CT overcomes many limitations of standard radiography by permitting cross-sectional images of the rabbit head in multiple planes without superimposition of anatomic structures. Cone-beam CT (CBCT is an oral and maxillofacial imaging modality that produces high-resolution images. The objective of this study was to describe and compare the normal anatomic features of the dentition and surrounding maxillofacial structures in healthy rabbits on CBCT and conventional CT. Ten New Zealand white rabbit cadaver heads were scanned using CBCT and conventional CT. Images were evaluated using Anatomage Invivo 5 software. The maxillofacial anatomy was labeled on CBCT images and the mean lengths and widths of the teeth were determined. The visibility of relevant dental and anatomic features (pulp cavity, germinal center, tooth outline, periodontal ligament were scored and compared between conventional CT and CBCT. The thinnest teeth were the maxillary second incisor teeth at 1.29 ± 0.26 mm and the maxillary third molar teeth at 1.04 ±0.10 mm. In general, it was found that CBCT was superior to conventional CT when imaging the dentition. Importantly, the periodontal ligament was significantly (P<0.01 more visible on CBCT than on conventional CT. Ability to see the periodontal ligament with such detail may allow earlier detection and treatment of periodontal disease in rabbits. This study is the first of its kind and shows the feasibility and yield of CBCT when evaluating the maxillofacial features and dentition in rabbits.

  2. Clinical Application of Cone-Beam Computed Tomography of the Rabbit Head: Part 1 - Normal Dentition.

    Science.gov (United States)

    Riggs, G G; Arzi, Boaz; Cissell, Derek D; Hatcher, David C; Kass, Philip H; Zhen, Amy; Verstraete, Frank J M

    2016-01-01

    Domestic rabbits ( Oryctolagus cuniculus ) are increasingly popular as household pets; therefore, veterinarians need to be familiar with the most common diseases afflicting rabbits including dental diseases. Diagnostic approaches for dental disease include gross oral examination, endoscopic oral examination, skull radiography, and computed tomography (CT). CT overcomes many limitations of standard radiography by permitting cross-sectional images of the rabbit head in multiple planes without superimposition of anatomic structures. Cone-beam CT (CBCT) is an oral and maxillofacial imaging modality that produces high-resolution images. The objective of this study was to describe and compare the normal anatomic features of the dentition and surrounding maxillofacial structures in healthy rabbits on CBCT and conventional CT. Ten New Zealand white rabbit cadaver heads were scanned using CBCT and conventional CT. Images were evaluated using Anatomage Invivo 5 software. The maxillofacial anatomy was labeled on CBCT images, and the mean lengths and widths of the teeth were determined. The visibility of relevant dental and anatomic features (pulp cavity, germinal center, tooth outline, periodontal ligament) were scored and compared between conventional CT and CBCT. The thinnest teeth were the maxillary second incisor teeth at 1.29 ± 0.26 mm and the maxillary third molar teeth at 1.04 ± 0.10 mm. In general, it was found that CBCT was superior to conventional CT when imaging the dentition. Importantly, the periodontal ligament was significantly ( P  < 0.01) more visible on CBCT than on conventional CT. Ability to see the periodontal ligament with such detail may allow earlier detection and treatment of periodontal disease in rabbits. This study is the first of its kind and shows the feasibility and yield of CBCT when evaluating the maxillofacial features and dentition in rabbits.

  3. Comparative Evaluation of Cast Aluminum Alloys for Automotive Cylinder Heads: Part II—Mechanical and Thermal Properties

    Science.gov (United States)

    Roy, Shibayan; Allard, Lawrence F.; Rodriguez, Andres; Porter, Wallace D.; Shyam, Amit

    2017-05-01

    The first part of this study documented the as-aged microstructure of five cast aluminum alloys namely, 206, 319, 356, A356, and A356+0.5Cu, that are used for manufacturing automotive cylinder heads (Roy et al. in Metall Mater Trans A, 2016). In the present part, we report the mechanical response of these alloys after they have been subjected to various levels of thermal exposure. In addition, the thermophysical properties of these alloys are also reported over a wide temperature range. The hardness variation due to extended thermal exposure is related to the evolution of the nano-scale strengthening precipitates for different alloy systems (Al-Cu, Al-Si-Cu, and Al-Si). The effect of strengthening precipitates (size and number density) on the mechanical response is most obvious in the as-aged condition, which is quantitatively demonstrated by implementing a strength model. Significant coarsening of precipitates from long-term heat treatment removes the strengthening efficiency of the nano-scale precipitates for all these alloys systems. Thermal conductivity of the alloys evolve in an inverse manner with precipitate coarsening compared to the strength, and the implications of the same for the durability of cylinder heads are noted.

  4. Botulinum Toxin in Management of Limb Tremor

    Directory of Open Access Journals (Sweden)

    Elina Zakin

    2017-11-01

    Full Text Available Essential tremor is characterized by persistent, usually bilateral and symmetric, postural or kinetic activation of agonist and antagonist muscles involving either the distal or proximal upper extremity. Quality of life is often affected and one’s ability to perform daily tasks becomes impaired. Oral therapies, including propranolol and primidone, can be effective in the management of essential tremor, although adverse effects can limit their use and about 50% of individuals lack response to oral pharmacotherapy. Locally administered botulinum toxin injection has become increasingly useful in the management of essential tremor. Targeting of select muscles with botulinum toxin is an area of active research, and muscle selection has important implications for toxin dosing and functional outcomes. The use of anatomical landmarks with palpation, EMG guidance, electrical stimulation, and ultrasound has been studied as a technique for muscle localization in toxin injection. Earlier studies implemented a standard protocol for the injection of (predominantly wrist flexors and extensors using palpation and EMG guidance. Targeting of muscles by selection of specific activators of tremor (tailored to each patient using kinematic analysis might allow for improvement in efficacy, including functional outcomes. It is this individualized muscle selection and toxin dosing (requiring injection within various sites of a single muscle that has allowed for success in the management of tremors.

  5. Ground-motion prediction from tremor

    Science.gov (United States)

    Baltay, Annemarie S.; Beroza, Gregory C.

    2013-01-01

    The widespread occurrence of tremor, coupled with its frequency content and location, provides an exceptional opportunity to test and improve strong ground-motion attenuation relations for subduction zones. We characterize the amplitude of thousands of individual 5 min tremor events in Cascadia during three episodic tremor and slip events to constrain the distance decay of peak ground acceleration (PGA) and peak ground velocity (PGV). We determine the anelastic attenuation parameter for ground-motion prediction equations (GMPEs) to a distance of 150 km, which is sufficient to place important constraints on ground-motion decay. Tremor PGA and PGV show a distance decay that is similar to subduction-zone-specific GMPEs developed from both data and simulations; however, the massive amount of data present in the tremor observations should allow us to refine distance-amplitude attenuation relationships for use in hazard maps, and to search for regional variations and intrasubduction zone differences in ground-motion attenuation.

  6. Essential Tremor (ET): Coping Tips for Everyday Living

    Science.gov (United States)

    ... Request that your meat be cut in the kitchen before being served. Consider ordering finger foods to ... Tremor IETF Accepting Proposals for Grants Relevant to Essential Tremor IETF Champion Home About the IETF Volunteer ...

  7. Pallidal Dysfunction Drives a Cerebellothalamic Circuit into Parkinson Tremor

    NARCIS (Netherlands)

    Helmich, R.C.G.; Janssen, M.J.R.; Oyen, W.J.G.; Bloem, B.R.; Toni, I.

    2011-01-01

    Objective: Parkinson disease (PD) is characterized by striatal dopamine depletion, which explains clinical symptoms such as bradykinesia and rigidity, but not resting tremor. Instead, resting tremor is associated with increased activity in a distinct cerebellothalamic circuit. To date, it remains

  8. Pallidal dysfunction drives a cerebellothalamic circuit into Parkinson tremor

    NARCIS (Netherlands)

    Helmich, R.C.G.; Janssen, M.J.; Oyen, W.J.G.; Bloem, B.R.; Toni, I.

    2011-01-01

    OBJECTIVE: Parkinson disease (PD) is characterized by striatal dopamine depletion, which explains clinical symptoms such as bradykinesia and rigidity, but not resting tremor. Instead, resting tremor is associated with increased activity in a distinct cerebellothalamic circuit. To date, it remains

  9. Essential Tremor vs. Parkinson's Disease: How Do They Differ?

    Science.gov (United States)

    Essential Tremor (ET) ET vs Parkinson’s disease How do they differ? The characteristics listed in the table below can help differentiate between parkinsonian and essential tremor, but a medical professional should be consulted for ...

  10. Bilateral cerebellar activation in unilaterally challenged essential tremor

    NARCIS (Netherlands)

    Broersma, Marja; van der Stouwe, Anna M. M.; Buijink, Arthur W. G.; de Jong, Bauke M.; Groot, Paul F. C.; Speelman, Johannes D.; Tijssen, Marina A. J.; van Rootselaar, Anne-Fleur; Maurits, Natasha M.

    2016-01-01

    Essential tremor (ET) is one of the most common hyperkinetic movement disorders. Previous research into the pathophysiology of ET suggested underlying cerebellar abnormalities. In this study, we added electromyography as an index of tremor intensity to functional Magnetic Resonance Imaging

  11. Peripheral beta-adrenergic blockade treatment of parkinsonian tremor.

    Science.gov (United States)

    Foster, N L; Newman, R P; LeWitt, P A; Gillespie, M M; Larsen, T A; Chase, T N

    1984-10-01

    The effect of nadolol, a peripherally acting beta-adrenergic blocker, on resting, postural, and intention tremor was examined in 8 patients with idiopathic Parkinson's disease whose motor symptoms, other than tremor, were well controlled with conventional medications. In a double-blind, placebo-controlled, crossover design, patients received 80 to 320 mg of nadolol for six weeks while continuing their previous therapeutic regimen. Accelerometer readings showed a 34% reduction (p less than 0.025) in tremor distance, but no change in tremor frequency, during nadolol therapy. Maximum benefit was achieved with a dose of 240 mg, when resting tremor improved 54%, postural tremor 32%, and intention tremor 54%. Physician ratings and patient reports supported the accelerometer results. Nadolol appears to be a safe, effective adjunct to current dopaminergic and anticholinergic therapy for severe tremor in Parkinson's disease.

  12. Tremor pattern differentiates drug-induced resting tremor from Parkinson disease.

    Science.gov (United States)

    Nisticò, R; Fratto, A; Vescio, B; Arabia, G; Sciacca, G; Morelli, M; Labate, A; Salsone, M; Novellino, F; Nicoletti, A; Petralia, A; Gambardella, A; Zappia, M; Quattrone, A

    2016-04-01

    DAT-SPECT, is a well-established procedure for distinguishing drug-induced parkinsonism from Parkinson's disease (PD). We investigated the usefulness of blink reflex recovery cycle (BRrc) and of electromyographic parameters of resting tremor for the differentiation of patients with drug-induced parkinsonism with resting tremor (rDIP) from those with resting tremor due to PD. This was a cross-sectional study. In 16 patients with rDIP and 18 patients with PD we analysed electrophysiological parameters (amplitude, duration, burst and pattern) of resting tremor. BRrc at interstimulus intervals (ISI) of 100, 150, 200, 300, 400, 500 and 750 msec was also analysed in patients with rDIP, patients with PD and healthy controls. All patients and controls underwent DAT-SPECT. Rest tremor amplitude was higher in PD patients than in rDIP patients (p tremor showed a synchronous pattern in all patients with rDIP, whereas it had an alternating pattern in all PD patients (p tremor can be considered a useful investigation for differentiating rDIP from PD. Copyright © 2016. Published by Elsevier Ltd.

  13. Dopamine controls Parkinson's tremor by inhibiting the cerebellar thalamus.

    Science.gov (United States)

    Dirkx, Michiel F; den Ouden, Hanneke E M; Aarts, Esther; Timmer, Monique H M; Bloem, Bastiaan R; Toni, Ivan; Helmich, Rick C

    2017-03-01

    Parkinson's resting tremor is related to altered cerebral activity in the basal ganglia and the cerebello-thalamo-cortical circuit. Although Parkinson's disease is characterized by dopamine depletion in the basal ganglia, the dopaminergic basis of resting tremor remains unclear: dopaminergic medication reduces tremor in some patients, but many patients have a dopamine-resistant tremor. Using pharmacological functional magnetic resonance imaging, we test how a dopaminergic intervention influences the cerebral circuit involved in Parkinson's tremor. From a sample of 40 patients with Parkinson's disease, we selected 15 patients with a clearly tremor-dominant phenotype. We compared tremor-related activity and effective connectivity (using combined electromyography-functional magnetic resonance imaging) on two occasions: ON and OFF dopaminergic medication. Building on a recently developed cerebral model of Parkinson's tremor, we tested the effect of dopamine on cerebral activity associated with the onset of tremor episodes (in the basal ganglia) and with tremor amplitude (in the cerebello-thalamo-cortical circuit). Dopaminergic medication reduced clinical resting tremor scores (mean 28%, range -12 to 68%). Furthermore, dopaminergic medication reduced tremor onset-related activity in the globus pallidus and tremor amplitude-related activity in the thalamic ventral intermediate nucleus. Network analyses using dynamic causal modelling showed that dopamine directly increased self-inhibition of the ventral intermediate nucleus, rather than indirectly influencing the cerebello-thalamo-cortical circuit through the basal ganglia. Crucially, the magnitude of thalamic self-inhibition predicted the clinical dopamine response of tremor. Dopamine reduces resting tremor by potentiating inhibitory mechanisms in a cerebellar nucleus of the thalamus (ventral intermediate nucleus). This suggests that altered dopaminergic projections to the cerebello-thalamo-cortical circuit have a role

  14. Comparative evaluation of cast aluminum alloys for automotive cylinder heads: Part I Microstructure evolution

    International Nuclear Information System (INIS)

    Roy, Shibayan; Allard, Lawrence Frederick Jr; Rodriguez, Andres; Watkins, Thomas R.; Shyam, Amit

    2017-01-01

    The present study stages a comparative evaluation of microstructure and associated mechanical and thermal response for common cast aluminum alloys that are used for manufacturing automotive cylinder heads. The systems considered are Al-Cu (206-T6), Al-Si-Cu (319-T7), and Al-Si (356-T6, A356-T6, and A356 + 0.5Cu-T6). The focus of the present manuscript is on the evaluation of microstructure at various length scales after aging, while the second manuscript will deal with the mechanical and thermal response of these alloys due to short-term (aging) and long-term (pre-conditioning) heat treatments. At the grain-scale, the Al-Cu alloy possessed an equiaxed microstructure as opposed to the dendritic structure for the Al-Si-Cu or Al-Si alloys which is related to the individual solidification conditions for these alloy systems. The composition and morphology of intermetallic precipitates within the grain and at the grain/dendritic boundary are dictated by the alloy chemistry, solidification, and heat treatment conditions. At the nanoscale, these alloys contain various metastable strengthening precipitates (GPI and θ''θ'' in Al-Cu alloy, θ'θ' in Al-Si-Cu alloy, and β'β' in Al-Si alloys) with varying size, morphology, coherency, and thermal stability.

  15. Comparative Evaluation of Cast Aluminum Alloys for Automotive Cylinder Heads: Part I—Microstructure Evolution

    Science.gov (United States)

    Roy, Shibayan; Allard, Lawrence F.; Rodriguez, Andres; Watkins, Thomas R.; Shyam, Amit

    2017-05-01

    The present study stages a comparative evaluation of microstructure and associated mechanical and thermal response for common cast aluminum alloys that are used for manufacturing automotive cylinder heads. The systems considered are Al-Cu (206-T6), Al-Si-Cu (319-T7), and Al-Si (356-T6, A356-T6, and A356 + 0.5Cu-T6). The focus of the present manuscript is on the evaluation of microstructure at various length scales after aging, while the second manuscript will deal with the mechanical and thermal response of these alloys due to short-term (aging) and long-term (pre-conditioning) heat treatments. At the grain-scale, the Al-Cu alloy possessed an equiaxed microstructure as opposed to the dendritic structure for the Al-Si-Cu or Al-Si alloys which is related to the individual solidification conditions for these alloy systems. The composition and morphology of intermetallic precipitates within the grain and at the grain/dendritic boundary are dictated by the alloy chemistry, solidification, and heat treatment conditions. At the nanoscale, these alloys contain various metastable strengthening precipitates (GPI and θ^'' in Al-Cu alloy, θ^' in Al-Si-Cu alloy, and β^' in Al-Si alloys) with varying size, morphology, coherency, and thermal stability.

  16. Tremor Source Location at Okmok Volcano

    Science.gov (United States)

    Reyes, C. G.; McNutt, S. R.

    2007-12-01

    Initial results using an amplitude-based tremor location program have located several active tremor episodes under Cone A, a vent within Okmok volcano's 10 km caldera. Okmok is an andesite volcano occupying the north-eastern half of Umnak Island, in the Aleutian islands. Okmok is defined by a ~2000 y.b.p. caldera that contains multiple cinder cones. Cone A, the youngest of these, extruded lava in 1997 covering the caldera floor. Since April 2003, continuous seismic data have been recorded from eight vertical short-period stations (L4-C's) installed at distances from Cone A ranging from 2 km to 31 km. In 2004 four additional 3- component broadband stations were added, co-located with continuous GPS stations. InSAR and GPS measurements of post-eruption deformation show that Okmok experienced several periods of rapid inflation (Mann and Freymueller, 2002), from the center of the 10 km diameter caldera. While there are few locatable VT earthquakes, there has been nearly continuous low-level tremor with stronger amplitude bursts occurring at variable rates and durations. The character of occurrence remained relatively constant over the course of days to weeks until the signal ceased in mid 2005. Within any day, tremor behavior remains fairly consistent, with bursts closely resembling each other, suggesting a single main process or source location. The tremor is composed of irregular waves with a broad range of frequencies, though most energy resides between ~2 Hz and 6 Hz. Attempts to locate the tremor using traditional arrival time methods fail because the signal is emergent, with envelopes too ragged to correlate on time scales that hold much hope for a location. Instead, focus was shifted to the amplitude ratios at various stations. Candidates for the tremor source include the center of inflation and Cone A, 3 km to the south-west. For all dates on record, data were band pass filtered between 1 and 5 Hz, then evaluated in 20.48 second windows (N=2048, sampling rate

  17. Tremor da escrita: relato de caso

    Directory of Open Access Journals (Sweden)

    Denise Hack Nicaretta

    1994-03-01

    Full Text Available O tremor da escrita é distúrbio precipitado por atividade motora específica, geralmente a escrita. Analisamos este caso sob o ponto de vista clínico e terapêutico. O paciente apresentava tremor ao escrever tomando sua letra ilegível; sem qualquer outra alteração neurológica. Não havia antecedentes familiares, metabólicos, endócrinos, iatrogênicos, tóxicos ou traumáticos. No manuseio terapêutico não ocorreu resposta satisfatória ao propranolol, sendo discreta à primidona. A introdução de anticolinérgicos (tri-hexifenidil evidenciou certa melhora na sintomatologia, com redução do tremor no momento da escrita.

  18. San Andreas tremor cascades define deep fault zone complexity

    Science.gov (United States)

    Shelly, David R.

    2015-01-01

    Weak seismic vibrations - tectonic tremor - can be used to delineate some plate boundary faults. Tremor on the deep San Andreas Fault, located at the boundary between the Pacific and North American plates, is thought to be a passive indicator of slow fault slip. San Andreas Fault tremor migrates at up to 30 m s-1, but the processes regulating tremor migration are unclear. Here I use a 12-year catalogue of more than 850,000 low-frequency earthquakes to systematically analyse the high-speed migration of tremor along the San Andreas Fault. I find that tremor migrates most effectively through regions of greatest tremor production and does not propagate through regions with gaps in tremor production. I interpret the rapid tremor migration as a self-regulating cascade of seismic ruptures along the fault, which implies that tremor may be an active, rather than passive participant in the slip propagation. I also identify an isolated group of tremor sources that are offset eastwards beneath the San Andreas Fault, possibly indicative of the interface between the Monterey Microplate, a hypothesized remnant of the subducted Farallon Plate, and the North American Plate. These observations illustrate a possible link between the central San Andreas Fault and tremor-producing subduction zones.

  19. Abnormal 201Tl limb scan due to unilateral tremor

    International Nuclear Information System (INIS)

    Simons, M.; Schelstraete, K.; Bratzlavsky, M.

    1982-01-01

    A abnormal intra- and interextremity distribution pattern on 201 Tl was observed on the limb scan of a patient with a unilateral tremor. This is ascribed to the increased blood flow in the muscles responsible for the tremor. The suggestion is made that the existence of tremor should be considered as a possible explanation for unexpected abnormalities on 201 Tl limb scintigrams

  20. Unilateral rubral tremors in Wilson′s disease treated with dimercaprol

    Directory of Open Access Journals (Sweden)

    Rahul T Chakor

    2015-01-01

    Full Text Available Tremors are reported as the most frequent neurological manifestation of Wilson′s disease (WD in some series. Postural tremors, rest tremors, action tremors and wing-beating (rubral tremors are the different types of tremors seen in WD. We report a patient of WD with unilateral rubral tremors refractory to 1-year therapy with Penicillamine and anti-tremor medications. The tremors decreased considerably after adding chelation therapy with dimercaprol. Combination of Penicillamine and dimercaprol is an effective decoppering measure in rubral tremors of WD.

  1. Dramatic response to levetiracetam in post-ischaemic Holmes’ tremor

    Science.gov (United States)

    Striano, P; Elefante, Andrea; Coppola, Antonietta; Tortora, Fabio; Zara, Federico; Minetti, Carlo

    2009-01-01

    Holmes’ tremor refers to an unusual combination of rest, postural and kinetic tremor of extremities. Common causes of Holmes’ tremor include stroke, trauma, vascular malformations and multiple sclerosis, with lesions involving the thalamus, brain stem or cerebellum. Although some drugs (eg, levodopa and dopaminergic drugs, clonazepam and propranolol) have been occasionally reported to give some benefit, medical treatment of Holmes’ tremor is unsatisfactory, and many patients require thalamic surgery to achieve satisfactory control. We report a patient in whom post-ischaemic Holmes’ tremor dramatically responded to levetiracetam treatment. PMID:21686707

  2. Ambient Tremor, But No Triggered Tremor at the Northern Costa Rica Subduction Zone

    Science.gov (United States)

    Swiecki, Z.; Schwartz, S. Y.

    2010-12-01

    Non-volcanic tremor (NVT) has been found to be triggered during the passage of surface waves from various teleseismic events in locations around the world including Cascadia, Southwest Japan, Taiwan, and California. In this study we examine the northern Costa Rica subduction zone for evidence of triggered tremor. The Nicoya Peninsula segment of the northern Costa Rica margin experiences both slow-slip and tremor and is thus a prime candidate for triggered tremor observations. Eleven teleseismic events with magnitudes (Mw) greater than 8 occurring between 2006 and 2010 were examined using data from both broadband and short period sensors deployed on the Nicoya Peninsula, Costa Rica. Waveforms from several large regional events were also considered. The largest teleseismic and regional events (27 February 2010 Chile, Mw 8.8 and 28 May 2009 Honduras, Mw 7.3) induced peak ground velocities (PGV) at the NIcoya stations of ~2 and 6 mm/s, respectively; larger than PGVs in other locations that have triggered tremor. Many of the earthquakes examined occurred during small episodes of background ambient tremor. In spite of this, no triggered tremor was observed during the passage of seismic waves from any event. This is significant because other studies have demonstrated that NVT is not triggered everywhere by all events above some threshold magnitude, indicating that unique conditions are required for its occurrence. The lack of triggered tremor at the Costa Rica margin can help to better quantify the requisite conditions and triggering mechanisms. An inherent difference between the Costa Rica margin and the other subduction zones where triggered tremor exists is its erosional rather than accretionary nature. Its relatively low sediment supply likely results in a drier, lower pore fluid pressure, stronger and less compliant thrust interface that is less receptive to triggering tremor from external stresses generated by teleseismic or strong local earthquakes. Another

  3. Disorders of balance and gait in essential tremor are associated with midline tremor and age.

    Science.gov (United States)

    Hoskovcová, Martina; Ulmanová, Olga; Sprdlík, Otakar; Sieger, Tomáš; Nováková, Jana; Jech, Robert; Růžička, Evžen

    2013-02-01

    Disorders of balance and gait have been observed in patients with essential tremor (ET), but their association with tremor severity remains unclear. This study aimed to evaluate postural instability and gait changes in ET patients and to investigate their relationship to tremor characteristics with regard to cerebellar dysfunction as a possible common pathogenetic mechanism in ET. Thirty ET patients (8F, mean (SD) age 55.8 (17.8), range 19-81 years) and 25 normal controls (7F, 53.0 (17.7), 19-81) were tested with the scales of Activities-specific Balance Confidence (ABC), Fullerton Advanced Balance (FAB), and International Cooperative Ataxia Rating Scale (ICARS). Posturography and gait were assessed using a Footscan® system. Tremor was evaluated by the Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and accelerometry in five upper limb positions. A mean (SD) TRS sum score of 27.0 (13.2) corresponded to mild to moderate tremor severity in most patients. In comparison with controls, ET subjects exhibited lower tandem gait velocity (0.21 vs. 0.26 m/s, P = 0.028), more missteps (0.57 vs. 0.12, P = 0.039), and increased postural sway in tandem stance (sway area 301.1 vs. 202.9 mm(2), P = 0.045). In normal gait, step width increased with the midline tremor subscore of TRS (Pearson r = 0.60, P = 0.046). Moreover, significant correlations were found between age and quantitative measures of normal and tandem gait in ET patients but not in controls. ABC, FAB, and ICARS scores did not significantly differ between patients and controls. In conclusion, gait and balance alterations in ET patients occur even without subjective complaints. Their relationship with midline tremor and dependence on age suggest a connection with cerebellar dysfunction.

  4. Differences in striatal dopamine transporter density between tremor dominant and non-tremor Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kaasinen, Valtteri; Kinos, Maija; Joutsa, Juho [University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Turku (Finland); University of Turku and Turku University Hospital, Turku PET Centre, Turku (Finland); Seppaenen, Marko [University of Turku and Turku University Hospital, Turku PET Centre, Turku (Finland); University of Turku and Turku University Hospital, Department of Clinical Physiology and Nuclear Medicine, Turku (Finland); Noponen, Tommi [University of Turku and Turku University Hospital, Department of Clinical Physiology and Nuclear Medicine, Turku (Finland)

    2014-10-15

    Parkinson's disease (PD) can manifest with a tremor-dominant or a non-tremor (akinetic-rigid) phenotype. Although the tremor-dominant subtype may show a better prognosis, there is limited information on the phenotypic differences regarding the level of striatal dopamine transmission. The present study investigated striatal dopamine transporter (DAT) binding characteristics in a large sample of patients with and without tremor. [{sup 123}I]FP-CIT SPECT scans of 231 patients with a clinical diagnosis of PD and abnormal FP-CIT binding (157 with tremor, 74 without tremor) and 230 control patients with normal FP-CIT binding (148 with tremor, 82 without tremor) were analysed using an automated region-of-interest analysis of the scans (BRASS). Specific striatal binding ratios were compared between phenotypes and groups using age, sex, and symptom duration, predominant side of symptoms, dopaminergic medications and scanner as covariates. Patients with PD had 28.1 - 65.0 % lower binding in all striatal regions compared to controls (p < 0.001). The mean FP-CIT caudate nucleus uptake and the left caudate nucleus uptake were higher in PD patients with tremor than in PD patients without tremor (mean 9.0 % higher, left 10.5 % higher; p < 0.05), whereas there were no differences between tremor and non-tremor control patients. No significant effects of tremor on DAT binding were observed in the anterior or posterior putamen. The motor phenotype is associated with the extent of caudate dopamine terminal loss in PD, as dopamine function is relatively more preserved in tremor patients. Symptom type is related to caudate dopamine function only in association with Parkinsonian dopaminergic degeneration, not in intact dopamine systems in patients with non-PD tremor. (orig.)

  5. Essential Tremor: What We Can Learn from Current Pharmacotherapy

    Directory of Open Access Journals (Sweden)

    William Ondo

    2016-03-01

    Full Text Available Background: The pathophysiology of essential tremor, especially at the cellular level, is poorly understood. Although no drug has been specifically designed to treat essential tremor, several medications improve tremor, and others worsen it. Studying the mechanism of actions of these medications can help our understanding of tremor pathophysiology and contribute to future rational drug design. Methods: We reviewed literature, concentrating on mechanisms of action, of various medications that mitigate tremor. Results: Many medications have multiple mechanisms of actions, making simple correlations difficult. Medications that increase the duration of opening of gamma-aminobutyric acid (GABA-A receptors are most consistently associated with tremor improvement. Interestingly, drugs that increase GABA availability have not been associated with improved tremor. Other mechanisms possibly associated with tremor improvement include antagonism of alpha-2 delta subunits associated with calcium channels, inhibition of carbonic anhydrase, and inhibition of the synaptic vesicle protein 2A. Drugs that block voltage-gaited sodium channels do not affect tremor. The ideal beta-adrenergic blocker requires B2 affinity (non-cardiac selective, has no sympathomimetic properties, does not require membrane stabilization properties, and may benefit from good central nervous system penetration. Discussion: To date, serendipitous observations have provided most of our understanding of tremor cellular physiology. Based on similarities to currently effective drugs or rational approximations and inferences, several currently available agents should be considered for tremor trials.

  6. Essential Tremor: What We Can Learn from Current Pharmacotherapy.

    Science.gov (United States)

    Ondo, William

    2016-01-01

    The pathophysiology of essential tremor, especially at the cellular level, is poorly understood. Although no drug has been specifically designed to treat essential tremor, several medications improve tremor, and others worsen it. Studying the mechanism of actions of these medications can help our understanding of tremor pathophysiology and contribute to future rational drug design. We reviewed literature, concentrating on mechanisms of action, of various medications that mitigate tremor. Many medications have multiple mechanisms of actions, making simple correlations difficult. Medications that increase the duration of opening of gamma-aminobutyric acid (GABA)-A receptors are most consistently associated with tremor improvement. Interestingly, drugs that increase GABA availability have not been associated with improved tremor. Other mechanisms possibly associated with tremor improvement include antagonism of alpha-2 delta subunits associated with calcium channels, inhibition of carbonic anhydrase, and inhibition of the synaptic vesicle protein 2A. Drugs that block voltage-gaited sodium channels do not affect tremor. The ideal beta-adrenergic blocker requires B2 affinity (non-cardiac selective), has no sympathomimetic properties, does not require membrane stabilization properties, and may benefit from good central nervous system penetration. To date, serendipitous observations have provided most of our understanding of tremor cellular physiology. Based on similarities to currently effective drugs or rational approximations and inferences, several currently available agents should be considered for tremor trials.

  7. Treatment of resting tremor by beta-adrenergic blockade.

    Science.gov (United States)

    Foster, N L; Newman, R P; LeWitt, P A; Gillespie, M M; Chase, T N

    1984-10-01

    The effect of nadolol, a peripherally acting beta-adrenergic blocker, on resting tremor was examined in eight patients with idiopathic Parkinson's disease. With the use of a double-blind, placebo-controlled study of crossover design, patients received 80 to 320 mg of nadolol for 6 weeks while continuing their previous treatment regimen. Accelerometer readings showed a progressive reduction in tremor amplitude, but no change in tremor frequency, with increasing nadolol dosage. Maximum benefit was achieved at 240 mg, when resting tremor improved 50% (p less than 0.01). Physician ratings confirmed these findings. The results suggest that response to beta-adrenergic blockade may not be limited to postural or intention tremor and that such agents may not reliably differentiate between the tremor of Parkinson's disease and essential tremor.

  8. De fysiologische tremor van de hand

    NARCIS (Netherlands)

    Weerden, Tiemen Willem van

    1989-01-01

    Bij het innemen van een houding, zoals het willekeurig horizontaal gestrekt houden van de hand, vertoont het betrokken lichaamsdeel kleine fluctuaties in positie: de fysiologische tremor. Het doel van het proefschrift is, naast een beschrijving van het fenomeen, inzicht te geven in de oorzakelijke

  9. Differential effects of alpha-adrenoceptor blockade on essential, physiological and isoprenaline-induced tremor: evidence for a central origin of essential tremor.

    OpenAIRE

    Abila, B; Wilson, J F; Marshall, R W; Richens, A

    1985-01-01

    Intravenous thymoxamine reduced the power of essential tremor but increased that of physiological and isoprenaline-induced tremor. These findings indicate that essential and physiological tremor have dissimilar pathophysiological mechanisms. They also suggest that central adrenergic mechanisms are involved in the pathophysiology of essential tremor and that isoprenaline-induced tremor is not a good model of essential tremor. Furthermore, alpha-adrenoceptor blockers may be a useful therapy for...

  10. Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1).

    Science.gov (United States)

    Mañós, M; Giralt, J; Rueda, A; Cabrera, J; Martinez-Trufero, J; Marruecos, J; Lopez-Pousa, A; Rodrigo, J P; Castelo, B; Martínez-Galán, J; Arias, F; Chaves, M; Herranz, J J; Arrazubi, V; Baste, N; Castro, A; Mesía, R

    2017-07-01

    Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists must deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers several specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved. Copyright © 2017. Published by Elsevier Ltd.

  11. Report on the Aseismic Slip, Tremor, and Earthquakes Workshop

    Science.gov (United States)

    Gomberg, Joan; Roeloffs, Evelyn; Trehu, Anne; Dragert, Herb; Meertens, Charles

    2008-01-01

    This report summarizes the discussions and information presented during the workshop on Aseismic Slip, Tremor, and Earthquakes. Workshop goals included improving coordination among those involved in conducting research related to these phenomena, assessing the implications for earthquake hazard assessment, and identifying ways to capitalize on the education and outreach opportunities presented by these phenomena. Research activities of focus included making, disseminating, and analyzing relevant measurements; the relationships among tremor, aseismic or 'slow-slip', and earthquakes; and discovering the underlying causative physical processes. More than 52 participants contributed to the workshop, held February 25-28, 2008 in Sidney, British Columbia. The workshop was sponsored by the U.S. Geological Survey, the National Science Foundation?s Earthscope Program and UNAVCO Consortium, and the Geological Survey of Canada. This report has five parts. In the first part, we integrate the information exchanged at the workshop as it relates to advancing our understanding of earthquake generation and hazard. In the second part, we summarize the ideas and concerns discussed in workshop working groups on Opportunities for Education and Outreach, Data and Instrumentation, User and Public Needs, and Research Coordination. The third part presents summaries of the oral presentations. The oral presentations are grouped as they were at the workshop in the categories of phenomenology, underlying physical processes, and implications for earthquake hazards. The fourth part contains the meeting program and the fifth part lists the workshop participants. References noted in parentheses refer to the authors of presentations made at the workshop, and published references are noted in square brackets and listed in the Reference section. Appendix A contains abstracts of all participant presentations and posters, which also have been posted online, along with presentations and author contact

  12. Density distribution of currents induced inside the brain in the head part of the human model exposed to power frequency electric field

    Energy Technology Data Exchange (ETDEWEB)

    Chiba, Atsuo [Yongo National Collage of Technology (Japan); Isaka, Katsuo [University of Tokushima (Japan)

    1999-07-01

    The health effect of the weak current induced in the human body as a result of the interaction between human body and power frequency electric fields has been investigated. However, the current density inside the head part tissues of the human body exposed to the electric fields has rarely been discussed. In this paper, the finite element method is applied to the analysis of the current density distribution of the head part composed of scalp, skull, cerebrospinal liquid and brain tissues. The basic characteristics of the current density distributions of the brain in the asymmetrical human model have been made clear. (author)

  13. Linking Essential Tremor to the Cerebellum-Neuroimaging Evidence.

    Science.gov (United States)

    Cerasa, Antonio; Quattrone, Aldo

    2016-06-01

    Essential tremor (ET) is the most common pathological tremor disorder in the world, and post-mortem evidence has shown that the cerebellum is the most consistent area of pathology in ET. In the last few years, advanced neuroimaging has tried to confirm this evidence. The aim of the present review is to discuss to what extent the evidence provided by this field of study may be generalised. We performed a systematic literature search combining the terms ET with the following keywords: MRI, VBM, MRS, DTI, fMRI, PET and SPECT. We summarised and discussed each study and placed the results in the context of existing knowledge regarding the cerebellar involvement in ET. A total of 51 neuroimaging studies met our search criteria, roughly divided into 19 structural and 32 functional studies. Despite clinical and methodological differences, both functional and structural imaging studies showed similar findings but without defining a clear topography of neurodegeneration. Indeed, the vast majority of studies found functional and structural abnormalities in several parts of the anterior and posterior cerebellar lobules, but it remains to be established to what degree these neural changes contribute to clinical symptoms of ET. Currently, advanced neuroimaging has confirmed the involvement of the cerebellum in pathophysiological processes of ET, although a high variability in results persists. For this reason, the translation of this knowledge into daily clinical practice is again partially limited, although new advanced multivariate neuroimaging approaches (machine-learning) are proving interesting changes of perspective.

  14. Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits?

    NARCIS (Netherlands)

    Helmich, R.C.G.; Hallett, M.; Deuschl, G.; Toni, I.; Bloem, B.R.

    2012-01-01

    Tremor in Parkinson's disease has several mysterious features. Clinically, tremor is seen in only three out of four patients with Parkinson's disease, and tremor-dominant patients generally follow a more benign disease course than non-tremor patients. Pathophysiologically, tremor is linked to

  15. Cerebral causes and consequences of parkinsonian resting tremor: A tale of two circuits?

    NARCIS (Netherlands)

    Helmich, R.C.G.; Hallett, M.; Deuschl, G.; Toni, I.; Bloem, B.R.

    2012-01-01

    Tremor in Parkinson's disease has several mysterious features. Clinically, tremor is seen in only three out of four patients with Parkinson's disease, and tremor-dominant patients generally follow a more benign disease course than non-tremor patients. Pathophysiologically, tremor is linked to

  16. [The use of neuromodulation for the treatment of tremor].

    Science.gov (United States)

    Bendersky, Damián; Ajler, Pablo; Yampolsky, Claudio

    2014-01-01

    Tremor may be a disabling disorder and pharmacologic treatment is the first-line therapy for these patients. Nevertheless, this treatment may lead to a satisfactory tremor reduction in only 50% of patients with essential tremor. Thalamotomy was the treatment of choice for tremor refractory to medical therapy until deep brain stimulation (DBS) of the ventral intermedius nucleus (Vim) of the thalamus has started being used. Nowadays, thalamotomy is rarely performed. This article is a non-systematic review of the indications, results, programming parameters and surgical technique of DBS of the Vim for the treatment of tremor. In spite of the fact that it is possible to achieve similar clinical results using thalamotomy or DBS of the Vim, the former causes more adverse effects than the latter. Furthermore, DBS can be used bilaterally, whereas thalamotomy has a high risk of causing disartria when it is performed in both sides. DBS of the Vim achieved an adequate tremor improvement in several series of patients with tremor caused by essential tremor, Parkinson's disease or multiple sclerosis. Besides the Vim, there are other targets, which are being used by some authors, such as the zona incerta and the prelemniscal radiations. DBS of the Vim is a useful treatment for disabling tremor refractory to medical therapy. It is essential to carry out an accurate patient selection as well as to use a proper surgical technique. The best stereotactic target for tremor is still unknown, although the Vim is the most used one.

  17. Is Slow Slip a Cause or a Result of Tremor?

    Science.gov (United States)

    Luo, Y.; Ampuero, J. P.

    2017-12-01

    While various modeling efforts have been conducted to reproduce subsets of observations of tremor and slow-slip events (SSE), a fundamental but yet unanswered question is whether slow slip is a cause or a result of tremor. Tremor is commonly regarded as driven by SSE. This view is mainly based on observations of SSE without detected tremors and on (frequency-limited) estimates of total tremor seismic moment being lower than 1% of their concomitant SSE moment. In previous studies we showed that models of heterogeneous faults, composed of seismic asperities embedded in an aseismic fault zone matrix, reproduce quantitatively the hierarchical patterns of tremor migration observed in Cascadia and Shikoku. To address the title question, we design two end-member models of a heterogeneous fault. In the SSE-driven-tremor model, slow slip events are spontaneously generated by the matrix (even in the absence of seismic asperities) and drive tremor. In the Tremor-driven-SSE model the matrix is stable (it slips steadily in the absence of asperities) and slow slip events result from the collective behavior of tremor asperities interacting via transient creep (local afterslip fronts). We study these two end-member models through 2D quasi-dynamic multi-cycle simulations of faults governed by rate-and-state friction with heterogeneous frictional properties and effective normal stress, using the earthquake simulation software QDYN (https://zenodo.org/record/322459). We find that both models reproduce first-order observations of SSE and tremor and have very low seismic to aseismic moment ratio. However, the Tremor-driven-SSE model assumes a simpler rheology than the SSE-driven-tremor model and matches key observations better and without fine tuning, including the ratio of propagation speeds of forward SSE and rapid tremor reversals and the decay of inter-event times of Low Frequency Earthquakes. These modeling results indicate that, in contrast to a common view, SSE could be a result

  18. Brittle and ductile friction and the physics of tectonic tremor

    Science.gov (United States)

    Daub, Eric G.; Shelly, David R.; Guyer, Robert A.; Johnson, P.A.

    2011-01-01

    Observations of nonvolcanic tremor provide a unique window into the mechanisms of deformation and failure in the lower crust. At increasing depths, rock deformation gradually transitions from brittle, where earthquakes occur, to ductile, with tremor occurring in the transitional region. The physics of deformation in the transition region remain poorly constrained, limiting our basic understanding of tremor and its relation to earthquakes. We combine field and laboratory observations with a physical friction model comprised of brittle and ductile components, and use the model to provide constraints on the friction and stress state in the lower crust. A phase diagram is constructed that characterizes under what conditions all faulting behaviors occur, including earthquakes, tremor, silent transient slip, and steady sliding. Our results show that tremor occurs over a range of ductile and brittle frictional strengths, and advances our understanding of the physical conditions at which tremor and earthquakes take place.

  19. Hilbert-Huang transform based instrumental assessment of intention tremor in multiple sclerosis

    Science.gov (United States)

    Carpinella, Ilaria; Cattaneo, Davide; Ferrarin, Maurizio

    2015-08-01

    Objective. This paper describes a method to extract upper limb intention tremor from gyroscope data, through the Hilbert-Huang transform (HHT), a technique suitable for the study of nonlinear and non-stationary processes. The aims of the study were to: (i) evaluate the method’s ability to discriminate between healthy controls and MS subjects; (ii) validate the proposed procedure against clinical tremor scores assigned using Fahn’s tremor rating scale (FTRS); and (iii) compare the performance of the HHT-based method with that of linear band-pass filters. Approach. HHT was applied on gyroscope data collected on 20 MS subjects and 13 healthy controls (CO) during finger-to-nose tests (FNTs) instrumented with an inertial sensor placed on the hand. The results were compared to those obtained after traditional linear filtering. The tremor amplitude was quantified with instrumental indexes (TIs) and clinical FTRS ratings. Main results. The TIs computed after HHT-based filtering discriminated between CO and MS subjects with clinically-detected intention tremor (MS_T). In particular, TIs were significantly higher in the final part of the movement (TI2) with respect to the first part (TI1), and, for all components (X, Y, Z), MST showed a TI2 significantly higher than in CO subjects. Moreover, the HHT detected subtle alterations not visible from clinical ratings, as TI2 (Z-component) was significantly increased in MS subjects without clinically-detected tremor (MS_NT). The method’s validity was demonstrated by significant correlations between clinical FTRS scores and TI2 related to X (rs = 0.587, p = 0.006) and Y (rs = 0.682, p < 0.001) components. Contrarily, fewer differences among the groups and no correlation between instrumental and clinical indexes emerged after traditional filtering. Significance. The present results supported the use of the HHT-based procedure for a fully-automated quantitative and objective measure of intention tremor in MS, which can overcome

  20. Accuracy of forecast of mine tremors location

    Energy Technology Data Exchange (ETDEWEB)

    Jan Drzewieck [Central Mining Institute, Katowice (Poland)

    2009-09-15

    The Upper Silesian Coal Basin is one of the most active mining areas in the world in respect of seismicity. Underground mining in this area takes place in a special environment with a high degree of risk of unpredictable event occurrence. Especially dangerous are phenomena that occur during the extraction of deposits at great depths in the environment of compact rocks. Deep underground mining violates the balance of these rocks and induces dynamic phenomena at the longwall life (in terms of distance) referred to as mine tremors. The sources of these tremors are located in layers characterised by high strength, especially in thick sandstone strata occurring in the roof of the mined seam. In the paper a discussion is presented about the influence of mining intensity (longwall face speed) on the location of mine tremor sources, both in the direction of longwall life (in terms of distance) and towards the surface. The presented material has been prepared based on the results of tests and measurements carried out at the Central Mining Institute. 8 refs., 5 figs.

  1. The long-term outcome of orthostatic tremor.

    Science.gov (United States)

    Ganos, Christos; Maugest, Lucie; Apartis, Emmanuelle; Gasca-Salas, Carmen; Cáceres-Redondo, María T; Erro, Roberto; Navalpotro-Gómez, Irene; Batla, Amit; Antelmi, Elena; Degos, Bertrand; Roze, Emmanuel; Welter, Marie-Laure; Mestre, Tiago; Palomar, Francisco J; Isayama, Reina; Chen, Robert; Cordivari, Carla; Mir, Pablo; Lang, Anthony E; Fox, Susan H; Bhatia, Kailash P; Vidailhet, Marie

    2016-02-01

    Orthostatic tremor is a rare condition characterised by high-frequency tremor that appears on standing. Although the essential clinical features of orthostatic tremor are well established, little is known about the natural progression of the disorder. We report the long-term outcome based on the largest multicentre cohort of patients with orthostatic tremor. Clinical information of 68 patients with clinical and electrophysiological diagnosis of orthostatic tremor and a minimum follow-up of 5 years is presented. There was a clear female preponderance (76.5%) with a mean age of onset at 54 years. Median follow-up was 6 years (range 5-25). On diagnosis, 86.8% of patients presented with isolated orthostatic tremor and 13.2% had additional neurological features. At follow-up, seven patients who initially had isolated orthostatic tremor later developed further neurological signs. A total 79.4% of patients reported worsening of orthostatic tremor symptoms. These patients had significantly longer symptom duration than those without reported worsening (median 15.5 vs 10.5 years, respectively; p=0.005). There was no change in orthostatic tremor frequency over time. Structural imaging was largely unremarkable and dopaminergic neuroimaging (DaTSCAN) was normal in 18/19 cases. Pharmacological treatments were disappointing. Two patients were treated surgically and showed improvement. Orthostatic tremor is a progressive disorder with increased disability although tremor frequency is unchanged over time. In most cases, orthostatic tremor represents an isolated syndrome. Drug treatments are unsatisfactory but surgery may hold promise. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Temporal Variation of Tectonic Tremor Activity Associated with Nearby Earthquakes

    Science.gov (United States)

    Chao, K.; Van der Lee, S.; Hsu, Y. J.; Pu, H. C.

    2017-12-01

    Tectonic tremor and slow slip events, located downdip from the seismogenic zone, hold the key to recurring patterns of typical earthquakes. Several findings of slow aseismic slip during the prenucletion processes of nearby earthquakes have provided new insight into the study of stress transform of slow earthquakes in fault zones prior to megathrust earthquakes. However, how tectonic tremor is associated with the occurrence of nearby earthquakes remains unclear. To enhance our understanding of the stress interaction between tremor and earthquakes, we developed an algorithm for the automatic detection and location of tectonic tremor in the collisional tectonic environment in Taiwan. Our analysis of a three-year data set indicates a short-term increase in the tremor rate starting at 19 days before the 2010 ML6.4 Jiashian main shock (Chao et al., JGR, 2017). Around the time when the tremor rate began to rise, one GPS station recorded a flip in its direction of motion. We hypothesize that tremor is driven by a slow-slip event that preceded the occurrence of the shallower nearby main shock, even though the inferred slip is too small to be observed by all GPS stations. To better quantify what the necessary condition for tremor to response to nearby earthquakes is, we obtained a 13-year ambient tremor catalog from 2004 to 2016 in the same region. We examine the spatiotemporal relationship between tremor and 37 ML>=5.0 (seven events with ML>=6.0) nearby earthquakes located within 0.5 degrees to the active tremor sources. The findings from this study can enhance our understanding of the interaction among tremor, slow slip, and nearby earthquakes in the high seismic hazard regions.

  3. Evaluation of precipitates used in strainer head loss testing: Part II. Precipitates by in situ aluminum alloy corrosion

    International Nuclear Information System (INIS)

    Bahn, Chi Bum; Kasza, Ken E.; Shack, William J.; Natesan, Ken; Klein, Paul

    2011-01-01

    Graphical abstract: Display Omitted Research highlights: → Sump strainer head loss testing to evaluate chemical effects. → Aluminum hydroxide precipitates by in situ Al alloy corrosion caused head loss. → Intermetallic particles released from Al alloy can also cause significant head loss. → When evaluating Al effect on head loss, intermetallics should be considered. - Abstract: Vertical loop head loss tests were performed with 6061 and 1100 aluminum (Al) alloy plates immersed in borated solution at pH = 9.3 at room temperature and 60 o C. The results suggest that the potential for corrosion of an Al alloy to result in increased head loss across a glass fiber bed may depend on its microstructure, i.e., the size distribution and number density of intermetallic particles that are present in Al matrix and FeSiAl ternary compounds, as well as its Al release rate. Per unit mass of Al removed from solution, the WCAP-16530 aluminum hydroxide (Al(OH) 3 ) surrogate was more effective in increasing head loss than the Al(OH) 3 precipitates formed in situ by corrosion of Al alloy. However, in choosing a representative amount of surrogate for plant specific testing, consideration should be given to the potential for additional head losses due to intermetallic particles and the apparent reduction in the effective solubility of Al(OH) 3 when intermetallic particles are present.

  4. [S3 guideline. Part 2: Non-Traumatic Avascular Femoral Head Necrosis in Adults - Untreated Course and Conservative Treatment].

    Science.gov (United States)

    Roth, A; Beckmann, J; Smolenski, U; Fischer, A; Jäger, M; Tingart, M; Rader, C; Peters, K M; Reppenhagen, S; Nöth, U; Heiss, C; Maus, U

    2015-10-01

    In Germany there are 5000 to 7000 new cases of atraumatic avascular necrosis of the femoral head in adults per year. It occurs mostly in middle age. An increased frequency of idiopathic cases can be observed. Chemotherapy, corticoids and kidney transplants are frequently associated with the disease. In most cases the disease occurs on both sides. Early diagnosis is of particular importance, since in early stages it is most likely to avoid late damage with joint destruction. Whereas previously the temporary operational joint preservation and subsequent joint replacement were often the only option of treatment, conservative and joint-preserving measures today play an increasing role. After the AWMF guidelines for S3 guideline clinical questions were formulated. Over the period from 01/01/1970 to 31/05/2013 a literature search was conducted. Systematic reviews, metaanalyses, original papers and clinical trials of all designs were evaluated. There were a total of 3715 references, of which 422 for the assessment regarding SIGN were eligible and finally 180 were in accord with the defined inclusion and exclusion criteria. For the untreated course and the assessment of conservative measures, a total of 42 references was suitable. In formulating the recommendations the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system was used, which distinguishes A "shall", B "should" and 0 "can". If left untreated, the aFKN within 2 years leads to a subchondral fracture and subsequent collapse. After the diagnosis of femoral head necrosis, the risk of a disease of the opposite side is high within the next 2 years, then unlikely. The sole conservative treatment brings no benefit for the treatment of atraumatic avascular necrosis in the adult. Although it improves function, less pain can be obtained, and surgical intervention can be delayed, the progression is not stopped. Conservative treatment must therefore always be part of the overall treatment. In ARCO

  5. Serotonergic modulation of nicotine-induced kinetic tremor in mice

    Directory of Open Access Journals (Sweden)

    Naofumi Kunisawa

    2017-06-01

    Full Text Available We previously demonstrated that nicotine elicited kinetic tremor by elevating the neural activity of the inferior olive via α7 nicotinic acetylcholine (nACh receptors. Since α7 nACh receptors reportedly facilitate synaptic monoamine release, we explored the role of 5-HT receptors in induction and/or modulation of nicotine tremor. Treatment of mice with nicotine induced kinetic tremor that normally appeared during movement. The 5-HT1A agonist, 8-hydroxydipropylaminotetraline (8-OH-DPAT, significantly enhanced nicotine-induced tremor and the action of 8-OH-DPAT was antagonized by WAY-100135 (5-HT1A antagonist. In addition, the cerebral 5-HT depletion by repeated treatment with p-chlorophenylalanine did not reduce, but rather potentiated the facilitatory effects of 8-OH-DPAT. In contrast, the 5-HT2 agonist, 2,5-dimethoxy-4-iodoamphetamine (DOI, significantly attenuated nicotine tremor, which was antagonized by ritanserin (5-HT2 antagonist. The 5-HT3 agonist SR-57227 did not affect nicotine-induced tremor. Furthermore, when testing the direct actions of 5-HT antagonists, nicotine tremor was inhibited by WAY-100135, but was unaffected by ritanserin, ondansetron (5-HT3 antagonist or SB-258585 (5-HT6 antagonist. These results suggest that postsynaptic 5-HT1A receptors are involved in induction of nicotine tremor mediated by α7 nACh receptors. In addition, 5-HT2 receptors have an inhibitory modulatory role in induction of nicotine tremor.

  6. Observations of volcanic earthquakes and tremor at Deception Island - Antarctica

    Directory of Open Access Journals (Sweden)

    J. Morales

    1999-06-01

    Full Text Available Deception Island - South Shetlands, Antarctica is site of active volcanism. Since 1988 field surveys have been carried out with the aim of seismic monitoring, and in 1994 a seismic array was set up near the site of the Spanish summer base in order to better constrain the source location and spectral properties of the seismic events related to the volcanic activity. The array was maintained during the Antarctic summer of 1995 and the last field survey was carried out in 1996. Data show the existence of three different groups (or families of seismic events: 1 long period events, with a quasi-monochromatic spectral content (1-3 Hz peak frequency and a duration of more than 50 s, often occurring in small swarms lasting from several minutes to some day; 2 volcanic tremor, with a spectral shape similar to the long period events but with a duration of several minutes (2-10; 3 hybrid events, with a waveform characterised by the presence of a high frequency initial phase, followed by a low frequency phase with characteristics similar to those of the long period events. The high frequency phase of the hybrid events was analysed using polarisation techniques, showing the presence of P waves. This phase is presumably located at short epicentral distances and shallow source depth. All the analysed seismic events show back-azimuths between 120 and 330 degrees from north (corresponding to zones of volcanic activity showing no seismic activity in the middle of the caldera. Particle motion, Fourier spectral and spectrogram analysis show that the low frequency part of the three groups of the seismic signals have similar patterns. Moreover careful observations show that the high frequency phase which characterises the hybrid events is present in the long period and in the tremor events, even with lower signal to noise ratios. This evidence suggests that long period events are events in which the high frequency part is simply difficult to observe, due to a very

  7. TURKISH VERSION QUALITY OF LIFE IN ESSENTIAL TREMOR QUESTIONNAIRE (QUEST): VALIDITY AND RELIABILITY STUDY.

    Science.gov (United States)

    Güler, Sibel; Turan, F Nesrin

    2015-09-30

    Our aim was to translate the Quality of Life in Essential Tremor Questionnaire (QUEST) advanced by Troster (2005) and to analyse the validity and reliability of this questionnaire. Two hundred twelve consecutive patients with essential tremor (ET) and forty-three control subjects were included in the study. Permission for the translation and validation of the QUEST scale was obtained. The translation was performed according to the guidelines provided by the publisher. After the translation, the final version of the scale was administered to both groups to determine its reliability and validity. The QUEST Physical, Psychosocial, communication, Hobbies/leisure and Work/finance scores were 0.967, 0.968, 0.933, 0.964 and 0.925, respectively. There were good correlations between each of the QUEST scores that were indicative of good internal consistency. Additionally, we observed that all of the QUEST scores were most strongly related to the right and left arms (p=0.0001). However, we observed that all of the QUEST scores were weakly related to the voice, head and right leg (p=0.0001). These findings support the notion that the Turkish version of the Quality of Life in Essential Tremor (QUEST) questionnaire is a valid and reliable tool for the assessment of the quality of life of patients with ET.

  8. Loss of Balance between Striatal Feedforward Inhibition and Corticostriatal Excitation Leads to Tremor.

    Science.gov (United States)

    Oran, Yael; Bar-Gad, Izhar

    2018-02-14

    Fast-spiking interneurons (FSIs) exert powerful inhibitory control over the striatum and are hypothesized to balance the massive excitatory cortical and thalamic input to this structure. We recorded neuronal activity in the dorsolateral striatum and globus pallidus (GP) concurrently with the detailed movement kinematics of freely behaving female rats before and after selective inhibition of FSI activity using IEM-1460 microinjections. The inhibition led to the appearance of episodic rest tremor in the body part that depended on the somatotopic location of the injection within the striatum. The tremor was accompanied by coherent oscillations in the local field potential (LFP). Individual neuron activity patterns became oscillatory and coherent in the tremor frequency. Striatal neurons, but not GP neurons, displayed additional temporal, nonoscillatory correlations. The subsequent reduction in the corticostriatal input following muscimol injection to the corresponding somatotopic location in the primary motor cortex led to disruption of the tremor and a reduction of the LFP oscillations and individual neuron's phase-locked activity. The breakdown of the normal balance of excitation and inhibition in the striatum has been shown previously to be related to different motor abnormalities. Our results further indicate that the balance between excitatory corticostriatal input and feedforward FSI inhibition is sufficient to break down the striatal decorrelation process and generate oscillations resulting in rest tremor typical of multiple basal ganglia disorders. SIGNIFICANCE STATEMENT Fast-spiking interneurons (FSIs) play a key role in normal striatal processing by exerting powerful inhibitory control over the network. FSI malfunctions have been associated with abnormal processing of information within the striatum that leads to multiple movement disorders. Here, we study the changes in neuronal activity and movement kinematics following selective inhibition of these

  9. Complex evolution of transient slip derived from precise tremor locations in western Shikoku, Japan

    Science.gov (United States)

    Shelly, David R.; Beroza, Gregory C.; Ide, Satoshi

    2007-10-01

    Transient slip events, which occur more slowly than traditional earthquakes, are increasingly being recognized as important components of strain release on faults and may substantially impact the earthquake cycle. Surface-based geodetic instruments provide estimates of the overall slip distribution in larger transients but are unable to capture the detailed evolution of such slip, either in time or in space. Accompanying some of these slip transients is a relatively weak, extended duration seismic signal, known as nonvolcanic tremor, which has recently been shown to be generated by a sequence of shear failures occurring as part of the slip event. By precisely locating the tremor, we can track some features of slip evolution with unprecedented resolution. Here, we analyze two weeklong episodes of tremor and slow slip in western Shikoku, Japan. We find that these slip transients do not evolve in a smooth and steady fashion but contain numerous subevents of smaller size and shorter duration. In addition to along-strike migration rates of ˜10 km/d observed previously, much faster migration also occurs, usually in the slab dip direction, at rates of 25-150 km/h over distances of up to ˜20 km. We observe such migration episodes in both the updip and downdip directions. These episodes may be most common on certain portions of the plate boundary that generate strong tremor in intermittent bursts. The surrounding regions of the fault may slip more continuously, driving these stronger patches to repeated failures. Tremor activity has a strong tidal periodicity, possibly reflecting the modulation of slow slip velocity by tidal stresses.

  10. The complex evolution of transient slip revealed by precise tremor locations in western Shikoku, Japan

    Science.gov (United States)

    Shelly, D. R.; Beroza, G. C.; Ide, S.

    2007-12-01

    Transient slow slip events are increasingly being recognized as important components of strain release on faults and may substantially impact the earthquake cycle. Surface-based geodetic instruments provide estimates of the overall slip distribution in larger transients but are unable to capture the detailed evolution of such slip, either in time or space. Accompanying some of these slip transients is a relatively weak, extended duration seismic signal, known as non-volcanic tremor, which has recently been shown to be generated by a sequence of shear failures occurring as part of the slip event. By precisely locating the tremor, we can track some features of slip evolution with unprecedented resolution. Here, we analyze two weeklong episodes of tremor and slow slip in western Shikoku, Japan. We find that these slip transients do not evolve in a smooth and steady fashion but contain numerous sub-events of smaller size and shorter duration. In addition to along-strike migration rates of about 10 km/day observed previously, much faster migration also occurs, usually in the slab dip direction, at rates of 25-150 km/hour over distances of up to 20 km. We observe such migration episodes in both the up-dip and down-dip directions. These episodes may be most common on certain portions of the plate boundary that generate strong tremor in intermittent bursts. The surrounding regions of the fault may slip more continuously, driving these stronger patches to repeated failures. Tremor activity has a strong tidal periodicity, possibly reflecting the modulation of slow slip velocity by tidal stresses.

  11. Global search of triggered non-volcanic tremor

    Science.gov (United States)

    Chao, Tzu-Kai Kevin

    Deep non-volcanic tremor is a newly discovered seismic phenomenon with low amplitude, long duration, and no clear P- and S-waves as compared with regular earthquake. Tremor has been observed at many major plate-boundary faults, providing new information about fault slip behaviors below the seismogenic zone. While tremor mostly occurs spontaneously (ambient tremor) or during episodic slow-slip events (SSEs), sometimes tremor can also be triggered during teleseismic waves of distance earthquakes, which is known as "triggered tremor". The primary focus of my Ph.D. work is to understand the physical mechanisms and necessary conditions of triggered tremor by systematic investigations in different tectonic regions. In the first chapter of my dissertation, I conduct a systematic survey of triggered tremor beneath the Central Range (CR) in Taiwan for 45 teleseismic earthquakes from 1998 to 2009 with Mw ≥ 7.5. Triggered tremors are visually identified as bursts of high-frequency (2-8 Hz), non-impulsive, and long-duration seismic energy that are coherent among many seismic stations and modulated by the teleseismic surface waves. A total of 9 teleseismic earthquakes has triggered clear tremor in Taiwan. The peak ground velocity (PGV) of teleseismic surface waves is the most important factor in determining tremor triggering potential, with an apparent threshold of ˜0.1 cm/s, or 7-8 kPa. However, such threshold is partially controlled by the background noise level, preventing triggered tremor with weaker amplitude from being observed. In addition, I find a positive correlation between the PGV and the triggered tremor amplitude, which is consistent with the prediction of the 'clock-advance' model. This suggests that triggered tremor can be considered as a sped-up occurrence of ambient tremor under fast loading from the passing surface waves. Finally, the incident angles of surface waves also play an important rule in controlling the tremor triggering potential. The next

  12. Insights into Pathophysiology from Medication-induced Tremor

    Directory of Open Access Journals (Sweden)

    John C. Morgan

    2017-10-01

    Full Text Available Background: Medication-induced tremor (MIT is common in clinical practice and there are many medications/drugs that can cause or exacerbate tremors. MIT typically occurs by enhancement of physiological tremor (EPT, but not all drugs cause tremor in this way. In this manuscript, we review how some common examples of MIT have informed us about the pathophysiology of tremor.Methods: We performed a PubMed literature search for published articles dealing with MIT and attempted to identify articles that especially dealt with the medication’s mechanism of inducing tremor.Results: There is a paucity of literature that deals with the mechanisms of MIT, with most manuscripts only describing the frequency and clinical settings where MIT is observed. That being said, MIT emanates from multiple mechanisms depending on the drug and it often takes an individualized approach to manage MIT in a given patient.Discussion: MIT has provided some insight into the mechanisms of tremors we see in clinical practice. The exact mechanism of MIT is unknown for most medications that cause tremor, but it is assumed that in most cases physiological tremor is influenced by these medications. Some medications (epinephrine that cause EPT likely lead to tremor by peripheral mechanisms in the muscle (β-adrenergic agonists, but others may influence the central component (amitriptyline. Other drugs can cause tremor, presumably by blockade of dopamine receptors in the basal ganglia (dopamine-blocking agents, by secondary effects such as causing hyperthyroidism (amiodarone, or by other mechanisms. We will attempt to discuss what is known and unknown about the pathophysiology of the most common MITs.

  13. Scaling analysis of the effects of load on hand tremor movements in essential tremor

    Science.gov (United States)

    Blesić, S.; Stratimirović, Dj.; Milošević, S.; Marić, J.; Kostić, V.; Ljubisavljević, M.

    2011-05-01

    In this paper we have used the Wavelet Transform (WT) and the Detrended Fluctuation Analysis (DFA) methods to analyze hand tremor movements in essential tremor (ET), in two different recording conditions (before and after the addition of wrist-cuff load). We have analyzed the time series comprised of peak-to-peak (PtP) intervals, extracted from regions around the first three main frequency components of the power spectra (PwS) of the recorded tremors, in order to substantiate results related to the effects of load on ET, to distinguish between multiple sources of ET, and to separate the influence of peripheral factors on ET. Our results show that, in ET, the dynamical characteristics, that is, values of respective scaling exponents, of the main frequency component of recorded tremors change after the addition of load. Our results also show that in all the observed cases the scaling behavior of the calculated functions changes as well-the calculated WT scalegrams and DFA functions display a shift in the position of the crossover when the load is added. We conclude that the difference in behavior of the WT and DFA functions between different conditions in ET could be associated with the expected pathology in ET, or with some additional mechanism that controls movements in ET patients, and causes the observed changes in scaling behavior.

  14. Striations, duration, migration and tidal response in deep tremor.

    Science.gov (United States)

    Ide, Satoshi

    2010-07-15

    Deep tremor in subduction zones is thought to be caused by small repeating shear slip events on the plate interface with significant slow components. It occurs at a depth of about 30 kilometres and provides valuable information on deep plate motion and shallow stress accumulation on the fault plane of megathrust earthquakes. Tremor has been suggested to repeat at a regular interval, migrate at various velocities and be modulated by tidal stress. Here I show that some time-invariant interface property controls tremor behaviour, using precise location of tremor sources with event duration in western Shikoku in the Nankai subduction zone, Japan. In areas where tremor duration is short, tremor is more strongly affected by tidal stress and migration is inhibited. Where tremor lasts longer, diffusive migration occurs with a constant diffusivity of 10(4) m(2) s(-1). The control property may be the ratio of brittle to ductile areas, perhaps determined by the influence of mantle wedge serpentinization on the plate interface. The spatial variation of the controlling property seems to be characterized by striations in tremor source distribution, which follows either the current or previous plate subduction directions. This suggests that the striations and corresponding interface properties are formed through the subduction of inhomogeneous structure, such as seamounts, for periods as long as ten million years.

  15. Linear modeling of possible mechanisms for parkinson tremor generation

    NARCIS (Netherlands)

    Lohnberg, P.

    1978-01-01

    The power of Parkinson tremor is expressed in terms of possibly changed frequency response functions between relevant variables in the neuromuscular system. The derivation starts out from a linear loopless equivalent model of mechanisms for general tremor generation. Hypothetical changes in this

  16. Modulating basal ganglia and cerebellar activity to suppress parkinsonian tremor

    NARCIS (Netherlands)

    Heida, Tjitske; Zhao, Yan; van Wezel, Richard Jack Anton

    2013-01-01

    Despite extensive research, the detailed pathophysiology of the parkinsonian tremor is still unknown. It has been hypothesized that the generation of parkinsonian tremor is related to abnormal activity within the basal ganglia. The cerebello-thalamic-cortical loop has been suggested to indirectly

  17. Dopamine controls Parkinson's tremor by inhibiting the cerebellar thalamus

    NARCIS (Netherlands)

    Dirkx, M.F.M.; Ouden, H.E.M. den; Aarts, E.; Timmer, M.H.M.; Bloem, B.R.; Toni, I.; Helmich, R.C.G.

    2017-01-01

    Parkinson's resting tremor is related to altered cerebral activity in the basal ganglia and the cerebello-thalamo-cortical circuit. Although Parkinson's disease is characterized by dopamine depletion in the basal ganglia, the dopaminergic basis of resting tremor remains unclear: dopaminergic

  18. Phenomenology of tremor-like signals observed over hydrocarbon reservoirs

    NARCIS (Netherlands)

    Dangel, S.; Schaepman, M.E.; Stoll, E.P.; Carniel, R.; Barzandji, O.; Rode, E.D.; Singer, J.M.

    2003-01-01

    We have observed narrow-band, low-frequency (1.5-4 Hz, amplitude 0.01-10 mum/s) tremor signals on the surface over hydrocarbon reservoirs (oil, gas and water multiphase fluid systems in porous media) at currently 15 sites worldwide. These 'hydrocarbon tremors' possess remarkably similar spectral and

  19. Estimation of the phase response curve from Parkinsonian tremor.

    Science.gov (United States)

    Saifee, Tabish A; Edwards, Mark J; Kassavetis, Panagiotis; Gilbertson, Tom

    2016-01-01

    Phase response curves (PRCs), characterizing the response of an oscillator to weak external perturbation, have been estimated from a broad range of biological oscillators, including single neurons in vivo. PRC estimates, in turn, provide an intuitive insight into how oscillatory systems become entrained and how they can be desynchronized. Here, we explore the application of PRC theory to the case of Parkinsonian tremor. Initial attempts to establish a causal effect of subthreshold transcranial magnetic stimulation applied to primary motor cortex on the filtered tremor phase were unsuccessful. We explored the possible explanations of this and demonstrate that assumptions made when estimating the PRC in a traditional setting, such as a single neuron, are not arbitrary when applied to the case of tremor PRC estimation. We go on to extract the PRC of Parkinsonian tremor using an iterative method that requires varying the definition of the tremor cycle and estimating the PRC at multiple peristimulus time samples. Justification for this method is supported by estimates of PRC from simulated single neuron data. We provide an approach to estimating confidence limits for tremor PRC and discuss the interpretational caveats introduced by tremor harmonics and the intrinsic variability of the tremor's period. Copyright © 2016 the American Physiological Society.

  20. Fragile X-associated tremor/ataxia syndrome.

    Science.gov (United States)

    Hoem, Gry; Koht, Jeanette

    2017-10-31

    Fragile X-associated tremor/ataxia syndrome (FXTAS) is a hereditary neurodegenerative disorder caused by a mutation on the X chromosome. The major signs and symptoms are tremor, ataxia and parkinsonism. Up to one in 2 000 persons over 50 years of age will develop the syndrome. There is reason to believe that too few individuals in Norway undergo testing for this condition.

  1. Sensory electrical stimulation for suppression of postural tremor in patients with essential tremor.

    Science.gov (United States)

    Heo, Jae-Hoon; Kim, Ji-Won; Kwon, Yuri; Lee, Sang-Ki; Eom, Gwang-Moon; Kwon, Do-Young; Lee, Chan-Nyeong; Park, Kun-Woo; Manto, Mario

    2015-01-01

    Essential tremor is an involuntary trembling of body limbs in people without tremor-related disease. In previous study, suppression of tremor by sensory electrical stimulation was confirmed on the index finger. This study investigates the effect of sensory stimulation on multiple segments and joints of the upper limb. It denotes the observation regarding the effect's continuity after halting the stimulation. 18 patients with essential tremor (8 men and 10 women) participated in this study. The task, "arms stretched forward", was performed and sensory electrical stimulation was applied on four muscles of the upper limb (Flexor Carpi Radialis, Extensor Carpi Radialis, Biceps Brachii, and Triceps Brachii) for 15 seconds. Three 3-D gyro sensors were used to measure the angular velocities of segments (finger, hand, and forearm) and joints (metacarpophalangeal and wrist joints) for three phases of pre-stimulation (Pre), during-stimulation (On), and 5 minute post-stimulation (P5). Three characteristic variables of root-mean-squared angular velocity, peak power, and peak power frequency were derived from the vector sum of the sensor signals. At On phase, RMS velocity was reduced from Pre in all segments and joints while peak power was reduced from Pre in all segments and joints except for forearm segment. Sensory stimulation showed no effect on peak power frequency. All variables at P5 were similar to those at On at all segments and joints. The decrease of peak power of the index finger was noted by 90% during stimulation from that of On phase, which was maintained even after 5 min. The results indicate that sensory stimulation may be an effective clinical method to treat the essential tremor.

  2. Tectonic tremor and LFEs on a reverse fault in Taiwan

    Science.gov (United States)

    Aguiar, Ana C.; Chao, Kevin; Beroza, Gregory C.

    2017-07-01

    We compare low-frequency earthquakes (LFEs) from triggered and ambient tremor under the southern Central Range, Taiwan. We apply the PageRank algorithm used by Aguiar and Beroza (2014) that exploits the repetitive nature of the LFEs to find repeating LFEs in both ambient and triggered tremor. We use these repeaters to create LFE templates and find that the templates created from both tremor types are very similar. To test their similarity, we use both interchangeably and find that most of both the ambient and triggered tremor match the LFE templates created from either data set, suggesting that LFEs for both events have a common origin. We locate the LFEs by using local earthquake P wave and S wave information and find that LFEs from triggered and ambient tremor locate to between 20 and 35 km on what we interpret as the deep extension of the Chaochou-Lishan Fault.

  3. Vocal Tremor: Novel Therapeutic Target for Deep Brain Stimulation

    Directory of Open Access Journals (Sweden)

    Vinod K. Ravikumar

    2016-10-01

    Full Text Available 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. In this study, we describe our multidisciplinary procedure for awake, frameless DBS with optimal stimulation targets as well as acoustic analysis and laryngoscopic assessment to quantify tremor reduction. Finally, we investigate the most recent clinical evidence regarding the procedure.

  4. Reversible Holmes' tremor due to spontaneous intracranial hypotension.

    Science.gov (United States)

    Iyer, Rajesh Shankar; Wattamwar, Pandurang; Thomas, Bejoy

    2017-07-27

    Holmes' tremor is a low-frequency hand tremor and has varying amplitude at different phases of motion. It is usually unilateral and does not respond satisfactorily to drugs and thus considered irreversible. Structural lesions in the thalamus and brainstem or cerebellum are usually responsible for Holmes' tremor. We present a 23-year-old woman who presented with unilateral Holmes' tremor. She also had hypersomnolence and headache in the sitting posture. Her brain imaging showed brain sagging and deep brain swelling due to spontaneous intracranial hypotension (SIH). She was managed conservatively and had a total clinical and radiological recovery. The brain sagging with the consequent distortion of the midbrain and diencephalon was responsible for this clinical presentation. SIH may be considered as one of the reversible causes of Holmes' tremor. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Seismic network based detection, classification and location of volcanic tremors

    Science.gov (United States)

    Nikolai, S.; Soubestre, J.; Seydoux, L.; de Rosny, J.; Droznin, D.; Droznina, S.; Senyukov, S.; Gordeev, E.

    2017-12-01

    Volcanic tremors constitute an important attribute of volcanic unrest in many volcanoes, and their detection and characterization is a challenging issue of volcano monitoring. The main goal of the present work is to develop a network-based method to automatically classify volcanic tremors, to locate their sources and to estimate the associated wave speed. The method is applied to four and a half years of seismic data continuously recorded by 19 permanent seismic stations in the vicinity of the Klyuchevskoy volcanic group (KVG) in Kamchatka (Russia), where five volcanoes were erupting during the considered time period. The method is based on the analysis of eigenvalues and eigenvectors of the daily array covariance matrix. As a first step, following Seydoux et al. (2016), most coherent signals corresponding to dominating tremor sources are detected based on the width of the covariance matrix eigenvalues distribution. With this approach, the volcanic tremors of the two volcanoes known as most active during the considered period, Klyuchevskoy and Tolbachik, are efficiently detected. As a next step, we consider the array covariance matrix's first eigenvectors computed every day. The main hypothesis of our analysis is that these eigenvectors represent the principal component of the daily seismic wavefield and, for days with tremor activity, characterize the dominant tremor sources. Those first eigenvectors can therefore be used as network-based fingerprints of tremor sources. A clustering process is developed to analyze this collection of first eigenvectors, using correlation coefficient as a measure of their similarity. Then, we locate tremor sources based on cross-correlations amplitudes. We characterize seven tremor sources associated with different periods of activity of four volcanoes: Tolbachik, Klyuchevskoy, Shiveluch, and Kizimen. The developed method does not require a priori knowledge, is fully automatic and the database of network-based tremor fingerprints

  6. Differences in postural tremor dynamics with age and neurological disease.

    Science.gov (United States)

    Morrison, Steven; Newell, Karl M; Kavanagh, Justin J

    2017-06-01

    The overlap of dominant tremor frequencies and similarly amplified tremor observed for Parkinson's disease (PD) and essential tremor (ET) means differentiating between these pathologies is often difficult. As tremor exhibits non-linear properties, employing both linear and non-linear analyses may help distinguish between the tremor dynamics of aging, PD and ET. This study was designed to examine postural tremor in healthy older adults, PD and ET using standard linear and non-linear metrics. Hand and finger postural tremor was recorded in 15 healthy older adults (64 ± 6 years), 15 older individuals with PD (63 ± 6 years), and 10 persons with ET (68 ± 7 years). Linear measures of amplitude, frequency, and between-limb coupling (coherence) were performed. Non-linear measures of regularity (ApEn) and coupling (Cross-ApEn) were also used. Additionally, receiver operating characteristic analyses were performed for those measures that were significantly different between all groups. The results revealed that the linear measures only showed significant differences between the healthy adults and ET/PD persons, but no differences between the two neurological groups. Coherence showed higher bilateral coupling for ET but no differences in inter-limb coupling between PD and healthy subjects. However, ApEn values for finger tremor revealed significant differences between all groups, with tremor for ET persons being more regular (lower ApEn) overall. Similarly, Cross-ApEn results also showed differences between all groups, with ET persons showing strongest inter-limb coupling followed by PD and elderly. Overall, our findings point to the diagnostic potential for non-linear measures of coupling and tremor structure as biomarkers for discriminating between ET, PD and healthy persons.

  7. Motor and Non-motor Features: Differences between Patients with Isolated Essential Tremor and Patients with Both Essential Tremor and Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Apostolia Ghika

    2015-08-01

    Full Text Available Background: Patients with essential tremor (ET who develop Parkinson’s disease (ET->PD may differ with respect to motor features (MFs and non-motor features (NMFs from patients with isolated ET. Few studies have assessed this issue. Methods: In this retrospective chart review, we analyzed data on MFs and NMFs of 175 patients, including 54 ET->PD and 121 ET, actively followed in the Athens University 1st Neurology Department. Results: Significantly more ET->PD than ET patients reported asymmetric tremor at ET onset (68.5% vs. 14.9%, p<0.001.  Significantly more ET than ET->PD patients had head tremor (43.5% vs. 13.2%, p<0.001 and cerebellar signs (41.3% vs. 9.3%, p<0.001. More ET than ET->PD patients reported hearing impairment (65.3% vs. 28.3%, p<0.001 and restless legs syndrome (34.8% vs. 3.7%, p<0.001. Conversely, a larger proportion of ET->PD than ET patients reported rapid eye movement behavior disorder (51.9% vs. 10.0%, p<0.001, constipation (67.9% vs. 36.4%, p<0.001, and olfactory dysfunction (83.3% vs. 36.4%, p<0.001. Discussion: The subset of ET->PD patients may have distinct MFs and NMFs that should be assessed further for the possible predictive value for the emergence of PD.  

  8. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement.

    Science.gov (United States)

    Buglione, Michela; Cavagnini, Roberta; Di Rosario, Federico; Sottocornola, Lara; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Paganelli, Corrado; Majorana, Alessandra; Gastaldi, Giorgio; Bossi, Paolo; Berruti, Alfredo; Pavanato, Giovanni; Nicolai, Piero; Maroldi, Roberto; Barasch, Andrei; Russi, Elvio G; Raber-Durlacher, Judith; Murphy, Barbara; Magrini, Stefano M

    2016-01-01

    Radiotherapy alone or in combination with chemotherapy and/or surgery is the typical treatment for head and neck cancer patients. Acute side effects (such as oral mucositis, dermatitis, salivary changes, taste alterations, etc.), and late toxicities in particular (such as osteo-radionecrosis, hypo-salivation and xerostomia, trismus, radiation caries etc.), are often debilitating. These effects tend to be underestimated and insufficiently addressed in the medical community. A multidisciplinary group of head and neck cancer specialists met in Milan with the aim of reaching a consensus on clinical definitions and management of these toxicities. The Delphi Appropriateness method was used for developing the consensus, and external experts evaluated the conclusions. This paper contains 10 clusters of statements about the clinical definitions and management of head and neck cancer treatment sequels (dental pathologies and osteo-radionecroses) that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecroses (10 clusters of statements), whereas this second part deals with trismus and xerostomia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Effects of timolol and atenolol on benign essential tremor: placebo-controlled studies based on quantitative tremor recording.

    Science.gov (United States)

    Dietrichson, P; Espen, E

    1981-08-01

    Two different beta-adrenoreceptor antagonists, atenolol and timolol, were separately compared with a placebo in the suppression of essential tremor. In two-week single-blind placebo-controlled studies with cross-over, timolol (5 mg twice daily) and atenolol (100 mg once daily) produced an equal reduction in sitting heart rate and sitting blood pressure. Timolol was effective in reducing tremor while atenolol failed to reduce tremor amplitude. These results indicate that essential tremor can be reduced but not blocked, by the adrenergic blocker timolol with both beta 1 and beta 2 blocking properties; but not by the relatively selective beta 1 blocking drug atenolol. Possibly, the tremor reduction is medicated by a peripheral effect on beta 2 adrenoreceptors.

  10. Does eye tremor provide the hyperacuity phenomenon?

    International Nuclear Information System (INIS)

    Zozor, Steeve; Amblard, Pierre-Olivier; Duchêne, Cédric

    2009-01-01

    This paper is devoted to a study of the role of the fluctuations that the eye is subject to, from the point of view of noise-enhanced processing. To this end, a basic model of the retina is considered, namely a regular sampler subject to space and time fluctuations that model the random sampling and the involuntary eye tremor respectively. The filtering that can be done by the photoreceptor is also taken into account and the study focuses on a stochastic model of a natural scene. To quantify the effect of the noise, a coefficient of correlation between the signal acquired by a given photoreceptor and a given point of the scene that the eye is looking at is considered. It is shown both for academic examples and for a more realistic case that the fluctuations which affect the retina can induce noise-enhanced processing effects. The observed effect is then interpreted as a stochastic control of the retina via the random tremor

  11. Rest and action tremor in Parkinson's disease: effects of Deep Brain Stimulation

    NARCIS (Netherlands)

    Heida, Tjitske; Wentink, E.C.

    2010-01-01

    One of the cardinal symptoms of Parkinson’s disease is rest tremor. While rest tremor generally disappears during sleep and voluntary movement, action tremor may be triggered by voluntary movement, and may even be more disabling than rest tremor. Deep brain stimulation (DBS) in the subthalamic

  12. Quantitative methods for evaluating the efficacy of thalamic deep brain stimulation in patients with essential tremor.

    Science.gov (United States)

    Wastensson, Gunilla; Holmberg, Björn; Johnels, Bo; Barregard, Lars

    2013-01-01

    Deep brain stimulation (DBS) of the thalamus is a safe and efficient method for treatment of disabling tremor in patient with essential tremor (ET). However, successful tremor suppression after surgery requires careful selection of stimulus parameters. Our aim was to examine the possible use of certain quantitative methods for evaluating the efficacy of thalamic DBS in ET patients in clinical practice, and to compare these methods with traditional clinical tests. We examined 22 patients using the Essential Tremor Rating Scale (ETRS) and quantitative assessment of tremor with the stimulator both activated and deactivated. We used an accelerometer (CATSYS tremor Pen) for quantitative measurement of postural tremor, and a eurythmokinesimeter (EKM) to evaluate kinetic tremor in a rapid pointing task. The efficacy of DBS on tremor suppression was prominent irrespective of the method used. The agreement between clinical rating of postural tremor and tremor intensity as measured by the CATSYS tremor pen was relatively high (rs = 0.74). The agreement between kinetic tremor as assessed by the ETRS and the main outcome variable from the EKM test was low (rs = 0.34). The lack of agreement indicates that the EKM test is not comparable with the clinical test. Quantitative methods, such as the CATSYS tremor pen, could be a useful complement to clinical tremor assessment in evaluating the efficacy of DBS in clinical practice. Future studies should evaluate the precision of these methods and long-term impact on tremor suppression, activities of daily living (ADL) function and quality of life.

  13. Tremor frequency characteristics in Parkinson's disease under resting-state and stress-state conditions.

    Science.gov (United States)

    Lee, Hong Ji; Lee, Woong Woo; Kim, Sang Kyong; Park, Hyeyoung; Jeon, Hyo Seon; Kim, Han Byul; Jeon, Beom S; Park, Kwang Suk

    2016-03-15

    Tremor characteristics-amplitude and frequency components-are primary quantitative clinical factors for diagnosis and monitoring of tremors. Few studies have investigated how different patient's conditions affect tremor frequency characteristics in Parkinson's disease (PD). Here, we analyzed tremor characteristics under resting-state and stress-state conditions. Tremor was recorded using an accelerometer on the finger, under resting-state and stress-state (calculation task) conditions, during rest tremor and postural tremor. The changes of peak power, peak frequency, mean frequency, and distribution of power spectral density (PSD) of tremor were evaluated across conditions. Patients whose tremors were considered more than "mild" were selected, for both rest (n=67) and postural (n=25) tremor. Stress resulted in both greater peak powers and higher peak frequencies for rest tremor (pstate condition. The distributions of PSD of tremor were symmetrical, regardless of conditions. Tremor is more evident and typical tremor characteristics, namely a lower frequency as amplitude increases, are different in stressful condition. Patient's conditions directly affect neural oscillations related to tremor frequencies. Therefore, tremor characteristics in PD should be systematically standardized across patient's conditions such as attention and stress levels. Copyright © 2016. Published by Elsevier B.V.

  14. The distributed somatotopy of tremor: a window into the motor system

    NARCIS (Netherlands)

    Helmich, R.C.G.

    2013-01-01

    The posterior ventrolateral thalamus (VLp) plays a crucial role in Parkinson's tremor and in essential tremor: deep brain stimulation (DBS) of the VLp effectively diminishes both tremor types. Previous research has shown tremor oscillations in the VLp, but the spatial extent and somatotopy of these

  15. Effects of beta-blockers and nicardipine on oxotremorine-induced tremor in common marmosets.

    Science.gov (United States)

    Mitsuda, M; Nomoto, M; Iwata, S

    1999-10-01

    Effects of beta-blockers (propranolol, arotinolol and nipradilol) and a Ca2+ channel blocker (nicardipine) on oxotremorine-induced tremor were studied in common marmosets. Generalized tremor was elicited by an intraperitoneal administration of 0.25 mg/kg oxotremorine. Intensity of the tremor was classified into 7 degrees, and it was evaluated every 10 min. The total intensity of oxotremorine-induced tremor for each drug was expressed as "points", which were the sum of tremor intensity scores evaluated every 10 min up to 190 min following the administration of oxotremorine. Beta-blockers significantly suppressed the tremor. On the other hand, the Ca2+ channel blocker exacerbated the tremor.

  16. Serotonergic modulation of nicotine-induced kinetic tremor in mice.

    Science.gov (United States)

    Kunisawa, Naofumi; Iha, Higor A; Nomura, Yuji; Onishi, Misaki; Matsubara, Nami; Shimizu, Saki; Ohno, Yukihiro

    2017-06-01

    We previously demonstrated that nicotine elicited kinetic tremor by elevating the neural activity of the inferior olive via α7 nicotinic acetylcholine (nACh) receptors. Since α7 nACh receptors reportedly facilitate synaptic monoamine release, we explored the role of 5-HT receptors in induction and/or modulation of nicotine tremor. Treatment of mice with nicotine induced kinetic tremor that normally appeared during movement. The 5-HT 1A agonist, 8-hydroxydipropylaminotetraline (8-OH-DPAT), significantly enhanced nicotine-induced tremor and the action of 8-OH-DPAT was antagonized by WAY-100135 (5-HT 1A antagonist). In addition, the cerebral 5-HT depletion by repeated treatment with p-chlorophenylalanine did not reduce, but rather potentiated the facilitatory effects of 8-OH-DPAT. In contrast, the 5-HT 2 agonist, 2,5-dimethoxy-4-iodoamphetamine (DOI), significantly attenuated nicotine tremor, which was antagonized by ritanserin (5-HT 2 antagonist). The 5-HT 3 agonist SR-57227 did not affect nicotine-induced tremor. Furthermore, when testing the direct actions of 5-HT antagonists, nicotine tremor was inhibited by WAY-100135, but was unaffected by ritanserin, ondansetron (5-HT 3 antagonist) or SB-258585 (5-HT 6 antagonist). These results suggest that postsynaptic 5-HT 1A receptors are involved in induction of nicotine tremor mediated by α7 nACh receptors. In addition, 5-HT 2 receptors have an inhibitory modulatory role in induction of nicotine tremor. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  17. Focal mechanisms and tidal modulation for tectonic tremors in Taiwan

    Science.gov (United States)

    Ide, S.; Yabe, S.; Tai, H. J.; Chen, K. H.

    2015-12-01

    Tectonic tremors in Taiwan have been discovered beneath the southern Central Range, but their hosting structure has been unknown. Here we constrain the focal mechanism of underground deformation related to tremors, using moment tensor inversion in the very low frequency band and tidal stress analysis. Three types of seismic data are used for two analysis steps: detection of tremors and the moment tensor inversion. Short-period seismograms from CWBSN are used for tremor detection. Broadband seismograms from BATS and the TAIGER project are used for both steps. About 1000 tremors were detected using an envelope correlation method in the high frequency band (2-8 Hz). Broadband seismograms are stacked relative to the tremor timing, and inverted for a moment tensor in the low frequency band (0.02-0.05 Hz). The best solution was obtained at 32 km depth, as a double-couple consistent with a low-angle thrust fault dipping to the east-southeast, or a high-angle thrust with a south-southwest strike. Almost all tremors occur when tidal shear stress is positive and normal stress is negative (clamping). Since the clamping stress is high for a high-angle thrust fault, the low-angle thrust fault is more likely to be the fault plane. Tremor rate increases non-linearly with increasing shear stress, suggesting a velocity strengthening friction law. The high tidal sensitivity is inconsistent with horizontal slip motion suggested by previous studies, and normal faults that dominates regional shallow earthquakes. Our results favor thrust slip on a low-angle fault dipping to the east-southeast, consistent with the subduction of the Eurasian plate. The tremor region is characterized by a deep thermal anomaly with decrease normal stress. This region has also experienced enough subduction to produce metamorphic fluids. A large amount of fluid and low vertical stress may explain the high tidal sensitivity.

  18. Suppression of enhanced physiological tremor via stochastic noise: initial observations.

    Directory of Open Access Journals (Sweden)

    Carlos Trenado

    Full Text Available Enhanced physiological tremor is a disabling condition that arises because of unstable interactions between central tremor generators and the biomechanics of the spinal stretch reflex. Previous work has shown that peripheral input may push the tremor-related spinal and cortical systems closer to anti-phase firing, potentially leading to a reduction in tremor through phase cancellation. The aim of the present study was to investigate whether peripherally applied mechanical stochastic noise can attenuate enhanced physiological tremor and improve motor performance. Eight subjects with enhanced physiological tremor performed a visuomotor task requiring the right index finger to compensate a static force generated by a manipulandum to which Gaussian noise (3-35 Hz was applied. The finger position was displayed on-line on a monitor as a small white dot which the subjects had to maintain in the center of a larger green circle. Electromyogram (EMG from the active hand muscles and finger position were recorded. Performance was measured by the mean absolute deviation of the white dot from the zero position. Tremor was identified by the acceleration in the frequency range 7-12 Hz. Two different conditions were compared: with and without superimposed noise at optimal amplitude (determined at the beginning of the experiment. The application of optimum noise reduced tremor (accelerometric amplitude and EMG activity and improved the motor performance (reduced mean absolute deviation from zero. These data provide the first evidence of a significant reduction of enhanced physiological tremor in the human sensorimotor system due to application of external stochastic noise.

  19. Relationship between blood harmane and harmine concentrations in familial essential tremor, sporadic essential tremor and controls.

    Science.gov (United States)

    Louis, Elan D; Jiang, Wendy; Gerbin, Marina; Mullaney, Mary M; Zheng, Wei

    2010-12-01

    Harmane, a potent tremor-producing β-carboline alkaloid, may play a role in the etiology of essential tremor (ET). Blood harmane concentrations are elevated in ET cases compared with controls yet the basis for this elevation remains unknown. Decreased metabolic conversion (harmane to harmine) is one possible explanation. Using a sample of >500 individuals, we hypothesized that defective metabolic conversion of harmane to harmine might underlie the observed elevated harmane concentration in ET, and therefore expected to find a higher harmane to harmine ratio in familial ET than in sporadic ET or controls. Blood harmane and harmine concentrations were quantified by high performance liquid chromatography. There were 78 familial ET cases, 187 sporadic ET cases, and 276 controls. Blood harmane and harmine concentrations were correlated with one another (Spearman's r=0.24, p<0.001). The mean (±SD) harmane/harmine ratio=23.4±90.9 (range=0.1-987.5). The harmane/harmine ratio was highest in familial ET (46.7±140.4), intermediate in sporadic ET (28.3±108.1), and lowest in controls (13.5±50.3) (p=0.03). In familial ET cases, there was no association between this ratio and tremor severity (Spearman's r=0.08, p=0.48) or tremor duration (Spearman's r=0.14, p=0.24). The basis for the elevated blood harmane concentration, particularly in familial ET, is not known, although the current findings (highest harmane/harmine ratio in familial ET cases) lends support to the possibility that it could be the result of a genetically-driven reduction in harmane metabolism. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Jaw tremor as a physiological biomarker of bruxism.

    Science.gov (United States)

    Laine, C M; Yavuz, Ş U; D'Amico, J M; Gorassini, M A; Türker, K S; Farina, D

    2015-09-01

    To determine if sleep bruxism is associated with abnormal physiological tremor of the jaw during a visually-guided bite force control task. Healthy participants and patients with sleep bruxism were given visual feedback of their bite force and asked to trace triangular target trajectories (duration=20s, peak force bruxism have abnormal jaw tremor when engaged in a visually-guided bite force task. Measurement of jaw tremor may aid in the detection/evaluation of bruxism. In light of previous literature, our results also suggest that bruxism is marked by abnormal or mishandled peripheral feedback from the teeth. Copyright © 2015. Published by Elsevier Ireland Ltd.

  1. The Connective Tissue Components of Optic Nerve Head Cupping in Monkey Experimental Glaucoma Part 1: Global Change

    Science.gov (United States)

    Yang, Hongli; Ren, Ruojin; Lockwood, Howard; Williams, Galen; Libertiaux, Vincent; Downs, Crawford; Gardiner, Stuart K.; Burgoyne, Claude F.

    2015-01-01

    Purpose To characterize optic nerve head (ONH) connective tissue change within 21 monkey experimental glaucoma (EG) eyes, so as to identify its principal components. Methods Animals were imaged three to five times at baseline then every 2 weeks following chronic unilateral IOP elevation, and euthanized early through end-stage confocal scanning laser tomographic change. Optic nerve heads were serial-sectioned, three-dimensionally (3D) reconstructed, delineated, and quantified. Overall EG versus control eye differences were assessed by general estimating equations (GEE). Significant, animal-specific, EG eye change was required to exceed the maximum physiologic intereye differences in six healthy animals. Results Overall EG eye change was significant (P connective tissue components of ONH “cupping” in monkey EG which serve as targets for longitudinally staging and phenotyping ONH connective tissue alteration within all forms of monkey and human optic neuropathy. PMID:26641545

  2. Management of radiation therapy-induced mucositis in head and neck cancer patients. Part II: supportive treatments

    Directory of Open Access Journals (Sweden)

    Wei Cheong Ngeow

    2011-12-01

    Full Text Available Oropharyngeal mucositis is the acute inflammatory and ulcerative reaction of the oral mucosa following radiation therapy to the head and neck region. It is such a common problem that nearly all head and neck cancer patients develop some degree of mucositis. This complication is usually transient in nature but it also represents an important clinical problem as it is a painful, debilitating, dose-dependent side effect for which there is no widely acceptable prophylaxis or effective treatment. As several authoritative groups have recently either undertaken systematic reviews or issued guidelines on the management of mucositis, it is the aim of this review instead, to provide an overview of all the remedies and pharmaceutical agents available, as well as highlighting to researchers the gaps that need to be filled.

  3. Strategy for magnetic resonance imaging of the head: results of a semi-empirical model. Part 1

    International Nuclear Information System (INIS)

    Droege, R.T.; Wiener, S.N.; Rzeszotarski, M.S.

    1984-01-01

    This paper is an introduction to lesion detection problems of MR. A mathematical model previously developed for normal anatomy has been extended to predict the appearance of any hypothetical lesion in magnetic (MR) images of the head. The model is applied to selected clinical images to demonstrate the loss of lesion visibility attributable to ''crossover'' and ''boundary effect.'' The model is also used to explain the origins of these problems, and to demonstrate that appropriate gray-scale manipulations can remedy these problems

  4. Diagnosis of essential tremor vs. Parkinson's disease: NeuroSPECT by means of Trodat-1 Tc99m, a marker of Dopamine Transporter

    International Nuclear Information System (INIS)

    Mena, I.; Diaz, F.

    2002-01-01

    Background Information. We have recently reported that NeuroSPECT (NSP) of the Dopamine Transporter (DAT) is a highly sensitive method for early diagnosis of Parkinson's disease. Objectives. To evaluate the sensitivity of NSP of DAT in patients with essential tremor (E.T.) and compare them with parkinsonian patients (pts.) and normal controls, in order to assess the sensitivity to detect symptomatic impairment of concentration of DAT in Parkinson's Disease (PD) and normality in essential tremor, thus becoming an important diagnostic tool for this differential clinical diagnosis. Materials and Methods. The present study concerns 13 patients with essential tremor (E.T.), 20 pts. with Parkinson's Disease (P.D.). The ET pts, 5/13 were female and there mean age was 62 y. The PD pts age 62±11 years. The UPDRS V was 1, mean evolution, of 3.0 years, 5/20 were females. The average UPDRS III was 14,. They were compared with 25 healthy controls, 20/25 females, mean age was 54±14 years. The mean age of 13 E.T. pts was 60 y. (range 24-81 y). At onset of E.T. the mean age was 40 y. ( range 5-67 y.) 7 pts. were classified as sporadic tremor and 6 pts. as familial tremor. The frequency of tremor was 6.4 cycles/sec and the amplitude fluctuated between moderate and very intense. 8/13 pts suffered prolongation of postural tremor into resting tremor, while 3 of them had been diagnosed as P.D. at other Institutions. 3/13 pts had postural and brachial tremor, head tremor(5/13 pts.) voice or chin tremor in 1/13 pts. 3/13 pts suffered impairment of mild postural tremor during writing, eating or drinking. Three-dimensional images of the distribution of DAT in brain were gathered 4 hours after iv. injection of 30 mCi of Trodat-1 Tc 99m. Results. In normal controls there is maximal concentration of DAT in caudate and putamen. We establish a comparison with the occipital cortex where there is mild non specific concentration of DAT. In 13 pts. with Essential Tremor there was no significant

  5. Familial Cortical Myoclonic Tremor with Epilepsy and Cerebellar Changes: Description of a New Pathology Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sarvi Sharifi

    2012-08-01

    Full Text Available Background: Over 60 Asian and European families with cortical myoclonic tremor and epilepsy have been reported under various names. Cerebellar changes may be part of the syndrome. In this study, we report the neuropathology findings in a new Dutch familial cortical myoclonic tremor with epilepsy case and review the literature on this syndrome.Methods: Neuropathological investigations were performed for a third case of the Dutch pedigree. In addition, we searched the literature for pedigrees meeting the criteria for benign familial myoclonic tremor and epilepsy.Results: Our third Dutch case showed cerebellar Purkinje cell changes and a normal cerebral cortex. The pedigrees described show phenotypical differences, cerebellar symptoms and cerebellar atrophy to a variable degree. Japanese pedigrees with linkage to chromosome 8q have been reported with milder disease features than members of Italian pedigrees with linkage to chromosome 2p. French pedigrees (5p possibly show even more severe and progressive disease, including cognitive changes and cerebellar features.Discussion: Currently, familial cortical myoclonic tremor is not listed by the International League Against Epilepsy, although it can be differentiated from other epileptic syndromes. Genetic heterogeneity and phenotypical differences between pedigrees exist. Cerebellar changes seem to be part of the syndrome in at least a number of pedigrees.

  6. Brittle and ductile friction modeling of triggered tremor in Guerrero, Mexico

    Science.gov (United States)

    Zhang, Y.; Daub, E. G.; Wu, C.

    2017-12-01

    Low frequency earthquakes (LFEs), which make up the highest amplitude portions of non-volcanic tremor, are mostly found along subduction zones at a depth of 30-40km which is typically within the brittle-ductile transition zone. Previous studies in Guerrero, Mexico demonstrated a relationship between the bursts of LFEs and the contact states of fault interfaces, and LFEs that triggered by different mechanisms were observed along different parts of the subduction zone. To better understand the physics of fault interfaces at depth, especially the influence of contact states of these asperities, we use a brittle-ductile friction model to simulate the occurrence of LFE families from a model of frictional failure and slip. This model takes the stress state, slip rate, perturbation force, fault area, and brittle-ductile frictional contact characteristics and simulates the times and amplitudes of LFE occurrence for a single family. We examine both spontaneous and triggered tremor occurrence by including stresses due to external seismic waves, such as the 2010 Maule Earthquake, which triggered tremor and slow slip on the Guerrero section of the subduction zone. By comparing our model output with detailed observations of LFE occurrence, we can determine valuable constraints on the frictional properties of subduction zones at depth.

  7. Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS)

    Science.gov (United States)

    ... Other specialists, eg in the areas of psychiatry, psychology, rehabilitation, urology, cardiology, and movement disorders neurology, may ... problems), tremors, and other symptoms, and MRI findings. History of FXTAS FXTAS was first described in five ...

  8. Iceberg Harmonic Tremor, Seismometer Data, Antarctica, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — Seismometers were placed on a 25 km by 50 km iceberg called C16 in the Ross Sea, Antarctica, to identify the Iceberg harmonic Tremor (IHT) source mechanism and to...

  9. Palatal tremor after lithium and carbamazepine use: a case report

    Directory of Open Access Journals (Sweden)

    Kuruvilla Anju

    2010-06-01

    Full Text Available Abstract Introduction Palatal tremor, characterized by rhythmic contractions of the soft palate, can occur secondary to pathology in the dentato-rubro-olivary pathway, or in the absence of such structural lesions. Its pathogenesis is only partially understood. We describe a case of probable drug-induced palatal tremor. Case presentation A 27-year-old Indian man had taken carbamazepine and lithium for 7 years for the treatment of a manic episode. He presented with a one-year history of bilateral rhythmic oscillations of his soft palate and tremors of his tongue. There were no other abnormalities detected from his examination or after detailed investigation. Conclusion Palatal tremors may result from medication used in the treatment of psychiatric disorders.

  10. Evaluation of a screening instrument for essential tremor

    DEFF Research Database (Denmark)

    Lorenz, Delia; Papengut, Frank; Frederiksen, Henrik

    2008-01-01

    To evaluate a screening instrument for essential tremor (ET) consisting of a seven-item questionnaire and a spiral drawing. A total of 2,448 Danish twins aged 70 years or more and a second sample aged 60 years or more (n = 1,684) from a population-based northern German cross-sectional study (Pop....... Definite or probable ET was diagnosed in 104 patients, possible in 86 and other tremors in 98 patients. The sensitivity of the screening instrument was 70.5%, the positive predictive value was 64.9%, the specificity was 68.2%, and the negative predictive value was 73.5%. Tremor severity correlated...... significantly with higher spiral scores and more positive items. More patients were identified by spiral drawing in all tremor groups. The interrater and intrarater reliability for spirals ranged from 0.7 to 0.8 using intraclass coefficient. A cluster analysis revealed that the questionnaire can be reduced...

  11. Holmes' tremor as a delayed complication of thalamic stroke.

    Science.gov (United States)

    Martins, William Alves; Marrone, Luiz Carlos Porcello; Fussiger, Helena; Vedana, Viviane Maria; Cristovam, Rafael do Amaral; Taietti, Marjorye Z; Marrone, Antonio Carlos Huf

    2016-04-01

    Movement disorders are not commonly associated with stroke. Accordingly, thalamic strokes have rarely been associated with tremor, pseudo-athetosis and dystonic postures. We present a 75-year-old man who developed a disabling tremor 1 year after a posterolateral thalamic stroke. This tremor had low frequency (3-4 Hz), did not disappear on focus and was exacerbated by maintaining a static posture and on target pursuit, which made it very difficult to perform basic functions. MRI demonstrated an old ischemic lesion at the left posterolateral thalamus. Treatment with levodopa led to symptom control. Lesions in the midbrain, cerebellum and thalamus may cause Holmes' tremor. Delayed onset of symptoms is usually seen, sometimes appearing 2 years after the original injury. This may be due to maturation of a complex neuronal network, leading to slow dopaminergic denervation. Further studies are needed to improve our understanding of this unique disconnection syndrome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Rare association of central pontine myelinolysis with infantile tremor syndrome

    Directory of Open Access Journals (Sweden)

    Kalpana Datta

    2012-01-01

    Full Text Available Central pontine myelinolysis (CPM is an acute demyelination within the central basis pontis. Though exact mechanism is not known it is seen commonly with rapid correction of hyponatremia and also with pontine ischemia or infarction, demyelinating diseases, pontine neoplasm and different metabolic diseases. We report a rare association of CPM in a patient of Infantile Tremor Syndrom (ITS. ITS is a syndrome of tremor, mental and physical retardation, pigmentary changes of hair and skin and anemia in malnourished children. Though first reported in Indian subcontinent many identical cases were reported from around the world. Our case is a 15 month old child with generalized tremor, mild hepatosplenomegaly with features of grade II malnutrition including skin and hair changes. All the signs and symtoms of tremor improved after treatment with the World Health Organization (WHO protocol for protein energy malnutrition (PEM and administration of propranolol without any side effects.

  13. Cortical tremor: a variant of cortical reflex myoclonus.

    Science.gov (United States)

    Ikeda, A; Kakigi, R; Funai, N; Neshige, R; Kuroda, Y; Shibasaki, H

    1990-10-01

    Two patients with action tremor that was thought to originate in the cerebral cortex showed fine shivering-like finger twitching provoked mainly by action and posture. Surface EMG showed relatively rhythmic discharge at a rate of about 9 Hz, which resembled essential tremor. However, electrophysiologic studies revealed giant somatosensory evoked potentials (SEPs) with enhanced long-loop reflex and premovement cortical spike by the jerk-locked averaging method. Treatment with beta-blocker showed no effect, but anticonvulsants such as clonazepam, valproate, and primidone were effective to suppress the tremor and the amplitude of SEPs. We call this involuntary movement "cortical tremor," which is in fact a variant of cortical reflex myoclonus.

  14. Surface-wave potential for triggering tectonic (nonvolcanic) tremor

    Science.gov (United States)

    Hill, D.P.

    2010-01-01

    Source processes commonly posed to explain instances of remote dynamic triggering of tectonic (nonvolcanic) tremor by surface waves include frictional failure and various modes of fluid activation. The relative potential for Love- and Rayleigh-wave dynamic stresses to trigger tectonic tremor through failure on critically stressed thrust and vertical strike-slip faults under the Coulomb-Griffith failure criteria as a function of incidence angle is anticorrelated over the 15- to 30-km-depth range that hosts tectonic tremor. Love-wave potential is high for strike-parallel incidence on low-angle reverse faults and null for strike-normal incidence; the opposite holds for Rayleigh waves. Love-wave potential is high for both strike-parallel and strike-normal incidence on vertical, strike-slip faults and minimal for ~45?? incidence angles. The opposite holds for Rayleigh waves. This pattern is consistent with documented instances of tremor triggered by Love waves incident on the Cascadia mega-thrust and the San Andreas fault (SAF) in central California resulting from shear failure on weak faults (apparent friction, ????? 0.2). However, documented instances of tremor triggered by surface waves with strike-parallel incidence along the Nankai megathrust beneath Shikoku, Japan, is associated primarily with Rayleigh waves. This is consistent with the tremor bursts resulting from mixed-mode failure (crack opening and shear failure) facilitated by near-lithostatic ambient pore pressure, low differential stress, with a moderate friction coefficient (?? ~ 0.6) on the Nankai subduction interface. Rayleigh-wave dilatational stress is relatively weak at tectonic tremor source depths and seems unlikely to contribute significantly to the triggering process, except perhaps for an indirect role on the SAF in sustaining tremor into the Rayleigh-wave coda that was initially triggered by Love waves.

  15. Seismic tremors and magma wagging during explosive volcanism.

    Science.gov (United States)

    Jellinek, A Mark; Bercovici, David

    2011-02-24

    Volcanic tremor is a ubiquitous feature of explosive eruptions. This oscillation persists for minutes to weeks and is characterized by a remarkably narrow band of frequencies from about 0.5 Hz to 7 Hz (refs 1-4). Before major eruptions, tremor can occur in concert with increased gas flux and related ground deformation. Volcanic tremor is thus of particular value for eruption forecasting. Most models for volcanic tremor rely on specific properties of the geometry, structure and constitution of volcanic conduits as well as the gas content of the erupting magma. Because neither the initial structure nor the evolution of the magma-conduit system will be the same from one volcano to the next, it is surprising that tremor characteristics are so consistent among different volcanoes. Indeed, this universality of tremor properties remains a major enigma. Here we employ the contemporary view that silicic magma rises in the conduit as a columnar plug surrounded by a highly vesicular annulus of sheared bubbles. We demonstrate that, for most geologically relevant conditions, the magma column will oscillate or 'wag' against the restoring 'gas-spring' force of the annulus at observed tremor frequencies. In contrast to previous models, the magma-wagging oscillation is relatively insensitive to the conduit structure and geometry, which explains the narrow band of tremor frequencies observed around the world. Moreover, the model predicts that as an eruption proceeds there will be an upward drift in both the maximum frequency and the total signal frequency bandwidth, the nature of which depends on the explosivity of the eruption, as is often observed.

  16. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Xerostomia and trismus (Part 2). Literature review and consensus statement.

    Science.gov (United States)

    Buglione, Michela; Cavagnini, Roberta; Di Rosario, Federico; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Bossi, Paolo; Majorana, Alessandra; Gastaldi, Giorgio; Berruti, Alfredo; Trippa, Fabio; Nicolai, Pietro; Barasch, Andrei; Russi, Elvio G; Raber-Durlacher, Judith; Murphy, Barbara; Magrini, Stefano M

    2016-06-01

    Radiotherapy alone or in combination with chemotherapy and/or surgery is a well-known radical treatment for head and neck cancer patients. Nevertheless acute side effects (such as moist desquamation, skin erythema, loss of taste, mucositis etc.) and in particular late toxicities (osteoradionecrosis, xerostomia, trismus, radiation caries etc.) are often debilitating and underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met in Milan with the aim of reaching a consensus on a clinical definition and management of these toxicities. The Delphi Appropriateness method was used for this consensus and external experts evaluated the conclusions. The paper contains 20 clusters of statements about the clinical definition and management of stomatological issues that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecrosis (10 clusters of statements), whereas this second part deals with trismus and xerostomia (10 clusters of statements). Copyright © 2016. Published by Elsevier Ireland Ltd.

  17. Tremor cells in the human thalamus: differences among neurological disorders.

    Science.gov (United States)

    Brodkey, Jason A; Tasker, Ronald R; Hamani, Clement; McAndrews, Mary Pat; Dostrovsky, Jonathan O; Lozano, Andres M

    2004-07-01

    Thalamic neurons firing at frequencies synchronous with tremor are thought to play a critical role in the generation and maintenance of tremor. The authors studied the incidence and locations of neurons with tremor-related activity (TRA) in the thalamus of patients with varied pathological conditions-including Parkinson disease (PD), essential tremor (ET), multiple sclerosis (MS), and cerebellar disorders--to determine whether known differences in the effectiveness of thalamic stereotactic procedures for these tremors could be correlated to differences in the incidence or locations of TRA cells. Seventy-five operations were performed in 61 patients during which 686 TRA cells were recorded from 440 microelectrode trajectories in the thalamus. The locations of the TRA cells in relation to electrophysiologically defined thalamic nuclei and the commissural coordinates were compared among patient groups. The authors found that TRA cells are present in patients with each of these disorders and that these cells populate several nuclei in the ventral lateral tier of the thalamus. There were no large differences in the locations of TRA cells among the different diagnostic classes, although there was a difference in the incidence of TRA cells in patients with PD, who had greater than 3.8 times more cells per thalamic trajectory than patients with ET and approximately five times more cells than patients with MS or cerebellar disorders. There was an increased incidence of TRA in the thalamus of patients with PD. The location of thalamic TRA cells in patients with basal ganglia and other tremor disorders was similar.

  18. Cerebral causes and consequences of parkinsonian resting tremor: a tale of two circuits?

    Science.gov (United States)

    Hallett, Mark; Deuschl, Günther; Toni, Ivan; Bloem, Bastiaan R.

    2012-01-01

    Tremor in Parkinson's disease has several mysterious features. Clinically, tremor is seen in only three out of four patients with Parkinson's disease, and tremor-dominant patients generally follow a more benign disease course than non-tremor patients. Pathophysiologically, tremor is linked to altered activity in not one, but two distinct circuits: the basal ganglia, which are primarily affected by dopamine depletion in Parkinson's disease, and the cerebello-thalamo-cortical circuit, which is also involved in many other tremors. The purpose of this review is to integrate these clinical and pathophysiological features of tremor in Parkinson's disease. We first describe clinical and pathological differences between tremor-dominant and non-tremor Parkinson's disease subtypes, and then summarize recent studies on the pathophysiology of tremor. We also discuss a newly proposed ‘dimmer-switch model’ that explains tremor as resulting from the combined actions of two circuits: the basal ganglia that trigger tremor episodes and the cerebello-thalamo-cortical circuit that produces the tremor. Finally, we address several important open questions: why resting tremor stops during voluntary movements, why it has a variable response to dopaminergic treatment, why it indicates a benign Parkinson's disease subtype and why its expression decreases with disease progression. PMID:22382359

  19. [Assessment of anti-tremorogenic drugs--nicotine-induced tail-tremor model].

    Science.gov (United States)

    Suemaru, K; Kawasaki, H; Gomita, Y

    1997-06-01

    The repeated administration of nicotine at small doses, which do not produce whole body tremor or convulsion, causes tremor only in the tail (tail-tremor) of rats. The tremor is accompanied by locomotor hyperactivity without rigidity and immobility of the whole body, suggesting that the nicotine-induced tail-tremor model is useful for studying the mechanism underlying tremor associated with movement. The tail-tremor induced by nicotine was suppressed by mecamylamine, a nicotinic antagonist, but not by atropine or scopolamine, muscalinic antagonists. Moreover, the tail-tremor was suppressed by the beta-blockers propranolol and pindolol, as well as the benzodiazepines diazepam and clonazepam. Tremor at rest is observed only in Parkinson's disease, which is improved with anti-muscalinic drugs. Essential tremor is one of the typical tremors connected with movement (postural and kinetic tremor) and is improved with beta-blocker. These findings and results suggest that nicotine-induced tail-tremor is useful for the study of essential tremor in animal models.

  20. Functional Ability Improved in Essential Tremor by IncobotulinumtoxinA Injections Using Kinematically Determined Biomechanical Patterns - A New Future.

    Directory of Open Access Journals (Sweden)

    Olivia Samotus

    Full Text Available Effective treatment for functional disability caused by essential tremor is a significant unmet need faced by many clinicians today. Current literature regarding focal therapy by botulinum toxin type A (BoNT-A injections uses fixed dosing regimens, which cannot be individualized, provides only limited functional benefit and unacceptable muscle weakness commonly occurs. This 38-week open label study, the longest to-date, demonstrates how kinematic technology addressed all these issues by guiding muscle selection.Participants (n = 24 were assessed at weeks 0, 6, 16, 22, 32, and 38 and injected with incobotulinumtoxinA at weeks 0, 16, and 32. Clinical assessments including UPDRS tremor items, Fahn-Tolosa-Marin (FTM tremor rating scale assessing tremor severity, writing and functional ability, quality of life questionnaire (QUEST and objective kinematic assessments were completed at every visit. Participants performed two postural and two weight-bearing scripted tasks with motion sensors placed over the wrist, elbow and shoulder joints. These sensors captured angular tremor amplitude (RMS units and acceleration joint motion that was segmented into directional components: flexion-extension (F/E, pronation-supination and radial-ulnar at the wrist, F/E at the elbow, and F/E and adduction-abduction at the shoulder. Injection parameters were determined using kinematics, followed by the clinician's determination of which muscles would contribute to the specific upper limb tremor biomechanics and dosing per participant.Multi-joint biomechanical recordings allowed individualized muscle selection and showed significant improvement in whole-arm function, FTM parts A-C scores, at week 6 which continued throughout the study. By week 38, the total FTM score statistically significantly reduced from 16.2±4.6 at week 0 to 9.5±6.3 (p<0.0005. UPDRS item 21 score rating action tremor was significantly reduced from 2.6±0.5 at week 0 to 1.6±1.1 (p = 0.01 at week 32

  1. Clinical Application of Cone-Beam Computed Tomography of the Rabbit Head: Part 1 – Normal Dentition

    Science.gov (United States)

    Riggs, G. G.; Arzi, Boaz; Cissell, Derek D.; Hatcher, David C.; Kass, Philip H.; Zhen, Amy; Verstraete, Frank J. M.

    2016-01-01

    Domestic rabbits (Oryctolagus cuniculus) are increasingly popular as household pets; therefore, veterinarians need to be familiar with the most common diseases afflicting rabbits including dental diseases. Diagnostic approaches for dental disease include gross oral examination, endoscopic oral examination, skull radiography, and computed tomography (CT). CT overcomes many limitations of standard radiography by permitting cross-sectional images of the rabbit head in multiple planes without superimposition of anatomic structures. Cone-beam CT (CBCT) is an oral and maxillofacial imaging modality that produces high-resolution images. The objective of this study was to describe and compare the normal anatomic features of the dentition and surrounding maxillofacial structures in healthy rabbits on CBCT and conventional CT. Ten New Zealand white rabbit cadaver heads were scanned using CBCT and conventional CT. Images were evaluated using Anatomage Invivo 5 software. The maxillofacial anatomy was labeled on CBCT images, and the mean lengths and widths of the teeth were determined. The visibility of relevant dental and anatomic features (pulp cavity, germinal center, tooth outline, periodontal ligament) were scored and compared between conventional CT and CBCT. The thinnest teeth were the maxillary second incisor teeth at 1.29 ± 0.26 mm and the maxillary third molar teeth at 1.04 ± 0.10 mm. In general, it was found that CBCT was superior to conventional CT when imaging the dentition. Importantly, the periodontal ligament was significantly (P < 0.01) more visible on CBCT than on conventional CT. Ability to see the periodontal ligament with such detail may allow earlier detection and treatment of periodontal disease in rabbits. This study is the first of its kind and shows the feasibility and yield of CBCT when evaluating the maxillofacial features and dentition in rabbits. PMID:27800485

  2. Heads Up

    Science.gov (United States)

    ... Connect with Us HEADS UP Apps Reshaping the Culture Around Concussion in Sports Get HEADS UP on Your Web Site Concussion ... HEADS UP on your web site! Create a culture of safety for young athletes Officials, learn how you can ... UP to Providers HEADS UP to Youth Sports HEADS UP to School Sports HEADS UP to ...

  3. Discrimination of Parkinsonian Tremor From Essential Tremor by Voting Between Different EMG Signal Processing Techniques

    Directory of Open Access Journals (Sweden)

    A Hossen

    2014-06-01

    Full Text Available Parkinson's disease (PD and essential tremor (ET are the two most common disorders that cause involuntary muscle shaking movements, or what is called "tremor”. PD is a neurodegenerative disease caused by the loss of dopamine receptors which control and adjust the movement of the body. On the other hand, ET is a neurological movement disorder which also causes tremors and shaking, but it is not related to dopamine receptor loss; it is simply a tremor. The differential diagnosis between these two disorders is sometimes difficult to make clinically because of the similarities of their symptoms; additionally, the available tests are complex and expensive. Thus, the objective of this paper is to discriminate between these two disorders with simpler, cheaper and easier ways by using electromyography (EMG signal processing techniques. EMG and accelerometer records of 39 patients with PD and 41 with ET were acquired from the Hospital of Kiel University in Germany and divided into a trial group and a test group. Three main techniques were applied: the wavelet-based soft-decision technique, statistical signal characterization (SSC of the spectrum of the signal, and SSC of the amplitude variation of the Hilbert transform. The first technique resulted in a discrimination efficiency of 80% on the trial set and 85% on the test set. The second technique resulted in an efficiency of 90% on the trial set and 82.5% on the test set. The third technique resulted in an 87.5% efficiency on the trial set and 65.5% efficiency on the test set. Lastly, a final vote was done to finalize the discrimination using these three techniques, and as a result of the vote, accuracies of 92.5%, 85.0% and 88.75% were obtained on the trial data, test data and total data, respectively.

  4. Hazard Monitoring of Growing Lava Flow Fields Using Seismic Tremor

    Science.gov (United States)

    Eibl, E. P. S.; Bean, C. J.; Jónsdottir, I.; Hoskuldsson, A.; Thordarson, T.; Coppola, D.; Witt, T.; Walter, T. R.

    2017-12-01

    An effusive eruption in 2014/15 created a 85 km2 large lava flow field in a remote location in the Icelandic highlands. The lava flows did not threaten any settlements or paved roads but they were nevertheless interdisciplinarily monitored in detail. Images from satellites and aircraft, ground based video monitoring, GPS and seismic recordings allowed the monitoring and reconstruction of a detailed time series of the growing lava flow field. While the use of satellite images and probabilistic modelling of lava flows are quite common tools to monitor the current and forecast the future growth direction, here we show that seismic recordings can be of use too. We installed a cluster of seismometers at 15 km from the vents and recorded the ground vibrations associated with the eruption. This seismic tremor was not only generated below the vents, but also at the edges of the growing lava flow field and indicated the parts of the lava flow field that were most actively growing. Whilst the time resolution is in the range of days for satellites, seismic stations easily sample continuously at 100 Hz and could therefore provide a much better resolution and estimate of the lava flow hazard in real-time.

  5. Square biphasic pulse deep brain stimulation for essential tremor: The BiP tremor study.

    Science.gov (United States)

    De Jesus, Sol; Almeida, Leonardo; Shahgholi, Leili; Martinez-Ramirez, Daniel; Roper, Jaimie; Hass, Chris J; Akbar, Umer; Wagle Shukla, Aparna; Raike, Robert S; Okun, Michael S

    2018-01-01

    Conventional deep brain stimulation (DBS) utilizes regular, high frequency pulses to treat medication-refractory symptoms in essential tremor (ET). Modifications of DBS pulse shape to achieve improved effectiveness is a promising approach. The current study assessed the safety, tolerability and effectiveness of square biphasic pulse shaping as an alternative to conventional ET DBS. This pilot study compared biphasic pulses (BiP) versus conventional DBS pulses (ClinDBS). Eleven ET subjects with clinically optimized ventralis intermedius nucleus DBS were enrolled. Objective measures were obtained over 3 h while ON BiP stimulation. There was observed benefit in the Fahn-Tolosa Tremor Rating Scale (TRS) for BiP conditions when compared to the DBS off condition and to ClinDBS setting. Total TRS scores during the DBS OFF condition (28.5 IQR = 24.5-35.25) were significantly higher than the other time points. Following active DBS, TRS improved to (20 IQR = 13.8-24.3) at ClinDBS setting and to (16.5 IQR = 12-20.75) at the 3 h period ON BiP stimulation (p = 0.001). Accelerometer recordings revealed improvement in tremor at rest (χ 2  = 16.1, p = 0.006), posture (χ 2  = 15.9, p = 0.007) and with action (χ 2  = 32.1, p=<0.001) when comparing median total scores at ClinDBS and OFF DBS conditions to 3 h ON BiP stimulation. There were no adverse effects and gait was not impacted. BiP was safe, tolerable and effective on the tremor symptoms when tested up to 3 h. This study demonstrated the feasibility of applying a novel DBS waveform in the clinic setting. Larger prospective studies with longer clinical follow-up will be required. Copyright © 2017. Published by Elsevier Ltd.

  6. Heading and head injuries in soccer.

    Science.gov (United States)

    Kirkendall, D T; Jordan, S E; Garrett, W E

    2001-01-01

    In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

  7. Tremor, the curious third wheel of fault motion (Invited)

    Science.gov (United States)

    Vidale, J. E.

    2009-12-01

    The known universe of tectonic fault behavior has gained a new neighborhood in the last few years. Before, faults were considered to either conform to the reasonably well-understood earthquake cycle or else slide steadily. In the earthquake cycle, a fault stays locked for the years while stress is accumulating, then cracks and slides, releasing about 0.1-10 MPa of the stress on the fault. The crack spreads across the fault at roughly the shear wave velocity, kilometers per second. Sliding across the crack occurs at rates on the order of a meter per second. Deeper than the locked portion, faults were assumed to move stealthily and steadily. Disrupting this orderly bipartite universe has been tremor - a prolonged, noise-like, 1-10 Hz rumbling that has been spotted below the locked portion of a variety of faults. In subduction zones, often tremor is coincident with slow and low-stress-drop slip that takes many orders of magnitude longer to complete than garden-variety earthquakes, with the rupture progression estimated in km per day rather than per second. The so-called episodic tremor and slip (ETS) is seen to strike at much more regular intervals than old-fashioned quakes. Speculation and disjoint observations abound. Probably the observations represent just the most easily observed portions of a process that moves with power at all frequencies. The spectrum of tremor radiation is less “red” than that of earthquakes for periods shorter than their duration. Near-lithostatic pore pressure may play an important role in lubricating ETS activity. ETS activity appears generally restricted to only some major faults. Strong passing surface waves from distant great earthquakes trigger pulsations of tremor. Strong nearby earthquakes can cause weeks of stronger than normal tremor. The ebb and flow of diurnal tides cause a rise and fall in tremor amplitude. Tremor can contain earthquake-like short bursts of energy, even dozens of discrete pops, all with the less red spectra

  8. Deep brain stimulation in uncommon tremor disorders: indications, targets, and programming.

    Science.gov (United States)

    Artusi, Carlo Alberto; Farooqi, Ashar; Romagnolo, Alberto; Marsili, Luca; Balestrino, Roberta; Sokol, Leonard L; Wang, Lily L; Zibetti, Maurizio; Duker, Andrew P; Mandybur, George T; Lopiano, Leonardo; Merola, Aristide

    2018-03-06

    In uncommon tremor disorders, clinical efficacy and optimal anatomical targets for deep brain stimulation (DBS) remain inadequately studied and insufficiently quantified. We performed a systematic review of PubMed.gov and ClinicalTrials.gov. Relevant articles were identified using the following keywords: "tremor", "Holmes tremor", "orthostatic tremor", "multiple sclerosis", "multiple sclerosis tremor", "neuropathy", "neuropathic tremor", "fragile X-associated tremor/ataxia syndrome", and "fragile X." We identified a total of 263 cases treated with DBS for uncommon tremor disorders. Of these, 44 had Holmes tremor (HT), 18 orthostatic tremor (OT), 177 multiple sclerosis (MS)-associated tremor, 14 neuropathy-associated tremor, and 10 fragile X-associated tremor/ataxia syndrome (FXTAS). DBS resulted in favorable, albeit partial, clinical improvements in HT cases receiving Vim-DBS alone or in combination with additional targets. A sustained improvement was reported in OT cases treated with bilateral Vim-DBS, while the two cases treated with unilateral Vim-DBS demonstrated only a transient effect. MS-associated tremor responded to dual-target Vim-/VO-DBS, but the inability to account for the progression of MS-associated disability impeded the assessment of its long-term clinical efficacy. Neuropathy-associated tremor substantially improved with Vim-DBS. In FXTAS patients, while Vim-DBS was effective in improving tremor, equivocal results were observed in those with ataxia. DBS of select targets may represent an effective therapeutic strategy for uncommon tremor disorders, although the level of evidence is currently in its incipient form and based on single cases or limited case series. An international registry is, therefore, warranted to clarify selection criteria, long-term results, and optimal surgical targets.

  9. The occurrence of dystonia in upper-limb multiple sclerosis tremor.

    Science.gov (United States)

    Van der Walt, A; Buzzard, K; Sung, S; Spelman, T; Kolbe, S C; Marriott, M; Butzkueven, H; Evans, A

    2015-12-01

    The pathophysiology of multiple sclerosis (MS) tremor is uncertain with limited phenotypical studies available. To investigate whether dystonia contributes to MS tremor and its severity. MS patients (n = 54) with and without disabling uni- or bilateral upper limb tremor were recruited (39 limbs per group). We rated tremor severity, writing and Archimedes spiral drawing; cerebellar dysfunction (SARA score); the Global Dystonia Scale (GDS) for proximal and distal upper limbs, dystonic posturing, mirror movements, geste antagoniste, and writer's cramp. Geste antagoniste, mirror dystonia, and dystonic posturing were more frequent and severe (p tremor severity in tremor compared to non-tremor patients. A 1-unit increase in distal dystonia predicted a 0.52-Bain unit (95% confidence interval (CI) 0.08-0.97), p = 0.022) increase in tremor severity and a 1-unit (95% CI 0.48-1.6, p = 0.001) increase in drawing scores. A 1-unit increase in proximal dystonia predicted 0.93-Bain unit increase (95% CI 0.45-1.41, p tremor severity and 1.5-units (95% CI 0.62-2.41, p = 0.002) increase in the drawing score. Cerebellar function in the tremor limb and tremor severity was correlated (p tremor suggesting that MS tremor pathophysiology involves cerebello-pallido-thalamo-cortical network dysfunction. © The Author(s), 2015.

  10. Beta-blocker therapy for tremor in Parkinson's disease.

    Science.gov (United States)

    Crosby, N J; Deane, K H O; Clarke, C E

    2003-01-01

    The tremor of Parkinson's disease can cause considerable disability for the individual concerned. Traditional antiparkinsonian therapies such as levodopa have only a minor effect on tremor. Beta-blockers are used to attenuate other forms of tremor such as Essential Tremor or the tremor associated with anxiety. It is thought that beta-blockers may be of use in controlling the tremor of Parkinson's disease. To compare the efficacy and safety of adjuvant beta-blocker therapy against placebo for the treatment of tremor in patients with Parkinson's disease. Electronic searches of MEDLINE, EMBASE, SCISEARCH, BIOSIS, GEROLIT, OLDMEDLINE, LILACS, MedCarib, PASCAL, JICST-EPLUS, RUSSMED, DISSERTATION ABSTRACTS, SIGLE, ISI-ISTP, Aslib Index to Theses, The Cochrane Controlled Trials Register, Clinicaltrials.gov, metaRegister of Controlled Trials, NIDRR, NRR and CENTRAL were conducted. Grey literature was hand searched and the reference lists of identified studies and reviews examined. The manufacturers of beta-blockers were contacted. Randomised controlled trials of adjuvant beta-blocker therapy versus placebo in patients with a clinical diagnosis of idiopathic Parkinson's disease. Data was abstracted independently by two of the authors onto standardised forms and disagreements were resolved by discussion. Four randomised controlled trials were found comparing beta-blocker therapy with placebo in patients with idiopathic Parkinson's disease. These were double-blind cross-over studies involving a total of 72 patients. Three studies did not present data from the first arm, instead presenting results as combined data from both treatment arms and both placebo arms. The risk of a carry-over effect into the second arm meant that these results were not analysed. The fourth study presented data from each arm. This was in the form of a mean total score for tremor for each group. Details of the baseline scores, the numbers of patients in each group and standard deviations were not

  11. Annual modulation of non-volcanic tremor in northern Cascadia

    Science.gov (United States)

    Pollitz, Fred; Wech, Aaron G.; Kao, Honn; Burgmann, Roland

    2013-01-01

    Two catalogs of episodic tremor events in northern Cascadia, one from 2006 to 2012 and the other from 1997 to 2011, reveal two systematic patterns of tremor occurrence in southern Vancouver Island: (1) most individual events tend to occur in the third quarter of the year; (2) the number of events in prolonged episodes (i.e., episodic tremor and slip events), which generally propagate to Vancouver Island from elsewhere along the Cascadia subduction zone, is inversely correlated with the amount of precipitation that occurred in the preceding 2 months. We rationalize these patterns as the product of hydrologic loading of the crust of southern Vancouver Island and the surrounding continental region, superimposed with annual variations from oceanic tidal loading. Loading of the Vancouver Island crust in the winter (when the land surface receives ample precipitation) and unloading in the summer tends to inhibit and enhance downdip shear stress, respectively. Quantitatively, for an annually variable surface load, the predicted stress perturbation depends on mantle viscoelastic rheology. A mechanical model of downdip shear stress on the transition zone beneath Vancouver Island—driven predominantly by the annual hydrologic cycle—is consistent with the 1997–2012 tremor observations, with peak-to-peak downdip shear stress of about 0.4 kPa. This seasonal dependence of tremor occurrence appears to be restricted to southern Vancouver Island because of its unique situation as an elongated narrow-width land mass surrounded by ocean, which permits seasonal perturbations in shear stress at depth.

  12. [A Case of Psychogenic Tremor during Awake Craniotomy].

    Science.gov (United States)

    Kujirai, Kazumasa; Kamata, Kotoe; Uno, Toshihiro; Hamada, Keiko; Ozaki, Makoto

    2016-01-01

    A 31-year-old woman with a left frontal and parietal brain tumor underwent awake craniotomy. Propofol/remifentanil general anesthesia was induced. Following craniotomy, anesthetic administrations ceased. The level of consciousness was sufficient and she was not agitated. However, the patient complained of nausea 70 minutes into the awake phase. Considering the adverse effects of antiemetics and the upcoming surgical strategy, we did not give any medications. Nausea disappeared spontaneously while the operation was suspended. When surgical intervention extended to the left caudate nucleus, involuntary movement, classified as a tremor, with 5-6 Hz frequency, abruptly occurred on her left forearm. The patient showed emotional distress. Tremor appeared on her right forearm and subsequently spread to her lower extremities. Intravenous midazolam and fentanyl could not reduce her psychological stress. Since the tremor disturbed microscopic observation, general anesthesia was induced. Consequently, the tremor disappeared and did not recur. Based on the anatomical ground and the medication status, her involuntary movement was diagnosed as psychogenic tremor. Various factors can induce involuntary movements. In fact, intraoperative management of nausea and vomiting takes priority during awake craniotomy, but we should be reminded that some antiemetics potentially induce involuntary movement that could be caused by surgery around basal ganglia.

  13. Linking Essential Tremor to the Cerebellum: Clinical Evidence.

    Science.gov (United States)

    Benito-León, Julián; Labiano-Fontcuberta, Andrés

    2016-06-01

    Essential tremor (ET) might be a family of diseases unified by the presence of kinetic tremor, but also showing etiological, pathological, and clinical heterogeneity. In this review, we will describe the most significant clinical evidence, which suggests that ET is linked to the cerebellum. Data for this review were identified by searching PUBMED (January 1966 to May 2015) crossing the terms "essential tremor" (ET) and "cerebellum," which yielded 201 entries, 11 of which included the term "cerebellum" in the article title. This was supplemented by articles in the author's files that pertained to this topic. The wide spectrum of clinical features of ET that suggest that it originates as a cerebellar or cerebellar outflow problem include the presence of intentional tremor, gait and balance abnormalities, subtle features of dysarthria, and oculomotor abnormalities, as well as deficits in eye-hand coordination, motor learning deficits, incoordination during spiral drawing task, abnormalities in motor timing and visual reaction time, impairment of social abilities, improvement in tremor after cerebellar stroke, efficacy of deep brain stimulation (which blocks cerebellar outflow), and cognitive dysfunction. It is unlikely, however, that cerebellar dysfunction, per se, fully explains ET-associated dementia, because the cognitive deficits that have been described in patients with cerebellar lesions are generally mild. Overall, a variety of clinical findings suggest that in at least a sizable proportion of patients with ET, there is an underlying abnormality of the cerebellum and/or its pathways.

  14. Blood harmane, blood lead, and severity of hand tremor: evidence of additive effects.

    Science.gov (United States)

    Louis, Elan D; Factor-Litvak, Pam; Gerbin, Marina; Slavkovich, Vesna; Graziano, Joseph H; Jiang, Wendy; Zheng, Wei

    2011-03-01

    Tremor is a widespread phenomenon in human populations. Environmental factors are likely to play an etiological role. Harmane (1-methyl-9H-pyrido[3,4-β]indole) is a potent tremor-producing β-carboline alkaloid. Lead is another tremor-producing neurotoxicant. The effects of harmane and lead with respect to tremor have been studied in isolation. We tested the hypothesis that tremor would be particularly severe among individuals who had high blood concentrations of both of these toxicants. Blood concentrations of harmane and lead were each quantified in 257 individuals (106 essential tremor cases and 151 controls) enrolled in an environmental epidemiological study. Total tremor score (range = 0-36) was a clinical measure of tremor severity. The total tremor score ranged from 0 to 36, indicating that a full spectrum of tremor severities was captured in our sample. Blood harmane concentration correlated with total tremor score (p = 0.007), as did blood lead concentration (p = 0.045). The total tremor score was lowest in participants with both low blood harmane and lead concentrations (8.4 ± 8.2), intermediate in participants with high concentrations of either toxicant (10.5 ± 9.8), and highest in participants with high concentrations of both toxicants (13.7 ± 10.4) (p=0.01). Blood harmane and lead concentrations separately correlated with total tremor scores. Participants with high blood concentrations of both toxicants had the highest tremor scores, suggesting an additive effect of these toxicants on tremor severity. Given the very high population prevalence of tremor disorders, identifying environmental determinants is important for primary disease prevention. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Dynamic Variability of Isometric Action Tremor in Precision Pinching

    Directory of Open Access Journals (Sweden)

    Tim Eakin

    2012-01-01

    Full Text Available Evolutionary development of isometric force impulse frequencies, power, and the directional concordance of changes in oscillatory tremor during performance of a two-digit force regulation task was examined. Analyses compared a patient group having tremor confounding volitional force regulation with a control group having no neuropathological diagnosis. Dependent variables for tremor varied temporally and spatially, both within individual trials and across trials, across individuals, across groups, and between digits. Particularly striking findings were magnitude increases during approaches to cue markers and shifts in the concordance phase from pinching toward rigid sway patterns as the magnitude increased. Magnitudes were significantly different among trace line segments of the task and were characterized by differences in relative force required and by the task progress with respect to cue markers for beginning, reversing force change direction, or task termination. The main systematic differences occurred during cue marker approach and were independent of trial sequence order.

  16. Essential Palatal Tremor Managed by Cognitive Behavioral Therapy

    Directory of Open Access Journals (Sweden)

    Tomohisa Kitamura

    2015-01-01

    Full Text Available Background. Essential palatal tremor is a disorder of unknown etiology involving involuntary movement of the uvula and soft palate. Treatment attempts including drugs or surgery have been conducted to cease the rhythmical movement. Case Report. A 55-year-old female visited our department complaining of a sudden, noticeable, intermittent, and rhythmical clicking noise in her throat for five years. Oral examination revealed rhythmical contractions of the soft palate with clicking at the frequency of 120 per min. Magnetic resonance imaging (MRI examination of the brain performed after consulting with the department of neuropathic internal medicine showed no abnormalities. Thus, essential palatal tremor was diagnosed. The symptoms improved with cognitive behavioral therapy without drugs or surgical treatments. The patient is now able to stop the rhythmical movement voluntarily. Discussion. Cognitive behavioral therapy might be suitable as first-line therapy for essential palatal tremor because the therapy is noninvasive.

  17. Subglacial discharge at tidewater glaciers revealed by seismic tremor

    Science.gov (United States)

    Bartholomaus, Timothy C.; Amundson, Jason M.; Walter, Jacob I.; O'Neel, Shad; West, Michael E.; Larsen, Christopher F.

    2015-01-01

    Subglacial discharge influences glacier basal motion and erodes and redeposits sediment. At tidewater glacier termini, discharge drives submarine terminus melting, affects fjord circulation, and is a central component of proglacial marine ecosystems. However, our present inability to track subglacial discharge and its variability significantly hinders our understanding of these processes. Here we report observations of hourly to seasonal variations in 1.5–10 Hz seismic tremor that strongly correlate with subglacial discharge but not with basal motion, weather, or discrete icequakes. Our data demonstrate that vigorous discharge occurs from tidewater glaciers during summer, in spite of fast basal motion that could limit the formation of subglacial conduits, and then abates during winter. Furthermore, tremor observations and a melt model demonstrate that drainage efficiency of tidewater glaciers evolves seasonally. Glaciohydraulic tremor provides a means by which to quantify subglacial discharge variations and offers a promising window into otherwise obscured glacierized environments.

  18. Treatment of essential and parkinsonian tremor with nipradilol.

    Science.gov (United States)

    Yoshii, F; Shinohara, Y; Takeoka, T; Kitagawa, Y; Akiyama, K; Yazaki, K

    1996-11-01

    Nipradilol is a new type of beta-blocker which possesses nitroglycerin-like vasodilating action in addition to beta-blocking action. We investigated the efficacy and safety of nipradilol for treating tremor in 20 patients with essential tremor (ET group) and 20 patients with Parkinson's disease (PD group). All patients received nipradilol (6 mg per day) for more than 8 weeks. Improvement of tremor appeared within 2 or 4 weeks after the start of nipradilol therapy, and the efficacy rate, defined as "moderately effective" or over, was 42.5% in all 40 patients, while that defined as "slightly effective" or over was 87.5%. The efficacy rate tended to be higher in the ET group compared with the PD group. Mean blood pressure was significantly decreased from the 4th week after the start of treatment and heart rate was significantly reduced from the 2nd week of treatment. Laboratory examination showed no significant changes.

  19. Atenolol vs. propranolol in essential tremor. A controlled, quantitative study.

    Science.gov (United States)

    Larsen, T A; Teräväinen, H; Calne, D B

    1982-11-01

    The beta-1 selective, hydrophilic adrenoceptor blocking drug atenolol (100 mg daily) was compared to the non-selective, lipid-soluble beta-blocker propranolol (240 mg daily), and to placebo, in a double-blind cross-over study in 24 patients with essential tremor. Atenolol and propranolol caused a similar decrease in heart rate. Both beta-blockers also suppressed the tremor intensity; there was no significant difference between them, but both were significantly better than placebo. These drugs did not affect tremor frequency. Twelve of the patients preferred propranolol subjectively, one preferred atenolol and none preferred placebo. No marked side-effects were observed. It was concluded that atenolol and other cardio-selective blockers offer an alternative for patients unable to tolerate the non-selective drugs. The site of action and receptor sub-type involved have still to be determined.

  20. Tremor Detection Using Parametric and Non-Parametric Spectral Estimation Methods : A Comparison with Clinical Assessment

    NARCIS (Netherlands)

    Martinez Manzanera, Octavio; Elting, Jan Willem; van der Hoeven, Johannes H; Maurits, Natasha M

    2016-01-01

    In the clinic, tremor is diagnosed during a time-limited process in which patients are observed and the characteristics of tremor are visually assessed. For some tremor disorders, a more detailed analysis of these characteristics is needed. Accelerometry and electromyography can be used to obtain a

  1. MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes.

    Science.gov (United States)

    Fasano, Alfonso; Llinas, Maheleth; Munhoz, Renato P; Hlasny, Eugen; Kucharczyk, Walter; Lozano, Andres M

    2017-08-22

    To report the 6-month single-blinded results of unilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) in patients with tremors other than essential tremor. Three patients with tremor due to Parkinson disease, 2 with dystonic tremor in the context of cervicobrachial dystonia and writer's cramp, and 1 with dystonia gene-associated tremor underwent MRgFUS targeting the ventro-intermedius nucleus (Vim) of the dominant hemisphere. The primary endpoint was the reduction of lateralized items of the Tremor Rating Scale of contralateral hemibody assessed by a blinded rater. All patients achieved a statistically significant, immediate, and sustained improvement of the contralateral tremor score by 42.2%, 52.0%, 55.9%, and 52.9% at 1 week and 1, 3, and 6 months after the procedure, respectively. All patients experienced transient side effects and 2 patients experienced persistent side effects at the time of last evaluation: hemitongue numbness and hemiparesis with hemihypoesthesia. Vim MRgFUS is a promising, incision-free, but nevertheless invasive technique to effectively treat tremors other than essential tremor. Future studies on larger samples and longer follow-up will further define its effectiveness and safety. NCT02252380. This study provides Class IV evidence that for patients with tremor not caused by essential tremor, MRgFUS of the Vim improves the tremor of the contralateral hemibody at 6 months. © 2017 American Academy of Neurology.

  2. Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor.

    Science.gov (United States)

    Moraes, Bruno Teixeira de; Biase, Noemi Grigoletto de

    2016-01-01

    Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms. To develop a task-specific protocol to assess voice tremor by means of nasofibrolaryngoscopy and to identify those tasks that can distinguish between essential and dystonic tremor syndromes. Cross-sectional study. The transnasal fiberoptic laryngoscopy protocol, which consisted of the assessment of palate, pharynx and larynx tremor during the performance of several vocal and non-vocal tasks with distinct phenomenological characteristics, was applied to 19 patients with voice tremor. Patients were diagnosed with essential or dystonic tremor according to the phenomenological characterization of each group. Once they were classified, the tasks associated with the presence of tremor in each syndrome were identified. The tasks that significantly contributed to the differential diagnosis between essential and dystonic tremor were /s/ production, continuous whistling and reduction of tremor in falsetto. These tasks were phenomenologically different with respect to the presence of tremor in the two syndromes. The protocol of specific tasks by means of transnasal fiberoptic laryngoscopy is a viable method to differentiate between essential and dystonic voice tremor syndromes through the following tasks: /s/ production, continuous whistling and reduction of tremor in falsetto. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. ‘YES YES HEAD TREMOR’ case developing after cerebellar infarction

    Directory of Open Access Journals (Sweden)

    Uygar Utku

    2015-12-01

    Full Text Available Movement disorders, developing after cerebellar infarctions, are rare. One of them is 'Yes / Yes tremor' head tremor. A 73-year-old female patient was brought to the emergency department of our hospital with complaints of dizziness, nausea and vomiting. There was hypertension on her past history. She was taking anti-hypertension drug. Her neurological examination was normal except for right dysmetria, disdiadikokinesia and damaged knee-heel test. Electrocardiography was atrial fibrillation with rapid ventricular response. On the right cerebellar hemisphere, brain computerized tomography revealed consistent lesions with acute ischemic stroke. The patient showed clinically significant improvement in time and discharged with coumadine. When she came for drug control after two weeks, we detected her ‘Yes / Yes’ revealed style of head tremor started three days ago. The tremor was resting-postural. Its activity increased with excitement, decreased after resting and stopped while sleeping. She was intolerant although we initiated the treatment with primidone 250 mg tablets divided into eight. After continuing the treatment with gabapentine titrated 300 mg tablets, the head tremor of patient improved remarkedly in a short period of time. The phenomenon is presented due to its rarity and remarkableness.

  4. Nonvolcanic tremors deep beneath the San Andreas Fault.

    Science.gov (United States)

    Nadeau, Robert M; Dolenc, David

    2005-01-21

    We have discovered nonvolcanic tremor activity (i.e., long-duration seismic signals with no clear P or S waves) within a transform plate boundary zone along the San Andreas Fault near Cholame, California, the inferred epicentral region of the 1857 Fort Tejon earthquake (moment magnitude approximately 7.8). The tremors occur between 20 to 40 kilometers' depth, below the seismogenic zone (the upper approximately 15 kilometers of Earth's crust where earthquakes occur), and their activity rates may correlate with variations in local earthquake activity.

  5. Intermittent bilateral coherence in physiological and essential hand tremor

    Czech Academy of Sciences Publication Activity Database

    Chakraborty, Soma; Kopecká, J.; Šprdlík, Otakar; Hoskovcová, M.; Ulmanová, O.; Růžička, E.; Zápotocký, Martin

    2017-01-01

    Roč. 128, č. 4 (2017), s. 622-634 ISSN 1388-2457 R&D Projects: GA ČR(CZ) GBP304/12/G069 Institutional support: RVO:67985823 ; RVO:67985556 Keywords : physiological tremor * essential tremor * bilateral coupling * coherence * ballistocardiac impulse * accelerometry * wavelet analysis Subject RIV: FH - Neurology; BC - Control Systems Theory (UTIA-B) OBOR OECD: Neurosciences (including psychophysiology; Computer sciences, information science, bioinformathics (hardware development to be 2.2, social aspect to be 5.8) (UTIA-B) Impact factor: 3.866, year: 2016

  6. Clinical neurogenetics: fragile x-associated tremor/ataxia syndrome.

    Science.gov (United States)

    Hall, Deborah A; O'Keefe, Joan A

    2013-11-01

    This article summarizes the clinical findings, genetics, pathophysiology, and treatment of fragile X-associated tremor ataxia syndrome. The disorder occurs from a CGG repeat (55-200) expansion in the fragile X mental retardation 1 gene. It manifests clinically in kinetic tremor, gait ataxia, and executive dysfunction, usually in older men who carry the genetic abnormality. The disorder has distinct radiographic and pathologic findings. Symptomatic treatment is beneficial in some patients. The inheritance is X-linked and family members may be at risk for other fragile X-associated disorders. This information is useful to neurologists, general practitioners, and geneticists. Copyright © 2013. Published by Elsevier Inc.

  7. Nadolol for lithium tremor in the presence of liver damage.

    Science.gov (United States)

    Dave, M; Langbart, M M

    1994-03-01

    Lithium-induced tremor classically responds to treatment with propranolol. Since it is metabolized in the liver, propranolol may not be the drug of choice in those patients who have compromised liver function or who are recovering from prior liver diseases. Another nonselective beta-adrenergic blocker, nadolol, has no hepatic biotransformation. We present here the first case report of successful treatment of lithium-induced tremor with nadolol, which was selected because the patient had compromised liver function. The patient's liver function tests remained stable with the therapy.

  8. Cerebral gray matter volume losses in essential tremor: A case-control study using high resolution tissue probability maps.

    Science.gov (United States)

    Cameron, Eric; Dyke, Jonathan P; Hernandez, Nora; Louis, Elan D; Dydak, Ulrike

    2018-03-10

    Essential tremor (ET) is increasingly recognized as a multi-dimensional disorder with both motor and non-motor features. For this reason, imaging studies are more broadly examining regions outside the cerebellar motor loop. Reliable detection of cerebral gray matter (GM) atrophy requires optimized processing, adapted to high-resolution magnetic resonance imaging (MRI). We investigated cerebral GM volume loss in ET cases using automated segmentation of MRI T1-weighted images. MRI was acquired on 47 ET cases and 36 controls. Automated segmentation and voxel-wise comparisons of volume were performed using Statistical Parametric Mapping (SPM) software. To improve upon standard protocols, the high-resolution International Consortium for Brain Mapping (ICBM) 2009a atlas and tissue probability maps were used to process each subject image. Group comparisons were performed: all ET vs. Controls, ET with head tremor (ETH) vs. Controls, and severe ET vs. An analysis of variance (ANOVA) was performed between ET with and without head tremor and controls. Age, sex, and Montreal Cognitive Assessment (MoCA) score were regressed out from each comparison. We were able to consistently identify regions of cerebral GM volume loss in ET and in ET subgroups in the posterior insula, superior temporal gyri, cingulate cortex, inferior frontal gyri and other occipital and parietal regions. There were no significant increases in GM volume in ET in any comparisons with controls. This study, which uses improved methodologies, provides evidence that GM volume loss in ET is present beyond the cerebellum, and in fact, is widespread throughout the cerebrum as well. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Listening carefully: unique observations of harmonic tremor at Lascar volcano, Chile

    Directory of Open Access Journals (Sweden)

    M. Hellweg

    1999-06-01

    Full Text Available During the deployment of Proyecto de Investigación Sismológica de la Cordillera Occidental 94 (PISCO'94 in the Atacama Desert of Northern Chile, a broadband seismic station and a network of three short-period three-component stations were installed around the active volcano Lascar. The resulting data set includes a sequence of harmonic tremor with a fundamental at about 0.63 Hz and up to 30 overtones lasting 18 h. Power spectra and spectrograms of Lascar's harmonic tremor from the various stations demonstrate that the frequencies recorded cannot be explained as path effects, and must therefore be attributed to mechanisms at or near the source. The polarization of the wavefield cannot simply be explained as the propagation of any of the classical types of seismic waves, thus we apply new methods to the data to investigate the narrowband signals of the harmonic peaks. While the amplitude characteristics of these signals cannot be correlated across the network, frequency characteristics of the harmonic wavefield are consistent across stations and components. The tremor's fundamental frequency changes at the same time at all stations, indicating that such changes must be caused at the source. In addition, a change in the frequency of the fundamental, f1, is reflected exactly in the frequencies of the overtones, nf1 and peak-broadening in the power spectrum is the result of shifts in the fundamental frequency. It is therefore unlikely that the overtones are produced as resonances. This spectral behavior indicates rather that the source is some resonance at a single frequency within the magma, magma/gas or gas parts of the volcano whose amplitude exceeds the range for which the assumptions of linear acoustics are valid.

  10. Source and path effects in the wave fields of tremor and explosions at Stromboli Volcano, Italy

    Science.gov (United States)

    Chouet, B.; Saccorotti, G.; Martini, M.; Dawson, P.; De Luca, G.; Milana, G.; Scarpa, R.

    1997-01-01

    The wave fields generated by Strombolian activity are investigated using data from small-aperture seismic arrays deployed on the north flank of Stromboli and data from seismic and pressure transducers set up near the summit crater. Measurements of slowness and azimuth as a function of time clearly indicate that the sources of tremor and explosions are located beneath the summit crater at depths shallower than 200 m with occasional bursts of energy originating from sources extending to a depth of 3 km. Slowness, azimuth, and particle motion measurements reveal a complex composition of body and surface waves associated with topography, structure, and source properties. Body waves originating at depths shallower than 200 m dominate the wave field at frequencies of 0.5-2.5 Hz, and surface waves generated by the surficial part of the source and by scattering sources distributed around the island dominate at frequencies above 2.5 Hz. The records of tremor and explosions are both dominated by SH motion. Far-field records from explosions start with radial motion, and near-field records from those events show dominantly horizontal motion and often start with a low-frequency (1-2 Hz) precursor characterized by elliptical particle motion, followed within a few seconds by a high-frequency radial phase (1-10 Hz) accompanying the eruption of pyroclastics. The dominant component of the near- and far-field particle motions from explosions, and the timing of air and body wave phases observed in the near field, are consistent with a gaspiston mechanism operating on a shallow (<200 m deep), vertical crack-like conduit. Models of a degassing fluid column suggest that noise emissions originating in the collective oscillations of bubbles ascending in the magma conduit may provide an adequate self-excitation mechanism for sustained tremor generation at Stromboli. Copyright 1997 by the American Geophysical Union.

  11. Current assessment of integrated content of long-lived radionuclides in soils of the head part of the East Ural Radioactive Trace

    International Nuclear Information System (INIS)

    Molchanova, I.; Mikhailovskaya, L.; Antonov, K.; Pozolotina, V.; Antonova, E.

    2014-01-01

    Based on the datasets obtained during investigations from 2003 to 2012, the spatial distributions of 90 Sr, 137 Cs, and 239,240 Pu content in the soils of the head part of the East Ural Radioactive Trace (EURT) were mapped using the geographic information system ArcGIS. Taking into account the presence of spatial autocorrelation and anisotropy in the source data, an ordinary kriging method was applied to interpolate values of radionuclide contamination density at unsampled places. Further geostatistical data analysis was performed to determine the basic parameters of spatial dependencies and to integrally assess the contamination by long-lived radionuclides in soils of the central, east peripheral, and west peripheral parts of the trace. This analysis was based on simplified geometric models (sector- and rectangle-shaped areas). The Monte Carlo method was used to quantitatively assess the uncertainty of the values for the integrated quantities resulting from the statistical errors of the source data approximation. - Highlights: • We investigated 102 soil samples in 2003–2012 at different distances from PA Mayak. • We mapped spatial distribution of 90 Sr, 137 Cs, and 239,240 Pu at this area by ArcGIS. • Integrated content based on sector- and rectangle-shaped models are similar. • The studied area clearly split into central, west, and east parts. • Radionuclide content of the central part is higher two orders than of west and east. - Capsule abstract: The spatial distribution of 90 Sr, 137 Cs, and 239,240 Pu at the EURT area by ArcGIS

  12. Imaging different components of a tectonic tremor sequence in southwestern Japan using an automatic statistical detection and location method

    Science.gov (United States)

    Poiata, Natalia; Vilotte, Jean-Pierre; Bernard, Pascal; Satriano, Claudio; Obara, Kazushige

    2018-06-01

    In this study, we demonstrate the capability of an automatic network-based detection and location method to extract and analyse different components of tectonic tremor activity by analysing a 9-day energetic tectonic tremor sequence occurring at the downdip extension of the subducting slab in southwestern Japan. The applied method exploits the coherency of multiscale, frequency-selective characteristics of non-stationary signals recorded across the seismic network. Use of different characteristic functions, in the signal processing step of the method, allows to extract and locate the sources of short-duration impulsive signal transients associated with low-frequency earthquakes and of longer-duration energy transients during the tectonic tremor sequence. Frequency-dependent characteristic functions, based on higher-order statistics' properties of the seismic signals, are used for the detection and location of low-frequency earthquakes. This allows extracting a more complete (˜6.5 times more events) and time-resolved catalogue of low-frequency earthquakes than the routine catalogue provided by the Japan Meteorological Agency. As such, this catalogue allows resolving the space-time evolution of the low-frequency earthquakes activity in great detail, unravelling spatial and temporal clustering, modulation in response to tide, and different scales of space-time migration patterns. In the second part of the study, the detection and source location of longer-duration signal energy transients within the tectonic tremor sequence is performed using characteristic functions built from smoothed frequency-dependent energy envelopes. This leads to a catalogue of longer-duration energy sources during the tectonic tremor sequence, characterized by their durations and 3-D spatial likelihood maps of the energy-release source regions. The summary 3-D likelihood map for the 9-day tectonic tremor sequence, built from this catalogue, exhibits an along-strike spatial segmentation of

  13. Imaging different components of a tectonic tremor sequence in southwestern Japan using an automatic statistical detection and location method

    Science.gov (United States)

    Poiata, Natalia; Vilotte, Jean-Pierre; Bernard, Pascal; Satriano, Claudio; Obara, Kazushige

    2018-02-01

    In this study, we demonstrate the capability of an automatic network-based detection and location method to extract and analyse different components of tectonic tremor activity by analysing a 9-day energetic tectonic tremor sequence occurring at the down-dip extension of the subducting slab in southwestern Japan. The applied method exploits the coherency of multi-scale, frequency-selective characteristics of non-stationary signals recorded across the seismic network. Use of different characteristic functions, in the signal processing step of the method, allows to extract and locate the sources of short-duration impulsive signal transients associated with low-frequency earthquakes and of longer-duration energy transients during the tectonic tremor sequence. Frequency-dependent characteristic functions, based on higher-order statistics' properties of the seismic signals, are used for the detection and location of low-frequency earthquakes. This allows extracting a more complete (˜6.5 times more events) and time-resolved catalogue of low-frequency earthquakes than the routine catalogue provided by the Japan Meteorological Agency. As such, this catalogue allows resolving the space-time evolution of the low-frequency earthquakes activity in great detail, unravelling spatial and temporal clustering, modulation in response to tide, and different scales of space-time migration patterns. In the second part of the study, the detection and source location of longer-duration signal energy transients within the tectonic tremor sequence is performed using characteristic functions built from smoothed frequency-dependent energy envelopes. This leads to a catalogue of longer-duration energy sources during the tectonic tremor sequence, characterized by their durations and 3-D spatial likelihood maps of the energy-release source regions. The summary 3-D likelihood map for the 9-day tectonic tremor sequence, built from this catalogue, exhibits an along-strike spatial segmentation of

  14. Automated detection and characterization of harmonic tremor in continuous seismic data

    Science.gov (United States)

    Roman, Diana C.

    2017-06-01

    Harmonic tremor is a common feature of volcanic, hydrothermal, and ice sheet seismicity and is thus an important proxy for monitoring changes in these systems. However, no automated methods for detecting harmonic tremor currently exist. Because harmonic tremor shares characteristics with speech and music, digital signal processing techniques for analyzing these signals can be adapted. I develop a novel pitch-detection-based algorithm to automatically identify occurrences of harmonic tremor and characterize their frequency content. The algorithm is applied to seismic data from Popocatepetl Volcano, Mexico, and benchmarked against a monthlong manually detected catalog of harmonic tremor events. During a period of heightened eruptive activity from December 2014 to May 2015, the algorithm detects 1465 min of harmonic tremor, which generally precede periods of heightened explosive activity. These results demonstrate the algorithm's ability to accurately characterize harmonic tremor while highlighting the need for additional work to understand its causes and implications at restless volcanoes.

  15. Nonlinear dynamic mechanism of vocal tremor from voice analysis and model simulations

    Science.gov (United States)

    Zhang, Yu; Jiang, Jack J.

    2008-09-01

    Nonlinear dynamic analysis and model simulations are used to study the nonlinear dynamic characteristics of vocal folds with vocal tremor, which can typically be characterized by low-frequency modulation and aperiodicity. Tremor voices from patients with disorders such as paresis, Parkinson's disease, hyperfunction, and adductor spasmodic dysphonia show low-dimensional characteristics, differing from random noise. Correlation dimension analysis statistically distinguishes tremor voices from normal voices. Furthermore, a nonlinear tremor model is proposed to study the vibrations of the vocal folds with vocal tremor. Fractal dimensions and positive Lyapunov exponents demonstrate the evidence of chaos in the tremor model, where amplitude and frequency play important roles in governing vocal fold dynamics. Nonlinear dynamic voice analysis and vocal fold modeling may provide a useful set of tools for understanding the dynamic mechanism of vocal tremor in patients with laryngeal diseases.

  16. Heterogeneity of Monosymptomatic Resting Tremor in a Prospective Study: Clinical Features, Electrophysiological Test, and Dopamine Transporter Positron Emission Tomography

    Institute of Scientific and Technical Information of China (English)

    Hua-Guang Zheng; Rong Zhang; Xin Li; Fang-Fei Li; Ya-Chen Wang; Xue-Mei Wang; Ling-Long Lu

    2015-01-01

    Background:The relationship between monosymptomatic resting tremor (mRT) and Parkinson's disease (PD) remains controversial.In this study,we aimed to assess the function ofpresynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography (DAT-PET) and to evaluate the utility of clinical features or electrophysiological studies in differential diagnosis.Methods:Thirty-three consecutive patients with mRT were enrolled prospectively.The Unified Parkinson's Disease Rating Scale and electromyography were tested before DAT-PET.Striatal asymmetry index (SAI) was calculated,and a normal DAT-PET was defined as a SAI of <15%.Scans without evidence of dopaminergic deficits (SWEDDs) were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging.Results:Twenty-eight mRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD,while the remained 5 with a normal DAT-PET scan were SWEDDs.As for UPRDS,the dressing and hygiene score,walking in motor experiences of daily living (Part Ⅱ) and motor examination (Part Ⅲ) were significant different between two groups (P < 0.05 andP< 0.01,respectively).Bilateral tremor was more frequent in the SWEDDs group (P < 0.05).The frequency of resting tremor and the amplitude of postural tremor tend to be higher in the SWEDDs group (P =0.08 and P =0.05,respectively).Conclusions:mRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration,which can be determined by DAT-PET brain imaging.Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

  17. Rhythmic finger tapping reveals cerebellar dysfunction in essential tremor

    NARCIS (Netherlands)

    Buijink, A. W. G.; Broersma, M.; van der Stouwe, A. M. M.; van Wingen, G. A.; Groot, P. F. C.; Speelman, J. D.; Maurits, N. M.; van Rootselaar, A. F.

    Introduction: Cerebellar circuits are hypothesized to play a central role in the pathogenesis of essential tremor. Rhythmic finger tapping is known to strongly engage the cerebellar motor circuitry. We characterize cerebellar and, more specifically, dentate nucleus function, and neural correlates of

  18. Rhythmic finger tapping reveals cerebellar dysfunction in essential tremor

    NARCIS (Netherlands)

    Buijink, A. W. G.; Broersma, M.; van der Stouwe, A. M. M.; van Wingen, G. A.; Groot, P. F. C.; Speelman, J. D.; Maurits, N. M.; van Rootselaar, A. F.

    2015-01-01

    Cerebellar circuits are hypothesized to play a central role in the pathogenesis of essential tremor. Rhythmic finger tapping is known to strongly engage the cerebellar motor circuitry. We characterize cerebellar and, more specifically, dentate nucleus function, and neural correlates of cerebellar

  19. Knowledge gaps and research recommendations for essential tremor

    NARCIS (Netherlands)

    Hopfner, F.; Haubenberger, D.; Galpern, W.R.; Gwinn, K.; Veer, A. van der; White, S.; Bhatia, K.; Adler, C.H.; Eidelberg, D.; Ondo, W.; Stebbins, G.T.; Tanner, C.M.; Helmich, R.C.G.; Lenz, F.A.; Sillitoe, R.V.; Vaillancourt, D.; Vitek, J.L.; Louis, E.D.; Shill, H.A.; Frosch, M.P.; Foroud, T.; Kuhlenbaumer, G.; Singleton, A.; Testa, C.M.; Hallett, M.; Elble, R.; Deuschl, G.

    2016-01-01

    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)

  20. Acoustic Characteristics of Simulated Respiratory-Induced Vocal Tremor

    Science.gov (United States)

    Lester, Rosemary A.; Story, Brad H.

    2013-01-01

    Purpose: The purpose of this study was to investigate the relation of respiratory forced oscillation to the acoustic characteristics of vocal tremor. Method: Acoustical analyses were performed to determine the characteristics of the intensity and fundamental frequency (F[subscript 0]) for speech samples obtained by Farinella, Hixon, Hoit, Story,…

  1. Dementia in Fragile X-associated Tremor/Ataxia Syndrome

    Directory of Open Access Journals (Sweden)

    Ricardo Nitrini

    Full Text Available Abstract Fragile X-associated tremor/ataxia syndrome (FXTAS is a cause of movement disorders and cognitive decline which has probably been underdiagnosed, especially if its prevalence proves similar to those of progressive supranuclear palsy and amyotrophic lateral sclerosis. We report a case of a 74-year-old man who presented with action tremor, gait ataxia and forgetfulness. There was a family history of tremor and dementia, and one of the patient's grandsons was mentally deficient. Neuropsychological evaluation disclosed a frontal network syndrome. MRI showed hyperintensity of both middle cerebellar peduncles, a major diagnostic hallmark of FXTAS. Genetic testing revealed premutation of the FMR1 gene with an expanded (CGG90 repeat. The diagnosis of FXTAS is important for genetic counseling because the daughters of the affected individuals are at high risk of having offspring with fragile X syndrome. Tremors and cognitive decline should raise the diagnostic hypothesis of FXTAS, which MRI may subsequently reinforce, while the detection of the FMR1 premutation can confirm the condition.

  2. Propranolol as an adjunct therapy for hyperthyroid tremor.

    Science.gov (United States)

    Henderson, J M; Portmann, L; Van Melle, G; Haller, E; Ghika, J A

    1997-01-01

    We evaluated the use of propranolol as an adjunct to carbimazole in the treatment of hyperthyroid tremor and tachycardia in a double-blind, cross-over and placebo-controlled study. Seven patients were given carbimazole plus either placebo or propranolol (40 mg) for 1 month and then switched to the alternative adjunct treatment for a further month. All patients showed significant improvements (p tremor amplitude after 1 or 2 months from baseline. One month after the baseline, the mean improvements of heart rate were 23% for the carbimazole + placebo group and 38% for carbimazole + propranolol group. Tremor also improved during the 1st month of the study by 31% in the carbimazole + placebo group versus 59% in the carbimazole + propranolol group. Whereas further improvements were observed in both variables in those receiving propranolol as the second adjunct treatment, this was not the case in those who received placebo during the same period. These findings confirm that the beta-blocker propranolol is a useful adjunct in the early treatment of both the tremor and tachycardia of hyperthyroidism.

  3. O terramoto de Lisboa de 1755: tremores e temores

    Directory of Open Access Journals (Sweden)

    María José Ferro TAVARES

    2009-11-01

    Full Text Available RESUMEN: Con anterioridad al gran terremoto de 1755 ya se habían registrado en Portugal temblores de tierra de intensidad bastante significativa. En la actualidad, las cartas sismotectónicas enseñan que tanto la región de la Gran Lisboa, como la costa sur atlántica y costa algarvia son las que presentan mayor peligrosidad sísmica. Los temblores de tierra fueron desde siempre un asunto de preocupación para la población portuguesa que habitaba estas regiones, provocando temores y fobias que fueron transmitidos de generación en generación. En el presente trabajo se procura identificar las señales de cambios o de continuidad en la población portuguesa y las reacciones ante los efectos de los terremotos que desde tiempos remotos afectaran al país. Particular atención es atribuida a las interpretaciones de raíz escatológica, las primeras que surgieron y que gradualmente fueran sustituidas en el siglo XVII por explicaciones que invocaban la existencia de causas primeras (divinas y causas segundas (naturales en la discusión de este tipo de fenómenos. Va a ser con el terremoto de Lisboa, en 1755, cuando la experimentación surge como medio de explicación, inicialmente apenas en términos retóricos, para después, a partir del siglo XIX, en términos científicos, sustentar la aparición y desarrollo de la propia sismología. En Portugal, mientras exista un copioso acervo bibliográfico en lo que concierne a las referidas explicaciones, una actitud pragmática ante los terremotos ha prevalecido siempre, en el sentido de que es siempre más importante mitigar sus efectos, particularmente los efectos en la salud pública en lo que se refiere al terremoto de Lisboa, que determinar sus causas exactas.ABSTRACT: Before the great Lisbon earthquake of 1755 the continental part of Portugal had already experienced strong, catastrophic tremors; present day seismotectonic maps show that indeed the metropolitan area of the capital city, as well as

  4. Tremor Detection Using Parametric and Non-Parametric Spectral Estimation Methods: A Comparison with Clinical Assessment

    Science.gov (United States)

    Martinez Manzanera, Octavio; Elting, Jan Willem; van der Hoeven, Johannes H.; Maurits, Natasha M.

    2016-01-01

    In the clinic, tremor is diagnosed during a time-limited process in which patients are observed and the characteristics of tremor are visually assessed. For some tremor disorders, a more detailed analysis of these characteristics is needed. Accelerometry and electromyography can be used to obtain a better insight into tremor. Typically, routine clinical assessment of accelerometry and electromyography data involves visual inspection by clinicians and occasionally computational analysis to obtain objective characteristics of tremor. However, for some tremor disorders these characteristics may be different during daily activity. This variability in presentation between the clinic and daily life makes a differential diagnosis more difficult. A long-term recording of tremor by accelerometry and/or electromyography in the home environment could help to give a better insight into the tremor disorder. However, an evaluation of such recordings using routine clinical standards would take too much time. We evaluated a range of techniques that automatically detect tremor segments in accelerometer data, as accelerometer data is more easily obtained in the home environment than electromyography data. Time can be saved if clinicians only have to evaluate the tremor characteristics of segments that have been automatically detected in longer daily activity recordings. We tested four non-parametric methods and five parametric methods on clinical accelerometer data from 14 patients with different tremor disorders. The consensus between two clinicians regarding the presence or absence of tremor on 3943 segments of accelerometer data was employed as reference. The nine methods were tested against this reference to identify their optimal parameters. Non-parametric methods generally performed better than parametric methods on our dataset when optimal parameters were used. However, one parametric method, employing the high frequency content of the tremor bandwidth under consideration

  5. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols

    Science.gov (United States)

    Zecha, Judith A. E. M.; Raber-Durlacher, Judith E.; Nair, Raj G.; Epstein, Joel B.; Elad, Sharon; Hamblin, Michael R.; Barasch, Andrei; Migliorati, Cesar A.; Milstein, Dan M. J.; Genot, Marie-Thérèse; Lansaat, Liset; van der Brink, Ron; Arnabat-Dominguez, Josep; van der Molen, Lisette; Jacobi, Irene; van Diessen, Judi; de Lange, Jan; Smeele, Ludi E.; Schubert, Mark M.

    2016-01-01

    Purpose There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved and dosimetric parameters may lead to the management of a broader range of complications associated with HNC treatment. This could enhance patient adherence to cancer therapy, and improve quality of life and treatment outcomes. The mechanisms of action, dosimetric, and safety considerations for PBM have been reviewed in part 1. Part 2 discusses the head and neck treatment side effects for which PBM may prove to be effective. In addition, PBM parameters for each of these complications are suggested and future research directions are discussed. Methods Narrative review and presentation of PBM parameters are based on current evidence and expert opinion. Results PBM may have potential applications in the management of a broad range of side effects of (chemo)radiation therapy (CRT) in patients being treated for HNC. For OM management, optimal PBM parameters identified were as follows: wavelength, typically between 633 and 685 nm or 780–830 nm; energy density, laser or light-emitting diode (LED) output between 10 and 150 mW; dose, 2–3 J (J/cm2), and no more than 6 J/cm2 on the tissue surface treated; treatment schedule, two to three times a week up to daily; emission type, pulsed (<100 Hz); and route of delivery, intraorally and/or transcutaneously. To facilitate further studies, we propose potentially effective PBM parameters for prophylactic and therapeutic use in supportive care for dermatitis, dysphagia, dry mouth, dysgeusia, trismus, necrosis, lymphedema, and voice/speech alterations. Conclusion PBM may have a role in supportive care for a broad range of complications associated with the treatment of HNC with CRT

  6. Examination of Head Start students' and teachers' attitudes and behaviors toward trying new foods as part of a social marketing campaign

    OpenAIRE

    Stratton, Jessica Nicole

    2008-01-01

    Objective: To determine the impact of preschool teacher food-related attitudes and behaviors on child food behaviors. Design: A twelve-week intervention and observational study with teachers completing questionnaires before and after the intervention. Setting: Head Start classrooms throughout Virginia. Participants: 177 preschool Head Start teachers and 1534 children. Intervention(s): Food Friends, a twelve-week social marketing campaign, was conducted by Head Start teac...

  7. Essential Tremor, the Cerebellum, and Motor Timing: Towards Integrating Them into One Complex Entity

    Directory of Open Access Journals (Sweden)

    Martin Bareš

    2012-09-01

    Full Text Available Essential tremor (ET is the most common movement disorder in humans. It is characterized by a postural and kinetic tremor most commonly affecting the forearms and hands. Isolated head tremor has been found in 1–10% of patients, suggesting that ET may be a composite of several phenotypes. The exact pathophysiology of ET is still unknown. ET has been repeatedly shown as a disorder of mild cerebellar degeneration, particularly in postmortem studies. Clinical observations, electrophysiological, volumetric and functional imaging studies all reinforce the fact that the cerebellum is involved in the generation of ET. However, crucial debate exists as to whether ET is a neurodegenerative disease. Data suggesting that it is neurodegenerative include postmortem findings of pathological abnormalities in the brainstem and cerebellum, white matter changes on diffusion tensor imaging, and clinical studies demonstrating an association with cognitive and gait changes. There is also conflicting evidence against ET as a neurodegenerative disease: the improvement of gait abnormalities with ethanol administration, lack of gray matter volume loss on voxel-based morphometry, failure to confirm the prominent presence of Lewy bodies in the locus ceruleus, and other pathological findings. To clarify this issue, future research is needed to describe the mechanism of cellular changes in the ET brain and to understand the order in which they occur. The cerebellum has been shown to be involved in the timing of movement and sensation, acting as an internal timing system that provides the temporal representation of salient events spanning hundreds of milliseconds. It has been reported that cerebellar timing function is altered in patients with ET, showing an increased variability of rhythmic hand movements as well as diminished performance during predictive motor timing task. Based on current knowledge and observations, we argue that ET is essentially linked with cerebellar

  8. Contribution of inter-muscular synchronization in the modulation of tremor intensity in Parkinson's disease.

    Science.gov (United States)

    He, Xin; Hao, Man-Zhao; Wei, Ming; Xiao, Qin; Lan, Ning

    2015-12-01

    Involuntary central oscillations at single and double tremor frequencies drive the peripheral neuromechanical system of muscles and joints to cause tremor in Parkinson's disease (PD). The central signal of double tremor frequency was found to correlate more directly to individual muscle EMGs (Timmermann et al. 2003). This study is aimed at investigating what central components of oscillation contribute to inter-muscular synchronization in a group of upper extremity muscles during tremor in PD patients. 11 idiopathic, tremor dominant PD subjects participated in this study. Joint kinematics during tremor in the upper extremity was recorded along with EMGs of six upper arm muscles using a novel experimental apparatus. The apparatus provided support for the upper extremity on a horizontal surface with reduced friction, so that resting tremor in the arm can be recorded with a MotionMonitor II system. In each subject, the frequencies of rhythmic firings in upper arm muscles were determined using spectral analysis. Paired and pool-averaged coherence analyses of EMGs for the group of muscles were performed to correlate the level of inter-muscular synchronization to tremor amplitudes at shoulder and elbow. The phase shift between synchronized antagonistic muscle pairs was calculated to aid coherence analysis in the muscle pool. Recorded EMG revealed that rhythmic firings were present in most recorded muscles, which were either synchronized to form phase-locked bursting cycles at a subject specific frequency, or unsynchronized with a random phase distribution. Paired coherence showed a stronger synchronization among a subset of recorded arm muscles at tremor frequency than that at double tremor frequency. Furthermore, the number of synchronized muscles in the arm was positively correlated to tremor amplitudes at elbow and shoulder. Pool-averaged coherence at tremor frequency also showed a better correlation with the amplitude of resting tremor than that of double tremor

  9. The Patient Concerns Inventory integrated as part of routine head and neck cancer follow-up consultations: frequency, case-mix, and items initiated by the patient.

    Science.gov (United States)

    Rogers, S N; Thomson, F; Lowe, D

    2018-03-01

    Introduction The National Institute for Health and Care Excellence guidance Improving Supportive and Palliative Care for Adults with Cancer (2004) and the Cancer Reform Strategy (2007) support the premise that assessment and discussion of patients' needs for physical, social, psychological, and spiritual wellbeing should be undertaken during oncology follow-up. We report the use of the Patient Concerns Inventory in a routine head and neck cancer clinic setting over a seven-year period, summarising the number of available clinics, the number of patients completing the inventory within a clinic, the range of clinical characteristics and the concerns they wanted to discuss. Methods The data were analysed from oncology follow-up clinics between 1 August 2007 and 10 December 2014. Audit approval was given by the Clinical Audit Department, University Hospital Aintree. Results There were 386 patients with 1198 inventories completed at 220 clinics, median 6 (range 4-7) per clinic. The most common concerns raised by patients across all the clinic consultations were dry mouth (34%), fear of recurrence (33%), sore mouth (26%), dental health (25%), chewing (22%) and fatigue/tiredness (21%). Conclusions The incorporation of the Patient Concerns Inventory as part of routine oncology clinics allows for a more patient initiated and focused consultation available to the majority of patients throughout their follow-up. The inventory allows for greater opportunity to provide holistic targeted multiprofessional intervention and support.

  10. Sustained Medication Reduction Following Unilateral VIM Thalamic Stimulation for Essential Tremor.

    Science.gov (United States)

    Resnick, Andrew S; Okun, Michael S; Malapira, Teresita; Smith, Donald; Vale, Fernando L; Sullivan, Kelly; Miller, Amber; Jahan, Israt; Zesiewicz, Theresa

    2012-01-01

    Deep brain stimulation (DBS) is an increasingly utilized therapeutic modality for the management of medication refractory essential tremor (ET). The aim of this study was to determine whether DBS allowed for anti-tremor medication reduction within the year after the procedure was performed. We conducted a retrospective chart review and telephone interviews on 34 consecutive patients who had been diagnosed with ET, and who had undergone unilateral DBS surgery. Of the 34 patients in our cohort, 31 patients (91%) completely stopped all anti-tremor medications either before surgery (21 patients, 62%) or in the year following DBS surgery (10 patients, 29%). Patients who discontinued tremor medications before DBS surgery did so because their tremors either became refractory to anti-tremor medication, or they developed adverse events to tremor medications. Patients who stopped tremor medications after DBS surgery did so due to sufficient tremor control. Only three patients (9%) who were taking tremor medications at the time of surgery continued the use of a beta-blocker post-operatively for the purpose of hypertension management in all cases. The data from this study indicate that medication cessation is common following unilateral DBS for ET.

  11. Sustained Medication Reduction Following Unilateral VIM Thalamic Stimulation for Essential Tremor

    Directory of Open Access Journals (Sweden)

    Andrew S. Resnick

    2012-04-01

    Full Text Available Background: Deep brain stimulation (DBS is an increasingly utilized therapeutic modality for the management of medication refractory essential tremor (ET. The aim of this study was to determine whether DBS allowed for anti-tremor medication reduction within the year after the procedure was performed. Methods: We conducted a retrospective chart review and telephone interviews on 34 consecutive patients who had been diagnosed with ET, and who had undergone unilateral DBS surgery. Results: Of the 34 patients in our cohort, 31 patients (91% completely stopped all anti-tremor medications either before surgery (21 patients, 62% or in the year following DBS surgery (10 patients, 29%. Patients who discontinued tremor medications before DBS surgery did so because their tremors either became refractory to anti-tremor medication, or they developed adverse events to tremor medications. Patients who stopped tremor medications after DBS surgery did so due to sufficient tremor control. Only three patients (9% who were taking tremor medications at the time of surgery continued the use of a beta-blocker post-operatively for the purpose of hypertension management in all cases. Discussion: The data from this study indicate that medication cessation is common following unilateral DBS for ET. 

  12. One central oscillatory drive is compatible with experimental motor unit behaviour in essential and Parkinsonian tremor

    Science.gov (United States)

    Dideriksen, Jakob L.; Gallego, Juan A.; Holobar, Ales; Rocon, Eduardo; Pons, Jose L.; Farina, Dario

    2015-08-01

    Objective. Pathological tremors are symptomatic to several neurological disorders that are difficult to differentiate and the way by which central oscillatory networks entrain tremorogenic contractions is unknown. We considered the alternative hypotheses that tremor arises from one oscillator (at the tremor frequency) or, as suggested by recent findings from the superimposition of two separate inputs (at the tremor frequency and twice that frequency). Approach. Assuming one central oscillatory network we estimated analytically the relative amplitude of the harmonics of the tremor frequency in the motor neuron output for different temporal behaviors of the oscillator. Next, we analyzed the bias in the relative harmonics amplitude introduced by superimposing oscillations at twice the tremor frequency. These findings were validated using experimental measurements of wrist angular velocity and surface electromyography (EMG) from 22 patients (11 essential tremor, 11 Parkinson’s disease). The ensemble motor unit action potential trains identified from the EMG represented the neural drive to the muscles. Main results. The analytical results showed that the relative power of the tremor harmonics in the analytical models of the neural drive was determined by the variability and duration of the tremor bursts and the presence of the second oscillator biased this power towards higher values. The experimental findings accurately matched the analytical model assuming one oscillator, indicating a negligible functional role of secondary oscillatory inputs. Furthermore, a significant difference in the relative power of harmonics in the neural drive was found across the patient groups, suggesting a diagnostic value of this measure (classification accuracy: 86%). This diagnostic power decreased substantially when estimated from limb acceleration or the EMG. Signficance. The results indicate that the neural drive in pathological tremor is compatible with one central network

  13. Borehole Array Observations of Non-Volcanic Tremor at SAFOD

    Science.gov (United States)

    Ellsworth, W. L.; Luetgert, J. H.; Oppenheimer, D. H.

    2005-12-01

    We report on the observation of non-volcanic tremor made in the San Andreas Fault Observatory at Depth in May, 2005 during the deployment of a multi-level borehole seismic array in the SAFOD main hole. The seismic array consisted of 80 levels of hydraulically-clamped 3-component, 15 Hz omni-directional geophones spaced 15.24 m apart along a 1200 m section of the inclined borehole between 1538 and 2363 m below the ground surface. The array was provided by Paulsson Geophysical Services, Inc. (P/GSI), and recorded at a sample rate of 4000 sps on 24-bit Geode digital recorders provided by Geometrics, Inc. More than 2 TB of continuous data were recorded during the 2-week deployment. Selected local earthquakes and explosions recorded by the array are available at the Northern California Earthquake Data Center, and the entire unedited data set is available as assembled data at the IRIS Data Management Center. Both data sets are currently in the industry standard SEG2 format. Episodes of non-volcanic tremor are common along this reach of the San Andreas Fault according to Nadeau and Dolenc [2004, DOI: 10.1126/science.1107142], with many originating about 30 km southeast of SAFOD beneath the southern end of the Parkfield segment and northern end of the Simmler segment of the fault. We identified tremor episodes using spectrograms routinely produced by the Northern California Seismic Network (http://quake.usgs.gov/cgi-bin/sgrampark.pl) on which they appear as periods of elevated noise relative to the background. A particularly strong tremor episode occurred on May 10, 2005 between 19:39 and 20:00 UTC. In SAFOD, tremor spectral levels exceed the instrumental noise floor to at least 40 Hz. The spatially unaliased recording of the tremor wavefield on the P/GSI array reveal individual phases that can be tracked continuously across the array. The wavefield is composed of both up- and down-going shear waves that form quasi-stationary interference patterns in which areas of

  14. Gamma knife thalamotomy for Parkinson's tremor: A 5-year experience

    International Nuclear Information System (INIS)

    Duma, Christopher M.; Jacques, Deane B.; Kopyov, Oleg V.; Mark, Rufus J.; Copcutt, Brian G.

    1996-01-01

    Purpose: Elderly, high-risk surgical patients, may be unfit for radiofrequency thalamotomy for Parkinson's tremor. We have performed gamma knife radiosurgery in this select patient population, in lieu of open surgery, in an attempt at amelioration of disabling tremor. Materials and Methods: Radiosurgical nucleus ventralis intermedalis thalamotomy using gamma unit technique was performed on 38 patients (median age, 72 years; range: 50-88 years) over a period of 5 years. A median dose of 155 Gy (range: 110-160 Gy) was delivered using a single 4-mm collimator to 40 nuclei (2 patients underwent bilateral thalamotomy) using only anatomical atlas landmarks. The number of males and females were evenly divided, and their ages ranged from 50 to 88 years (median: 72 years). Two-thirds of the patients underwent left thalamotomy for right-sided trmor. Patients were followed-up for a median of 14 months (range: 6 to 43 months). Independent neurological evaluation of tremor as well as subjective patient evaluation were based on a 4-tiered scale: no improvement, mild improvement (0-33% effect), good improvement (33-66% effect), and excellent improvement (66-100%). Results: Eight thalamotomies (20%) failed, four (10%) gave mild improvement, and 28 (70%) gave good to excellent improvement of tremor (median time of onset of improvement was 3 months; range: 1-11 months). In 12 patients (32%) the tremor was eliminated completely. Concordance between independent neurologist evaluation and that of the patient was significant (p<0.001). Two patients in the failure group had an initial transient improvement. Two patients who underwent unilateral thalamotomy had bilateral improvement of their tremor. A permanent 5-6 mm lesion was seen on all follow-up MRIs and there were no radiological complications. A worsening of hand strength was seen in only patient. Conclusion: The safety and efficacy of gamma unit radiosurgical thalamotomy is on par with that of radiofrequency thalamotomy, and in a

  15. [S3 Guideline. Part 3: Non-Traumatic Avascular Necrosis in Adults - Surgical Treatment of Atraumatic Avascular Femoral Head Necrosis in Adults].

    Science.gov (United States)

    Maus, U; Roth, A; Tingart, M; Rader, C; Jäger, M; Nöth, U; Reppenhagen, S; Heiss, C; Beckmann, J

    2015-10-01

    The present article describes the guidelines for the surgical treatment of atraumatic avascular necrosis (aFKN). These include joint preserving and joint replacement procedures. As part of the targeted literature, 43 publications were included and evaluated to assess the surgical treatment. According to the GRADE and SIGN criteria level of evidence (LoE), grade of recommendation (EC) and expert consensus (EK) were listed for each statement and question. The analysed studies have shown that up to ARCO stage III, joint-preserving surgery can be performed. A particular joint-preserving surgery currently cannot be recommended as preferred method. The selection of the method depends on the extent of necrosis. Core decompression performed in stage ARCO I (reversible early stage) or stage ARCO II (irreversible early stage) with medial or central necrosis with an area of less than 30 % of the femoral head shows better results than conservative therapy. In ARCO stage III with infraction of the femoral head, the core decompression can be used for a short-term pain relief. For ARCO stage IIIC or stage IV core decompression should not be performed. In these cases, the indication for implantation of a total hip replacement should be checked. Additional therapeutic procedures (e.g., osteotomies) and innovative treatment options (advanced core decompression, autologous bone marrow, bone grafting, etc.) can be discussed in the individual case. In elective hip replacement complications and revision rates have been clearly declining for decades. In the case of an underlying aFKN, however, previous joint-preserving surgery (osteotomies and grafts in particular) can complicate the implantation of a THA significantly. However, the implant life seems to be dependent on the aetiology. Higher revision rates for avascular necrosis are particularly expected in sickle cell disease, Gaucher disease, or kidney transplantation patients. Furthermore, the relatively young age of the patient

  16. Estimating seismic moment magnitude (Mw) of tremor bursts in northern Cascadia: Implications for the “seismic efficiency” of episodic tremor and slip

    Science.gov (United States)

    Kao, Honn; Wang, Kelin; Dragert, Herb; Kao, Jason Y.; Rogers, Garry

    2010-10-01

    We develop a method to estimate the seismic moments of deep non-volcanic tremor bursts observed in northern Cascadia. For each tremor burst, the maximum amplitudes at individual stations within a time window ±5 s around the predicted arrivals of the S phase are measured and compared to the maximum S amplitudes measured from synthetic seismograms. The proposed method is thoroughly calibrated using 464 local earthquakes and the results show excellent consistency between the reported ML and the estimated Mw. We apply the method to northern Cascadia tremors and infer that most bursts have Mw˜1.0-1.7. The corresponding b value appears to be 1, consistent with that of ordinary earthquakes but over a narrower Mw range. Comparison of cumulative tremor Mw and the Mw estimated from the accompanying slow slip suggests that the “seismic efficiency” of the Episodic Tremor and Slip (ETS) is of the order of 0.1% or less.

  17. Evolving Concepts in Posterior Subthalamic Area Deep Brain Stimulation for Treatment of Tremor: Surgical Neuroanatomy and Practical Considerations.

    Science.gov (United States)

    Ramirez-Zamora, Adolfo; Smith, Heather; Kumar, Vignessh; Prusik, Julia; Phookan, Sujoy; Pilitsis, Julie G

    2016-01-01

    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. 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. A comprehensive literature review was performed searching for articles discussing tremors and PSA stimulation. We performed a quantitative analysis comparing different DBS tremor targets. Tremor improvement is consistently documented in most reports with an average reduction in tremor of 79% depending on the specific tremor syndrome. Tremor benefit in patients with multiple sclerosis (MS) tremor was significantly higher than for other stimulation targets. Transient paresthesias, imbalance, dizziness and dysarthria are the most common side effects with PSA DBS. PSA DBS is an effective and safe treatment for tremor control and should be considered in patients with refractory tremors with associated cerebellar or dystonic features, proximal tremors and MS tremor. © 2016 S. Karger AG, Basel.

  18. Thalamic Ventral Intermediate Nucleus Deep Brain Stimulation for Orthostatic Tremor

    Directory of Open Access Journals (Sweden)

    Alexander C. Lehn

    2017-07-01

    Full Text Available Background: Orthostatic tremor (OT was first described in 1977. It is characterized by rapid tremor of 13–18 Hz and can be recorded in the lower limbs and trunk muscles. OT remains difficult to treat, although some success has been reported with deep brain stimulation (DBS.Case Report: We report a 68-year-old male with OT who did not improve significantly after bilateral thalamic stimulation.Discussion: Although some patients were described who improved after DBS surgery, more information is needed about the effect of these treatment modalities on OT, ideally in the form of randomized trial data. 

  19. Botulinum Toxin for the Treatment of Tremor and Tics.

    Science.gov (United States)

    Lotia, Mitesh; Jankovic, Joseph

    2016-02-01

    The therapeutic applications of botulinum toxin (BoNT) have grown manifold since its initial approval in 1989 by the U.S. Food and Drug Administration for the treatment of strabismus, blepharospasm, and other facial spasms. Although it is the most potent biologic toxin known to man, long-term studies have established its safety in the treatment of a variety of neurologic and nonneurologic disorders. Despite a paucity of randomized controlled trials, BoNT has been found to be beneficial in treating a variety of tremors and tics when used by clinicians skilled in the administration of the drug for these hyperkinetic movement disorders. Botulinum toxin injections can provide meaningful improvement in patients with localized tremors and tics; in some cases, they may be an alternative to other treatments with more undesirable adverse effects. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. [Treatment of lithium tremor with the beta receptor blocker, pindolol].

    Science.gov (United States)

    Floru, L; Tegeler, J; Wolmsen, H

    1979-01-01

    In a cross-over study with Pindolol, 15 mg/day, against placebo, we studied during 4 weeks 22 patients aged between 20 and 65 years who where treated by means of lithium carbonate retard (Quilonum Retard). The tremor was measured twice a week by means of three apparative methods: an accelerometer, a 'hole-plate' and an 'aimed tapping plate', both constructed by Janke, and was also studied by means of a self-evaluation rating-scale. We obtained a positive therapeutic effect of Pindolol on lithium-induced tremor, which was statistically significant by means of the 'hole-plate' and of self-evaluation. Differences in results are discussed.

  1. Shooting performance is related to forearm temperature and hand tremor size.

    Science.gov (United States)

    Lakie, M; Villagra, F; Bowman, I; Wilby, R

    1995-08-01

    The changes in postural tremor of the hand and the subsequent effect on shooting performance produced by moderate cooling and heating of the forearm were studied in six subjects. Cooling produced a large decrease in tremor size of the ipsilateral hand, whereas warming the limb produced an increase in tremor size. Cooling or warming the forearm did not change the peak frequency of tremor significantly, which was quite stable for each subject. The improvement in shooting performance after cooling the forearm, as measured by grouping pattern of the shots, reached statistical significance and warming caused a significant worsening. This measure of performance was shown to correlate (r = 0.776) inversely with tremor size. The causes and implications of these changes are discussed. It is suggested that local cooling may be useful for people who wish temporarily to reduce tremor in order to improve dexterity for shooting and for other purposes.

  2. Task-specific kinetic finger tremor affects the performance of carrom players.

    Science.gov (United States)

    Kahathuduwa, Chanaka N; Weerasinghe, Vajira S; Dassanayake, Tharaka L; Priyadarshana, Rajeewa; Dissanayake, Arunika L; Perera, Christine

    2016-01-01

    We aimed to determine the effect of task-specific kinetic finger tremor, as indexed by surface electromyography (EMG), on the accuracy of a carrom stroke. Surface EMG of extensor digitorum communis muscle of the playing arm was recorded during rest, isometric contraction and stroke execution in 17 male carrom players with clinically observed finger tremor and 18 skill- and age-matched controls. Log-transformed power spectral densities (LogPSDs) of surface EMG activity (signifying tremor severity) at a 1-s pre-execution period correlated with angular error of the stroke. LogPSDs in 4-10 Hz range were higher in players with tremor than controls during pre-execution (P kinetic finger tremor in carrom players. This finger tremor during the immediate pre-execution phase appears to be a significant determinant of stroke accuracy.

  3. Propranolol, clonidine, urapidil and trazodone infusion in essential tremor: a double-blind crossover trial.

    Science.gov (United States)

    Caccia, M R; Osio, M; Galimberti, V; Cataldi, G; Mangoni, A

    1989-05-01

    Accelerometric tremorgrams were recorded from 25 subjects affected by essential tremor and analysed by a Berg-Fourier frequency analyser before and during venous infusion of the following drugs: propranolol (beta-blocker), clonidine (alpha-presynaptic adrenergic agonist), urapidil (alpha-postsynaptic blocker), trazodone (adrenolytic agent) and placebo. The washout interval between infusions was 3 days. Recordings and data analyses were performed in a double-blind crossover trial. Tremor was classified as: at rest; postural (arms hyperextended); and intention (finger-nose test). Analysis of the results showed that propranolol and clonidine reduced significantly (P = 0.01 and P = 0.009, respectively) the power spectrum of postural tremor, but left at rest and intention tremors unchanged. No significant effects on the tremor power spectrum were observed after placebo, urapidil or trazodone administration. None of the drugs had any effect on tremor frequency.

  4. Altered brain network measures in patients with primary writing tremor

    Energy Technology Data Exchange (ETDEWEB)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant [National Institute of Mental Health and Neurosciences, Department of Clinical Neurosciences, Bangalore, Karnataka (India); National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore, Karnataka (India); Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn [National Institute of Mental Health and Neurosciences, Department of Neuroimaging and Interventional Radiology, Bangalore, Karnataka (India); Yadav, Ravi; Pal, Pramod Kumar [National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurology, Bangalore, Karnataka (India)

    2017-10-15

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results. (orig.)

  5. Altered brain network measures in patients with primary writing tremor

    International Nuclear Information System (INIS)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant; Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn; Yadav, Ravi; Pal, Pramod Kumar

    2017-01-01

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results. (orig.)

  6. Altered brain network measures in patients with primary writing tremor.

    Science.gov (United States)

    Lenka, Abhishek; Jhunjhunwala, Ketan Ramakant; Panda, Rajanikant; Saini, Jitender; Bharath, Rose Dawn; Yadav, Ravi; Pal, Pramod Kumar

    2017-10-01

    Primary writing tremor (PWT) is a rare task-specific tremor, which occurs only while writing or while adopting the hand in the writing position. The basic pathophysiology of PWT has not been fully understood. The objective of this study is to explore the alterations in the resting state functional brain connectivity, if any, in patients with PWT using graph theory-based analysis. This prospective case-control study included 10 patients with PWT and 10 age and gender matched healthy controls. All subjects underwent MRI in a 3-Tesla scanner. Several parameters of small-world functional connectivity were compared between patients and healthy controls by using graph theory-based analysis. There were no significant differences in age, handedness (all right handed), gender distribution (all were males), and MMSE scores between the patients and controls. The mean age at presentation of tremor in the patient group was 51.7 ± 8.6 years, and the mean duration of tremor was 3.5 ± 1.9 years. Graph theory-based analysis revealed that patients with PWT had significantly lower clustering coefficient and higher path length compared to healthy controls suggesting alterations in small-world architecture of the brain. The clustering coefficients were lower in PWT patients in left and right medial cerebellum, right dorsolateral prefrontal cortex (DLPFC), and left posterior parietal cortex (PPC). Patients with PWT have significantly altered small-world brain connectivity in bilateral medial cerebellum, right DLPFC, and left PPC. Further studies with larger sample size are required to confirm our results.

  7. Is there a Premotor Phase of Essential Tremor?

    Directory of Open Access Journals (Sweden)

    Abhishek Lenka

    2017-10-01

    Full Text Available Background: Essential tremor (ET is the most common tremor disorder. In addition to its hallmark feature, kinetic tremor of the upper limbs, patients may have a number of non-motor symptoms and signs (NMS. Several lines of evidence suggest that ET is a neurodegenerative disorder and certain NMS may antedate the onset of tremor. This article comprehensively reviews the evidence for the existence of a "premotor phase" of ET, and discusses plausible biological explanations and implications.Methods: A PubMed search in May 2017 identified articles for this review.Results: The existence of a premotor phase of ET gains support primarily from longitudinal data. In individuals who develop incident ET, baseline (i.e., premotor evaluations reveal greater cognitive dysfunction, a faster rate of cognitive decline, and the presence of a protective effect of education against dementia. In addition, baseline evaluations also reveal more self-reported depression, antidepressant medication use, and shorter sleep duration in individuals who eventually develop incident ET. In cross-sectional studies, certain personality traits and NMS (e.g., olfactory dysfunction also suggest the existence of a premotor phase.Discussion: There is preliminary evidence supporting the existence of a premotor phase of ET. The mechanisms are unclear; however, the presence of Lewy bodies in some ET brains in autopsy studies and involvement of multiple neural networks in ET as evident from the neuroimaging studies, are possible contributors. Most evidence is from a longitudinal cohort (Neurological Disorders of Central Spain: NEDICES; additional longitudinal studies are warranted to gain better insights into the premotor phase of ET.

  8. Fentanyl bolus induces muscle tremors in sevoflurane-anaesthetized piglets.

    Science.gov (United States)

    Ringer, S K; Spielmann, N; Weiss, M; Mauch, J Y

    2016-08-01

    Intravenous fentanyl (10 mcg/kg) or saline (control) was randomly administered to 10 healthy sevoflurane-mono-anaesthetized piglets. Trembling was assessed by two blinded observers using a visual analogue scale (VAS) and a simple ordinal scale at baseline and 5 min (T5) after drug administration. If no trembling was observed at that time point, the opposite treatment was administered and piglets were re-evaluated after another 5 min (T10). Four out of five piglets showed trembling after fentanyl (T5), while none given saline showed any trembling. With fentanyl the VAS scores were significantly higher at T5 compared either with baseline or with the control treatment. Control animals received fentanyl after the 5 min evaluation and all piglets showed clear trembling afterwards. The median time after fentanyl administration until first muscle tremors was 51 (20-840) s. In summary, nine out of 10 sevoflurane-anaesthetized piglets showed muscle tremors after intravenous fentanyl. Tremors subsided over time and no specific treatment was necessary. © The Author(s) 2015.

  9. Orthostatic Tremor: An Update on a Rare Entity

    Science.gov (United States)

    Benito-León, Julián; Domingo-Santos, Ángela

    2016-01-01

    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. We did not exclude papers on the basis of language, country, or publication date. The electronic database searches were supplemented by articles in the authors’ files that pertained to this topic. Results Owing to its rarity, the current understanding of OT is limited and is mostly based on small case series or case reports. Despite this, a growing body of evidence indicates that OT might be a progressive condition that is clinically heterogeneous (primary vs. secondary cases) with a broader spectrum of clinical features, mainly cerebellar signs, and possible cognitive impairment and personality disturbances. Along with this, advanced neuroimaging techniques are now demonstrating distinct anatomical and functional changes, some of which are consistent with neuronal loss. Discussion OT might be a family of diseases, unified by the presence of leg tremor, but further characterized by etiological and clinical heterogeneity. More work is needed to understand the pathogenesis of this condition. PMID:27713855

  10. Volcanic tremor associated with eruptive activity at Bromo volcano

    Directory of Open Access Journals (Sweden)

    E. Gottschämmer

    1999-06-01

    Full Text Available Three broadband stations were deployed on Bromo volcano, Indonesia, from September to December 1995. The analysis of the seismograms shows that the signals produced by the volcanic sources cover the frequency range from at least 25 Hz down to periods of several minutes and underlines, therefore, the importance of broadband recordings. Frequency analysis reveals that the signal can be divided into four domains. In the traditional frequency range of volcanic tremor (1-10 Hz sharp transitions between two distinct values of the tremor amplitude can be observed. Additional tremor signal including frequencies from 10 to 20 Hz could be found during late November and early December. Throughout the whole experiment signals with periods of some hundred seconds were observed which are interpreted as ground tilts. For these long-period signals a particle motion analysis was performed in order to estimate the source location. Depth and radius can be estimated when the source is modeled as a sudden pressure change in a sphere. The fourth frequency range lies between 0.1 and 1 Hz and is dominated by two spectral peaks which are due to marine microseism. The phase velocity and the direction of wave propagation of these signals could be determined using the tripartite-method.

  11. TREMOR: A wireless MEMS accelerograph for dense arrays

    Science.gov (United States)

    Evans, J.R.; Hamstra, R.H.; Kundig, C.; Camina, P.; Rogers, J.A.

    2005-01-01

    The ability of a strong-motion network to resolve wavefields can be described on three axes: frequency, amplitude, and space. While the need for spatial resolution is apparent, for practical reasons that axis is often neglected. TREMOR is a MEMS-based accelerograph using wireless Internet to minimize lifecycle cost. TREMOR instruments can economically augment traditional ones, residing between them to improve spatial resolution. The TREMOR instrument described here has dynamic range of 96 dB between ??2 g, or 102 dB between ??4 g. It is linear to ???1% of full scale (FS), with a response function effectively shaped electronically. We developed an economical, very low noise, accurate (???1%FS) temperature compensation method. Displacement is easily recovered to 10-cm accuracy at full bandwidth, and better with care. We deployed prototype instruments in Oakland, California, beginning in 1998, with 13 now at mean spacing of ???3 km - one of the most densely instrumented urban centers in the United States. This array is among the quickest in returning (PGA, PGV, Sa) vectors to ShakeMap, ???75 to 100 s. Some 13 events have been recorded. A ShakeMap and an example of spatial variability are shown. Extensive tests of the prototypes for a commercial instrument are described here and in a companion paper. ?? 2005, Earthquake Engineering Research Institute.

  12. Corticomuscular transmission of tremor signals by propriospinal neurons in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Manzhao Hao

    Full Text Available Cortical oscillatory signals of single and double tremor frequencies act together to cause tremor in the peripheral limbs of patients with Parkinson's disease (PD. But the corticospinal pathway that transmits the tremor signals has not been clarified, and how alternating bursts of antagonistic muscle activations are generated from the cortical oscillatory signals is not well understood. This paper investigates the plausible role of propriospinal neurons (PN in C3-C4 in transmitting the cortical oscillatory signals to peripheral muscles. Kinematics data and surface electromyogram (EMG of tremor in forearm were collected from PD patients. A PN network model was constructed based on known neurophysiological connections of PN. The cortical efferent signal of double tremor frequencies were integrated at the PN network, whose outputs drove the muscles of a virtual arm (VA model to simulate tremor behaviors. The cortical efferent signal of single tremor frequency actuated muscle spindles. By comparing tremor data of PD patients and the results of model simulation, we examined two hypotheses regarding the corticospinal transmission of oscillatory signals in Parkinsonian tremor. Hypothesis I stated that the oscillatory cortical signals were transmitted via the mono-synaptic corticospinal pathways bypassing the PN network. The alternative hypothesis II stated that they were transmitted by way of PN multi-synaptic corticospinal pathway. Simulations indicated that without the PN network, the alternating burst patterns of antagonistic muscle EMGs could not be reliably generated, rejecting the first hypothesis. However, with the PN network, the alternating burst patterns of antagonist EMGs were naturally reproduced under all conditions of cortical oscillations. The results suggest that cortical commands of single and double tremor frequencies are further processed at PN to compute the alternating burst patterns in flexor and extensor muscles, and the

  13. Corticomuscular transmission of tremor signals by propriospinal neurons in Parkinson's disease.

    Science.gov (United States)

    Hao, Manzhao; He, Xin; Xiao, Qin; Alstermark, Bror; Lan, Ning

    2013-01-01

    Cortical oscillatory signals of single and double tremor frequencies act together to cause tremor in the peripheral limbs of patients with Parkinson's disease (PD). But the corticospinal pathway that transmits the tremor signals has not been clarified, and how alternating bursts of antagonistic muscle activations are generated from the cortical oscillatory signals is not well understood. This paper investigates the plausible role of propriospinal neurons (PN) in C3-C4 in transmitting the cortical oscillatory signals to peripheral muscles. Kinematics data and surface electromyogram (EMG) of tremor in forearm were collected from PD patients. A PN network model was constructed based on known neurophysiological connections of PN. The cortical efferent signal of double tremor frequencies were integrated at the PN network, whose outputs drove the muscles of a virtual arm (VA) model to simulate tremor behaviors. The cortical efferent signal of single tremor frequency actuated muscle spindles. By comparing tremor data of PD patients and the results of model simulation, we examined two hypotheses regarding the corticospinal transmission of oscillatory signals in Parkinsonian tremor. Hypothesis I stated that the oscillatory cortical signals were transmitted via the mono-synaptic corticospinal pathways bypassing the PN network. The alternative hypothesis II stated that they were transmitted by way of PN multi-synaptic corticospinal pathway. Simulations indicated that without the PN network, the alternating burst patterns of antagonistic muscle EMGs could not be reliably generated, rejecting the first hypothesis. However, with the PN network, the alternating burst patterns of antagonist EMGs were naturally reproduced under all conditions of cortical oscillations. The results suggest that cortical commands of single and double tremor frequencies are further processed at PN to compute the alternating burst patterns in flexor and extensor muscles, and the neuromuscular dynamics

  14. Orthostatic Tremor: A Spectrum of Fast and Slow Frequencies or Distinct Entities?

    OpenAIRE

    Rigby, Heather B.; Rigby, Matthew H.; Caviness, John N.

    2015-01-01

    Background: Orthostatic tremor (OT) is defined by the presence of a high-frequency (13–18 Hz) tremor of the legs upon standing associated with a feeling of unsteadiness. However, some patients have discharge frequencies of <13 Hz, so-called “slow OT”. The aim of this study was to characterize patients with unsteadiness upon standing found to have <13 Hz tremor discharges on neurophysiologic testing. Methods: A retrospective review was performed on all subjects with a d...

  15. Low-dose acute vanillin is beneficial against harmaline-induced tremors in rats.

    Science.gov (United States)

    Abdulrahman, Al Asmari; Faisal, Kunnathodi; Meshref, Ali Al Amri; Arshaduddin, Mohammed

    2017-03-01

    To study the effect of pretreatment with low doses of vanillin, a flavoring agent used as a food additive, on harmaline-induced tremor in rats. Sprague Dawley rats (110 ± 5 g) were divided into groups of six animals each. Vanillin (6.25 mg, 12.5 mg, and 25 mg/kg) was administered by gavage to different groups of rats, 30 minutes before the induction of tremor. Harmaline (10 mg/kg, i.p.) was used for the induction of tremor. The latency of onset, duration, tremor intensity, tremor index, and spontaneous locomotor activity were recorded. A separate batch of animals was used for the determination of serotonin (5HT) and 5 hydroxyindole acetic acid (5HIAA) levels in the brain. Harmaline treatment resulted in characteristic tremor that lasted for more than 2 hours and decreased the locomotor activity of rats. Pre-treatment with vanillin significantly reduced the duration, intensity, and tremor index of harmaline-treated animals. Vanillin treatment also significantly attenuated harmaline-induced decrease in the locomotor activity. An increase in 5HT levels and the changes in 5HIAA/5HT ratio observed in harmaline treated rats were significantly corrected in vanillin pretreated animals. Vanillin in low doses reduces harmaline-induced tremor in rats, probably through its modulating effect on serotonin levels in the brain. These findings suggest a beneficial effect of vanillin in essential tremor.

  16. Using an Earthquake Simulator to Model Tremor Along a Strike Slip Fault

    Science.gov (United States)

    Cochran, E. S.; Richards-Dinger, K. B.; Kroll, K.; Harrington, R. M.; Dieterich, J. H.

    2013-12-01

    We employ the earthquake simulator, RSQSim, to investigate the conditions under which tremor occurs in the transition zone of the San Andreas fault. RSQSim is a computationally efficient method that uses rate- and state- dependent friction to simulate a wide range of event sizes for long time histories of slip [Dieterich and Richards-Dinger, 2010; Richards-Dinger and Dieterich, 2012]. RSQSim has been previously used to investigate slow slip events in Cascadia [Colella et al., 2011; 2012]. Earthquakes, tremor, slow slip, and creep occurrence are primarily controlled by the rate and state constants a and b and slip speed. We will report the preliminary results of using RSQSim to vary fault frictional properties in order to better understand rupture dynamics in the transition zone using observed characteristics of tremor along the San Andreas fault. Recent studies of tremor along the San Andreas fault provide information on tremor characteristics including precise locations, peak amplitudes, duration of tremor episodes, and tremor migration. We use these observations to constrain numerical simulations that examine the slip conditions in the transition zone of the San Andreas Fault. Here, we use the earthquake simulator, RSQSim, to conduct multi-event simulations of tremor for a strike slip fault modeled on Cholame section of the San Andreas fault. Tremor was first observed on the San Andreas fault near Cholame, California near the southern edge of the 2004 Parkfield rupture [Nadeau and Dolenc, 2005]. Since then, tremor has been observed across a 150 km section of the San Andreas with depths between 16-28 km and peak amplitudes that vary by a factor of 7 [Shelly and Hardebeck, 2010]. Tremor episodes, comprised of multiple low frequency earthquakes (LFEs), tend to be relatively short, lasting tens of seconds to as long as 1-2 hours [Horstmann et al., in review, 2013]; tremor occurs regularly with some tremor observed almost daily [Shelly and Hardebeck, 2010; Horstmann

  17. Aging, hypertension and physiological tremor: the contribution of the cardioballistic impulse to tremorgenesis in older adults.

    Science.gov (United States)

    Morrison, Steven; Sosnoff, Jacob J; Heffernan, Kevin S; Jae, Sae Young; Fernhall, Bo

    2013-03-15

    For older adults, an increase in physiological tremor is a common motor feature. This increase is believed to primarily reflect a general decline in function of the neuromuscular system. However, given that tremor is derived from a number of intrinsic sources, age-related changes in other physiological functions like the cardiac system may also negatively alter tremor output. The aim of this study was to examine what impact age and increased cardiac input (hypertension) have on physiological tremor. Heart rate, blood pressure, and postural/resting tremor were recorded in three groups; 1) young, healthy adults, 2) old, normotensive adults, and 3) old, hypertensive adults. The results demonstrated that the old hypertensive adults had greater postural tremor compared to the young healthy individuals. Coherence analysis revealed significant coupling between blood pressure-tremor and between heart rate-tremor for all individuals. The strength of this coupling was greatest for the older, hypertensive individuals. Together these results show that, for older adults, the combined effects of age and cardiac disease have the greatest impact on physiological tremor rather than any single factor alone. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Multiple Seismic Array Observations for Tracing Deep Tremor Activity in Western Shikoku, Japan

    Science.gov (United States)

    Takeda, T.; Matsuzawa, T.; Shiomi, K.; Obara, K.

    2011-12-01

    Deep non-volcanic tremors become very active during episodic slow-slip events in western Japan and Cascadia. The episodic tremor and slow-slip events in western Shikoku, Japan, occur at a typical interval of 6 months. Recently, it has been reported that tremor migration activity is complex and shows different migrating directions depending on time scales (Ghosh et al., 2010). Such characteristics of tremor are important to understand the mechanism of tremor and the relationship between tremor and SSEs. However it is difficult to determine the location of tremors with high accuracy because tremors show faint signals and make the identification of P/S-wave arrivals difficult. Seismic array analysis is useful to evaluate tremor activity, especially to estimate the arrival direction of seismic energy (e.g. Ueno et al., 2010, Ghosh et al., 2010), as it can distinguish multiple tremor sources occurring simultaneously. Here, we have conducted seismic array observation and analyzed seismic data during tremor activity by applying the MUSIC method to trace tremor location and its migration in western Shikoku. We have installed five seismic arrays in western Shikoku since January 2011. One of the arrays contains 30 stations with 3-component seismometers with a natural frequency of 2 Hz (Type-L array). The array aperture size is 2 km and the mean interval between stations is approximately 200 m. Each of the other arrays (Type-S array) contains 9 seismic stations with the same type of seismometers of the Type-L array, and is deployed surrounding the Type-L array. The small array aperture size is 800 m and its mean station interval is approximately 150 m. All array stations have recorded continuous waveform data at a sampling of 200Hz. In May 2011, an episodic tremor and a short-term slip event occurred for the first time during the observation period. We could retrieve the array seismic data during the whole tremor episode. The analysis of data from the type-L array confirms

  19. Deep Brain Stimulation for the Treatment of Tremor and Ataxia Associated with Abetalipoproteinemia

    Directory of Open Access Journals (Sweden)

    Antonios Mammis

    2012-07-01

    Full Text Available Background: Abetalipoproteinemia is a rare disorder of fat absorption, characterized by vitamin deficiency, acanthocytosis, and neurologic symptoms including ataxia and tremor.Case Report: A 41-year-old male with abetalipoproteinemia is presented. He underwent staged bilateral thalamic deep brain stimulation (DBS for the treatment of his tremors. After DBS, the patient achieved significant improvements in his tremors, ataxia, and quality of life.Discussion: Thalamic DBS proved to be both safe and efficacious in the management of ataxia and tremors in a patient with abetalipoproteinemia. This is the first report of DBS in abetalipoproteinemia in the literature. 

  20. Parkinsonian rest tremor can be detected accurately based on neuronal oscillations recorded from the subthalamic nucleus.

    Science.gov (United States)

    Hirschmann, J; Schoffelen, J M; Schnitzler, A; van Gerven, M A J

    2017-10-01

    To investigate the possibility of tremor detection based on deep brain activity. We re-analyzed recordings of local field potentials (LFPs) from the subthalamic nucleus in 10 PD patients (12 body sides) with spontaneously fluctuating rest tremor. Power in several frequency bands was estimated and used as input to Hidden Markov Models (HMMs) which classified short data segments as either tremor-free rest or rest tremor. HMMs were compared to direct threshold application to individual power features. Applying a threshold directly to band-limited power was insufficient for tremor detection (mean area under the curve [AUC] of receiver operating characteristic: 0.64, STD: 0.19). Multi-feature HMMs, in contrast, allowed for accurate detection (mean AUC: 0.82, STD: 0.15), using four power features obtained from a single contact pair. Within-patient training yielded better accuracy than across-patient training (0.84vs. 0.78, p=0.03), yet tremor could often be detected accurately with either approach. High frequency oscillations (>200Hz) were the best performing individual feature. LFP-based markers of tremor are robust enough to allow for accurate tremor detection in short data segments, provided that appropriate statistical models are used. LFP-based markers of tremor could be useful control signals for closed-loop deep brain stimulation. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  1. Resolving the Detailed Spatiotemporal Slip Evolution of Deep Tremor in Western Japan

    Science.gov (United States)

    Ohta, Kazuaki; Ide, Satoshi

    2017-12-01

    We study the detailed spatiotemporal behavior of deep tremor in western Japan through the development and application of a new slip inversion method. Although many studies now recognize tremor as shear slip along the plate interface manifested in low-frequency earthquake (LFE) swarms, a conventional slip inversion analysis is not available for tremor due to insufficient knowledge of source locations and Green's functions. Here we introduce synthetic template waveforms, which are typical tremor waveforms obtained by stacking LFE seismograms at arranged points along the plate interface. Using these synthetic template waveforms as substitutes for Green's functions, we invert the continuous tremor waveforms using an iterative deconvolution approach with Bayesian constraints. We apply this method to two tremor burst episodes in western and central Shikoku, Japan. The estimated slip distribution from a 12 day tremor burst episode in western Shikoku is heterogeneous, with several patchy areas of slip along the plate interface where rapid moment releases with durations of tremor burst episode that occurred coincidentally with a very low frequency earthquake (VLF), we observe that the source size of the VLF is much larger than that estimated from tremor activity in western Shikoku. These differences in the size of the slip region may dictate the visibility of VLF signals in observed seismograms, which has implications for the mechanics of slow earthquakes and subduction zone processes.

  2. White matter microstructure damage in tremor-dominant Parkinson's disease patients

    International Nuclear Information System (INIS)

    Luo, ChunYan; Song, Wei; Chen, Qin; Yang, Jing; Shang, Hui-Fang; Gong, QiYong

    2017-01-01

    Resting tremor is one of the cardinal motor features of Parkinson's disease (PD). Several lines of evidence suggest resting tremor may have different underlying pathophysiological processes from those of bradykinesia and rigidity. The current study aims to identify white matter microstructural abnormalities associated with resting tremor in PD. We recruited 60 patients with PD (30 with tremor-dominant PD and 30 with nontremor-dominant PD) and 26 normal controls. All participants underwent clinical assessment and diffusion tensor MRI. We used tract-based spatial statistics to investigate white matter integrity across the entire white matter tract skeleton. Compared with both healthy controls and the nontremor-dominant PD patients, the tremor-dominant PD patients were characterized by increased mean diffusivity (MD) and axial diffusivity (AD) along multiple white matter tracts, mainly involving the cerebello-thalamo-cortical (CTC) pathway. The mean AD value in clusters with significant difference was correlated with resting tremor score in the tremor-dominant PD patients. There was no significant difference between the nontremor-dominant PD patients and controls. Our results support the notion that resting tremor in PD is a distinct condition in which significant microstructural white matter changes exist and provide evidence for the involvement of the CTC in tremor genesis of PD. (orig.)

  3. Toward Expanding Tremor Observations in the Northern San Andreas Fault System in the 1990s

    Science.gov (United States)

    Damiao, L. G.; Dreger, D. S.; Nadeau, R. M.; Taira, T.; Guilhem, A.; Luna, B.; Zhang, H.

    2015-12-01

    The connection between tremor activity and active fault processes continues to expand our understanding of deep fault zone properties and deformation, the tectonic process, and the relationship of tremor to the occurrence of larger earthquakes. Compared to tremors in subduction zones, known tremor signals in California are ~5 to ~10 smaller in amplitude and duration. These characteristics, in addition to scarce geographic coverage, lack of continuous data (e.g., before mid-2001 at Parkfield), and absence of instrumentation sensitive enough to monitor these events have stifled tremor detection. The continuous monitoring of these events over a relatively short time period in limited locations may lead to a parochial view of the tremor phenomena and its relationship to fault, tectonic, and earthquake processes. To help overcome this, we have embarked on a project to expand the geographic and temporal scope of tremor observation along the Northern SAF system using available continuous seismic recordings from a broad array of 100s of surface seismic stations from multiple seismic networks. Available data for most of these stations also extends back into the mid-1990s. Processing and analysis of tremor signal from this large and low signal-to-noise dataset requires a heavily automated, data-science type approach and specialized techniques for identifying and extracting reliable data. We report here on the automated, envelope based methodology we have developed. We finally compare our catalog results with pre-existing tremor catalogs in the Parkfield area.

  4. White matter microstructure damage in tremor-dominant Parkinson's disease patients

    Energy Technology Data Exchange (ETDEWEB)

    Luo, ChunYan; Song, Wei; Chen, Qin; Yang, Jing; Shang, Hui-Fang [Sichuan University, Department of Neurology, West China Hospital, Chengdu, Sichuan (China); Gong, QiYong [Sichuan University, Huaxi MR Research Center, Department of Radiology, West China Hospital, Chengdu, Sichuan (China)

    2017-07-15

    Resting tremor is one of the cardinal motor features of Parkinson's disease (PD). Several lines of evidence suggest resting tremor may have different underlying pathophysiological processes from those of bradykinesia and rigidity. The current study aims to identify white matter microstructural abnormalities associated with resting tremor in PD. We recruited 60 patients with PD (30 with tremor-dominant PD and 30 with nontremor-dominant PD) and 26 normal controls. All participants underwent clinical assessment and diffusion tensor MRI. We used tract-based spatial statistics to investigate white matter integrity across the entire white matter tract skeleton. Compared with both healthy controls and the nontremor-dominant PD patients, the tremor-dominant PD patients were characterized by increased mean diffusivity (MD) and axial diffusivity (AD) along multiple white matter tracts, mainly involving the cerebello-thalamo-cortical (CTC) pathway. The mean AD value in clusters with significant difference was correlated with resting tremor score in the tremor-dominant PD patients. There was no significant difference between the nontremor-dominant PD patients and controls. Our results support the notion that resting tremor in PD is a distinct condition in which significant microstructural white matter changes exist and provide evidence for the involvement of the CTC in tremor genesis of PD. (orig.)

  5. Co-Prevalence of Tremor with Spasmodic Dysphonia: A Case-Control Study

    Science.gov (United States)

    White, Laura; Klein, Adam; Hapner, Edie; Delgaudio, John; Hanfelt, John; Jinnah, H. A.; Johns, Michael

    2011-01-01

    OBJECTIVES/HYPOTHESIS The aim of this study was to define the co-prevalence of tremor with spasmodic dysphonia (SD). STUDY DESIGN A single institution prospective, case-control study was performed from May 2010 to July 2010. METHODS Consecutive patients with SD (cases) and other voice disorders (controls) were enrolled prospectively. Each participant underwent a voice evaluation and an evaluation for tremor. RESULTS 146 voice disorder controls and 128 patients with SD were enrolled. 26% of patients with SD had vocal tremor, 21% had non-vocal tremor. Patients with SD were 2.8 times more likely to have co-prevalent tremor than the control group (OR = 2.81; 95% CI, 1.55 to 5.08) and only 35% of patients with SD had been seen by a neurologist for the evaluation of dystonia and tremor. CONCLUSIONS Tremor is highly prevalent in patients with SD. It is important for each patient diagnosed with SD to undergo an evaluation for tremor, this is especially important in patients diagnosed with vocal tremor. Level of evidence 3b. PMID:21792965

  6. Protective head of sensors

    International Nuclear Information System (INIS)

    Liska, K.; Anton, P.

    1987-01-01

    The discovery concerns the protective heads of diagnostic assemblies of nuclear power plants for conductors of the sensors from the fuel and control parts of the said assemblies. A detailed description is presented of the design of the protective head which, as compared with the previous design, allows quick and simple assembly with reduced risk of damaging the sensors. The protective head may be used for diagnostic assemblies both in power and in research reactors and it will be used for WWER reactor assemblies. (A.K.). 3 figs

  7. Seismic Tremors and Three-Dimensional Magma Wagging

    Science.gov (United States)

    Liao, Y.; Bercovici, D.

    2015-12-01

    Seismic tremor is a feature shared by many silicic volcanoes and is a precursor of volcanic eruption. Many of the characteristics of tremors, including their frequency band from 0.5 Hz to 7 Hz, are common for volcanoes with very different geophysical and geochemical properties. The ubiquitous characteristics of tremor imply that it results from some generation mechanism that is common to all volcanoes, instead of being unique to each volcano. Here we present new analysis on the magma-wagging mechanism that has been proposed to generate tremor. The model is based on the suggestion given by previous work (Jellinek & Bercovici 2011; Bercovici et.al. 2013) that the magma column is surrounded by a compressible, bubble-rich foam annulus while rising inside the volcanic conduit, and that the lateral oscillation of the magma inside the annulus causes observable tremor. Unlike the previous two-dimensional wagging model where the displacement of the magma column is restricted to one vertical plane, the three-dimensional model we employ allows the magma column to bend in different directions and has angular motion as well. Our preliminary results show that, without damping from viscous deformation of the magma column, the system retains angular momentum and develops elliptical motion (i.e., the horizontal displacement traces an ellipse). In this ''inviscid'' limit, the magma column can also develop instabilities with higher frequencies than what is found in the original two-dimensional model. Lateral motion can also be out of phase for various depths in the magma column leading to a coiled wagging motion. For the viscous-magma model, we predict a similar damping rate for the uncoiled magma column as in the two-dimensional model, and faster damping for the coiled magma column. The higher damping thus requires the existence of a forcing mechanism to sustain the oscillation, for example the gas-driven Bernoulli effect proposed by Bercovici et al (2013). Finally, using our new 3

  8. Fragile X-associated tremor/ataxia syndrome: An under-recognised cause of tremor and ataxia.

    Science.gov (United States)

    Kalus, Sarah; King, John; Lui, Elaine; Gaillard, Frank

    2016-01-01

    Fragile X-associated tremor/ataxia syndrome (FXTAS) is a progressive degenerative movement disorder resulting from a fragile X "premutation", defined as 55-200 CGG repeats in the 5'-untranslated region of the FMR1 gene. The FMR1 premutation occurs in 1/800 males and 1/250 females, with FXTAS affecting 40-45% of male and 8-16% of female premutation carriers over the age of 50. FXTAS typically presents with kinetic tremor and cerebellar ataxia. FXTAS has a classical imaging profile which, in concert with clinical manifestations and genetic testing, participates vitally in its diagnosis. The revised FXTAS diagnostic criteria include two major radiological features. The "MCP sign", referring to T2 hyperintensity in the middle cerebellar peduncle, has long been considered the radiological hallmark of FXTAS. Recently included as a major radiological criterion in the diagnosis of FXTAS is T2 hyperintensity in the splenium of the corpus callosum. Other imaging features of FXTAS include T2 hyperintensities in the pons, insula and periventricular white matter as well as generalised brain and cerebellar atrophy. FXTAS is an under-recognised and misdiagnosed entity. In patients with unexplained tremor, ataxia and cognitive decline, the presence of middle cerebellar peduncle and/or corpus callosum splenium hyperintensity should raise suspicion of FXTAS. Diagnosis of FXTAS has important implications not only for the patient but also, through genetic counselling and testing, for future generations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Deep Brain Stimulation of the Dentato-Rubro-Thalamic Tract: Outcomes of Direct Targeting for Tremor.

    Science.gov (United States)

    Fenoy, Albert J; Schiess, Mya C

    2017-07-01

    Targeting the dentato-rubro-thalamic tract (DRTt) has been suggested to be efficacious in deep brain stimulation (DBS) for tremor suppression, both in case reports and post-hoc analyses. This prospective observational study sought to analyze outcomes after directly targeting the DRTt in tremor patients. 20 consecutively enrolled intention tremor patients obtained pre-operative MRI with diffusion tensor (dTi) sequences. Mean baseline tremor amplitude based on The Essential Tremor Rating Assessment Scale was recorded. The DRTt was drawn for each individual on StealthViz software (Medtronic) using the dentate nucleus as the seed region and the ipsilateral pre-central gyrus as the end region and then directly targeted during surgery. Intraoperative testing confirmed successful tremor control. Post-operative analysis of electrode position relative to the DRTt was performed, as was post-operative assessment of tremor improvement. The mean age of patients was 66.8 years; mean duration of tremor was 16 years. Mean voltage for the L electrode = 3.4 V; R = 2.6 V. Mean distance from the center of the active electrode contact to the DRTt was 0.9 mm on the L, and 0.8 mm on the R. Improvement in arm tremor amplitude from baseline after DBS was significant (P tremor suppression. Accounting for hardware, software, and model limitations, depiction of the DRTt allows for placement of electrode contacts directly within the fiber tract for modulation despite any anatomical variation, which reproducibly resulted in good tremor control. © 2017 International Neuromodulation Society.

  10. Nonvolcanic tremors and their correlation with slow slip events in Mexico

    Science.gov (United States)

    Kolstoglodov, V.; Shapiro, N. M.; Larson, K.; Payero, J.; Husker, A.; Santiago, L. A.; Clayton, R.; Peyrat, S.

    2009-04-01

    Significant activity of nonvolcanic tremor (NVT) has been observed in the central Mexico (Guerrero) subduction zone since 2001 when continuous seismic records became available. Albeit the quality of these records is poor, it is possible to estimate a temporal variation of energy in the range of 1-2Hz (best signal/noise ratio for the NVT), which clearly indicate the maximum of NVT energy release (En) during the 2001-2002 and 2006 large aseismic slow slip events (SSE) registered by a GPS network. In particular the En is higher for the 2001-2002 SSE which had larger surface displacements and extension than the 2006 SSE. A more detailed and accurate study of NVT activity was carried out using the data collected during the MASE experiment in Mexico. MASE consisted of 100 broad band seismometers in operation for ~2.5 years (2005-2007) along the profile oriented SSW-NNE from Acapulco, and crossing over the subduction zone for a distance of ~500 km. Epicenters and depths of individual tremor events determined using the envelope cross-correlation technique have rather large uncertainties partly originated from the essentially 2D geometry of the network. The "energy" approach is more efficient in this case because it provides an average NVT activity evolution in time and space. The data processing consists of a band pass (1-2Hz) filter of the raw 100 Hz sampled N-S component records, application a 10 min-width median filter to eliminate an effect of local seismic events and noise, and integration of the energy and normalization of daily En using an average coda amplitude from several regional earthquakes of M~5. A time-space distribution of En reveals a strong correlation between NVT energy release and 2006 SSE, which also replicates the two-phase character of this slow event and a migration of the slow slip maximum from North to South. There are also a few clear episodes of relatively high NVT energy release that do not correspond to any significant geodetic signal in GPS

  11. Nonvolcanic Tremor Activity is Highly Correlated With Slow Slip Events, Mexico

    Science.gov (United States)

    Kostoglodov, V.; Shapiro, N.; Larson, K. M.; Payero, J. S.; Husker, A.; Santiago, L. A.; Clayton, R. W.

    2008-12-01

    Significant activity of nonvolcanic tremor (NVT) has been observed in the central Mexico (Guerrero) subduction zone since 2001 when continuous seismic records became available. Although the quality of these records is poor, it is possible to estimate a temporal variation of energy in the range of 1-2Hz (best signal/noise ratio for the NVT). These clearly indicate a maximum of NVT energy release (En) during the 2001-2002 and 2006 large aseismic slow slip events (SSE) registered by the Guerrero GPS network. In particular En is higher for the 2001-2002 SSE which had larger surface displacements and extension than the 2006 SSE. A more detailed and accurate study of NVT activity was carried out using the data collected during the MASE experiment in Mexico. MASE consisted of 100 broad band seismometers in operation for ~2.5 years (2005-2007) along the profile oriented SSW-NNE from Acapulco, and crossing over the subduction zone for a distance of ~500 km. Epicenters and depths of individual tremor events determined using the envelope cross-correlation technique have rather large uncertainties, partly originated from the essentially 2D geometry of the network. The 'energy' approach is more efficient in this case because it provides an average NVT activity evolution in time and space. The data processing consists of a band pass (1-2Hz) filter of the raw 100 Hz sampled N-S component records, application a 10 min-width median filter to eliminate the effect of local seismic events and noise, and integration of the energy and normalization of daily En using an average coda amplitude from several regional earthquakes of M~5. A time-space distribution of En reveals a strong correlation between NVT energy release and the 2006 SSE, which also replicates the two-phase character of this slow event and a migration of the slow slip maximum from North to South. There are also a few clear episodes of relatively high NVT energy release that do not correspond to any significant geodetic

  12. Genç erkek esansiyel tremor hastalarında anksiyete ve depresyon düzeyleri

    OpenAIRE

    Yaşar, Halit; Balıbey, Hakan; Tekeli, Hakan; Alay, Semih; Şenol, Mehmet Güney; Türker, Türker; Bayar, Nalan

    2014-01-01

    Objective: Essential tremor (ET), characterized by postural and kinetic tremor seen on hands and arms, is the most common movement disorder that causes significant disability. Besides the motor symptoms such as tremor, ET is also often accompanied by psychiatric symptoms such as anxiety and depression. We identified our objectives as to compare the level of anxiety and depression in young male patients with ET with the normal and to determine the relationship between this level and tremor sev...

  13. Connectivity derived thalamic segmentation in deep brain stimulation for tremor

    Directory of Open Access Journals (Sweden)

    Harith Akram

    Full Text Available The ventral intermediate nucleus (VIM of the thalamus is an established surgical target for stereotactic ablation and deep brain stimulation (DBS in the treatment of tremor in Parkinson's disease (PD and essential tremor (ET. It is centrally placed on a cerebello-thalamo-cortical network connecting the primary motor cortex, to the dentate nucleus of the contralateral cerebellum through the dentato-rubro-thalamic tract (DRT. The VIM is not readily visible on conventional MR imaging, so identifying the surgical target traditionally involved indirect targeting that relies on atlas-defined coordinates. Unfortunately, this approach does not fully account for individual variability and requires surgery to be performed with the patient awake to allow for intraoperative targeting confirmation. The aim of this study is to identify the VIM and the DRT using probabilistic tractography in patients that will undergo thalamic DBS for tremor. Four male patients with tremor dominant PD and five patients (three female with ET underwent high angular resolution diffusion imaging (HARDI (128 diffusion directions, 1.5 mm isotropic voxels and b value = 1500 preoperatively. Patients received VIM-DBS using an MR image guided and MR image verified approach with indirect targeting. Postoperatively, using parallel Graphical Processing Unit (GPU processing, thalamic areas with the highest diffusion connectivity to the primary motor area (M1, supplementary motor area (SMA, primary sensory area (S1 and contralateral dentate nucleus were identified. Additionally, volume of tissue activation (VTA corresponding to active DBS contacts were modelled. Response to treatment was defined as 40% reduction in the total Fahn-Tolosa-Martin Tremor Rating Score (FTMTRS with DBS-ON, one year from surgery. Three out of nine patients had a suboptimal, long-term response to treatment. The segmented thalamic areas corresponded well to anatomically known counterparts in the ventrolateral

  14. Continuous theta-burst stimulation of the primary motor cortex in essential tremor

    DEFF Research Database (Denmark)

    Hellriegel, Helge; Schulz, Eva M; Siebner, Hartwig R

    2012-01-01

    We investigated whether essential tremor (ET) can be altered by suppressing the corticospinal excitability in the primary motor cortex (M1) with transcranial magnetic stimulation.......We investigated whether essential tremor (ET) can be altered by suppressing the corticospinal excitability in the primary motor cortex (M1) with transcranial magnetic stimulation....

  15. Emotion modulation of the startle reflex in essential tremor: Blunted reactivity to unpleasant and pleasant pictures.

    Science.gov (United States)

    Lafo, Jacob A; Mikos, Ania; Mangal, Paul C; Scott, Bonnie M; Trifilio, Erin; Okun, Michael S; Bowers, Dawn

    2017-01-01

    Essential tremor is a highly prevalent movement disorder characterized by kinetic tremor and mild cognitive-executive changes. These features are commonly attributed to abnormal cerebellar changes, resulting in disruption of cerebellar-thalamo-cortical networks. Less attention has been paid to alterations in basic emotion processing in essential tremor, despite known cerebellar-limbic interconnectivity. In the current study, we tested the hypothesis that a psychophysiologic index of emotional reactivity, the emotion modulated startle reflex, would be muted in individuals with essential tremor relative to controls. Participants included 19 essential tremor patients and 18 controls, who viewed standard sets of unpleasant, pleasant, and neutral pictures for six seconds each. During picture viewing, white noise bursts were binaurally presented to elicit startle eyeblinks measured over the orbicularis oculi. Consistent with past literature, controls' startle eyeblink responses were modulated according to picture valence (unpleasant > neutral > pleasant). In essential tremor participants, startle eyeblinks were not modulated by emotion. This modulation failure was not due to medication effects, nor was it due to abnormal appraisal of emotional picture content. Neuroanatomically, it remains unclear whether diminished startle modulation in essential tremor is secondary to aberrant cerebellar input to the amygdala, which is involved in priming the startle response in emotional contexts, or due to more direct disruption between the cerebellum and brainstem startle circuitry. If the former is correct, these findings may be the first to reveal dysregulation of emotional networks in essential tremor. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Multicentre European study of thalamic stimulation in parkinsonian and essential tremor

    NARCIS (Netherlands)

    Limousin, P.; Speelman, J. D.; Gielen, F.; Janssens, M.

    1999-01-01

    Thalamic stimulation has been proposed to treat disabling tremor. The aims of this multicentre study were to evaluate the efficacy and the morbidity of thalamic stimulation in a large number of patients with parkinsonian or essential tremor. One hundred and eleven patients were included in the study

  17. Wavelet coherence analysis: A new approach to distinguish organic and functional tremor types.

    Science.gov (United States)

    Kramer, G; Van der Stouwe, A M M; Maurits, N M; Tijssen, M A J; Elting, J W J

    2018-01-01

    To distinguish tremor subtypes using wavelet coherence analysis (WCA). WCA enables to detect variations in coherence and phase difference between two signals over time and might be especially useful in distinguishing functional from organic tremor. In this pilot study, polymyography recordings were studied retrospectively of 26 Parkinsonian (PT), 26 functional (FT), 26 essential (ET), and 20 enhanced physiological (EPT) tremor patients. Per patient one segment of 20 s in duration, in which tremor was present continuously in the same posture, was selected. We studied several coherence and phase related parameters, and analysed all possible muscle combinations of the flexor and extensor muscles of the upper and fore arm. The area under the receiver operating characteristic curve (AUC-ROC) was applied to compare WCA and standard coherence analysis to distinguish tremor subtypes. The percentage of time with significant coherence (PTSC) and the number of periods without significant coherence (NOV) proved the most discriminative parameters. FT could be discriminated from organic (PT, ET, EPT) tremor by high NOV (31.88 vs 21.58, 23.12 and 10.20 respectively) with an AUC-ROC of 0.809, while standard coherence analysis resulted in an AUC-ROC of 0.552. EMG-EMG WCA analysis might provide additional variables to distinguish functional from organic tremor. WCA might prove to be of additional value to discriminate between tremor types. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  18. Tremor-tide correlations and near-lithostatic pore pressure on the deep San Andreas fault.

    Science.gov (United States)

    Thomas, Amanda M; Nadeau, Robert M; Bürgmann, Roland

    2009-12-24

    Since its initial discovery nearly a decade ago, non-volcanic tremor has provided information about a region of the Earth that was previously thought incapable of generating seismic radiation. A thorough explanation of the geologic process responsible for tremor generation has, however, yet to be determined. Owing to their location at the plate interface, temporal correlation with geodetically measured slow-slip events and dominant shear wave energy, tremor observations in southwest Japan have been interpreted as a superposition of many low-frequency earthquakes that represent slip on a fault surface. Fluids may also be fundamental to the failure process in subduction zone environments, as teleseismic and tidal modulation of tremor in Cascadia and Japan and high Poisson ratios in both source regions are indicative of pressurized pore fluids. Here we identify a robust correlation between extremely small, tidally induced shear stress parallel to the San Andreas fault and non-volcanic tremor activity near Parkfield, California. We suggest that this tremor represents shear failure on a critically stressed fault in the presence of near-lithostatic pore pressure. There are a number of similarities between tremor in subduction zone environments, such as Cascadia and Japan, and tremor on the deep San Andreas transform, suggesting that the results presented here may also be applicable in other tectonic settings.

  19. Atypical Porcine Pestivirus: A Possible Cause of Congenital Tremor Type A-II in Newborn Piglets

    NARCIS (Netherlands)

    de Groof, Ad; Deijs, Martin; Guelen, Lars; van Grinsven, Lotte; van Os-Galdos, Laura; Vogels, Wannes; Derks, Carmen; Cruijsen, Toine; Geurts, Victor; Vrijenhoek, Mieke; Suijskens, Janneke; van Doorn, Peter; van Leengoed, Leo; Schrier, Carla; van der Hoek, Lia

    2016-01-01

    Congenital tremor type A-II in piglets has been regarded as a transmissible disease since the 1970s, possibly caused by a very recently-described virus: atypical porcine pestivirus (APPV). Here, we describe several strains of APPV in piglets with clinical signs of congenital tremor (10 of 10 farms

  20. Genetics Home Reference: fragile X-associated tremor/ataxia syndrome

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions FXTAS Fragile X-associated tremor/ataxia syndrome Printable PDF Open All ... Javascript to view the expand/collapse boxes. Description Fragile X-associated tremor/ataxia syndrome ( FXTAS ) is characterized by ...

  1. Deep Brain Stimulation for Essential Tremor: Aligning Thalamic and Posterior Subthalamic Targets in 1 Surgical Trajectory

    NARCIS (Netherlands)

    Bot, Maarten; van Rootselaar, Fleur; Contarino, Maria Fiorella; Odekerken, Vincent; Dijk, Joke; de Bie, Rob; Schuurman, Richard; van den Munckhof, Pepijn

    2017-01-01

    Ventral intermediate nucleus (VIM) deep brain stimulation (DBS) and posterior subthalamic area (PSA) DBS suppress tremor in essential tremor (ET) patients, but it is not clear which target is optimal. Aligning both targets in 1 surgical trajectory would facilitate exploring stimulation of either

  2. Head Lice

    Science.gov (United States)

    ... nits. You should also use hot water to wash any bed linens, towels, and clothing recently worn by the person who had head lice. Vacuum anything that can’t be washed, such as the couch, carpets, your child’s car seat, and any stuffed animals. Because head lice ...

  3. Investigations of outbursts and tremors in Polish collieries with application of radon measurements

    International Nuclear Information System (INIS)

    Wysocka, M.

    2010-01-01

    In the 80's and 90's of the last century some attempts were undertaken to apply specific radiometric methods to support the prediction of outbursts in collieries, located in Lower Silesian Coal Basin (LSCB) in south-western Poland. This idea was developed as an analogy to the application of radon changes in groundwater prior to earthquakes, and on this basis the hypothesis of variations of radon emanation from coal seams, preceding approaching outburst, was formulated. It has been stated, that a certain correlation between temporal and spatial variations of radon level and the level of outburst's hazard existed. Then, new investigations have been started in copper and coal mines with the hope to use radon as a tool for the prediction of another dynamic phenomena - tremors. In the case of these investigations, only weak evidences were found. In the last years the occurrence of outburst was noticed in the collieries of Upper Silesian Coal Basin (USCB). Therefore, we started observations of changes of radon concentration in gas, sampled from headings, driven in endangered coal seams. The goal of the research is an attempt to formulate '' radon index of outburst hazard '' to support other, routinely used, methods of the prediction of dangerous events. In this paper some results of investigations, done in collieries in LSCB and in copper mines are quoted to give the background for preliminary results of new research, ongoing in one of the coal mines in the Upper Silesia region. (authors)

  4. Comprehensive, blinded assessment of balance in orthostatic tremor.

    Science.gov (United States)

    Bhatti, Danish; Thompson, Rebecca; Xia, Yiwen; Hellman, Amy; Schmaderer, Lorene; Suing, Katie; McKune, Jennifer; Penke, Cynthia; Iske, Regan; Roeder, Bobbi Jo; Siu, Ka-Chun; Bertoni, John M; Torres-Russotto, Diego

    2018-02-01

    Orthostatic Tremor (OT) is a movement disorder characterized by a sensation of unsteadiness and tremors in the 13-18 Hz range present upon standing. The pathophysiology of OT is not well understood but there is a relationship between the sensation of instability and leg tremors. Despite the sensation of unsteadiness, OT patients do not fall often and balance in OT has not been formally assessed. We present a prospective blinded study comparing balance assessment in patients with OT versus healthy controls. We prospectively enrolled 34 surface Electromyography (EMG)-confirmed primary OT subjects and 21 healthy controls. Participants underwent evaluations of balance by blinded physical therapists (PT) with standardized, validated, commonly used balance scales and tasks. OT subjects were mostly female (30/34, 88%) and controls were majority males (13/20, 65%). The average age of OT subjects was 68.5 years (range 54-87) and for controls was 69.4 (range 32-86). The average duration of OT symptoms was 18 years. OT subjects did significantly worse on all the balance scales and on most balance tasks including Berg Balance Scale, Functional Gait Assessment, Dynamic Gait Index, Unipedal Stance Test, Functional Reach Test and pull test. Gait speed and five times sit to stand were normal in OT. Common validated balance scales are significantly abnormal in primary OT. Despite the objective finding of impaired balance, OT patients do not commonly have falls. The reported sensation of unsteadiness in this patient population seems to be out of proportion to the number of actual falls. Further studies are needed to determine which components of commonly used balance scales are affected by a sensation of unsteadiness and fear of falling. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Inhibition of Parkinsonian tremor with cutaneous afferent evoked by transcutaneous electrical nerve stimulation.

    Science.gov (United States)

    Hao, Man-Zhao; Xu, Shao-Qin; Hu, Zi-Xiang; Xu, Fu-Liang; Niu, Chuan-Xin M; Xiao, Qin; Lan, Ning

    2017-07-14

    Recent study suggests that tremor signals are transmitted by way of multi-synaptic corticospinal pathway. Neurophysiological studies have also demonstrated that cutaneous afferents exert potent inhibition to descending motor commands by way of spinal interneurons. We hypothesize in this study that cutaneous afferents could also affect the transmission of tremor signals, thus, inhibit tremor in patients with PD. We tested this hypothesis by activating cutaneous afferents in the dorsal hand skin innervated by superficial radial nerve using transcutaneous electrical nerve stimulation (TENS). Eight patients with PD having tremor dominant symptom were recruited to participate in this study using a consistent experimental protocol for tremor inhibition. Resting tremor and electromyogram (EMG) of muscles in the upper extremity of these subjects with PD were recorded, while surface stimulation was applied to the dorsal skin of the hand. Fifteen seconds of data were recorded for 5 s prior to, during and post stimulation. Power spectrum densities (PSDs) of tremor and EMG signals were computed for each data segment. The peak values of PSDs in three data segments were compared to detect evidence of tremor inhibition. At stimulation intensity from 1.5 to 1.75 times of radiating sensation threshold, apparent suppressions of tremor at wrist, forearm and upper arm and in the EMGs were observed immediately at the onset of stimulation. After termination of stimulation, tremor and rhythmic EMG bursts reemerged gradually. Statistical analysis of peak spectral amplitudes showed a significant difference in joint tremors and EMGs during and prior to stimulation in all 8 subjects with PD. The average percentage of suppression was 61.56% in tremor across all joints of all subjects, and 47.97% in EMG of all muscles. The suppression appeared to occur mainly in distal joints and muscles. There was a slight, but inconsistent effect on tremor frequency in the 8 patients with PD tested. Our

  6. Health Coordination Manual. Head Start Health Services.

    Science.gov (United States)

    Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

    Part 1 of this manual on coordinating health care services for Head Start children provides an overview of what Head Start health staff should do to meet the medical, mental health, nutritional, and/or dental needs of Head Start children, staff, and family members. Offering examples, lists, action steps, and charts for clarification, part 2…

  7. Geomorphological and Geoelectric Techniques for Kwoi's Multiple Tremor Assessment

    Science.gov (United States)

    Dikedi, P. N.

    2017-12-01

    This work epicentres on geomorphological and geoelectric techniques for multiple tremor assessment in Kwoi, Nigeria. Earth tremor occurrences have been noted by Akpan and Yakubu (2010) within the last 70 years, in nine regions in Nigeria; on September 11,12,20,22, 23 and 24, 2016, additional earth tremors rocked the village of Kwoi eleven times. Houses cracked and collapsed, a rock split and slid and smoke evolved at N9027''5.909''', E800'44.951'', from an altitude of 798m. By employing the Ohmega Meter and Schlumberger configuration, four VES points are sounded for subsurface structure characterisation. Thereafter, a cylindrical steel ring is hammered into the ground at the first point (VES 1) and earth samples are scooped from this location; this procedure is repeated for other points (VES 2, 3 and 4). Winresist, Geo-earth, and Surfer version 12.0.626 software are employed to generate geo-sections, lithology, resistivity profile, Iso resistivity and Isopach maps, of the region. Outcome of results reveal some lithological formations of lateritic topsoil, fractured basement and fresh basement; additionally, results reveal 206.6m, 90.7m, 73.2m and 99.4m fractured basement thicknesses for four points. Scooped samples are transferred to the specimen stage of a Scanning Electron Microscope (SEM). SEM images show rounded inter-granular boundaries—the granular structures act like micro-wheels making the upper crustal mass susceptible to movement at the slightest vibration. Collapsed buildings are sited around VES1 location; samples from VES 1 are the most well fragmented sample owing to multiple microfractures—this result explains why VES 1 has the thickest fractured basement. Abrupt frictional sliding occurs between networks of fault lines; there is a likelihood that friction is most intense at the rock slide site on N9027'21.516'' and E800'44.9993'', VES 1 at N9027'5.819'' and E8005'3.1120'' and smoke sites—holo-centres are suspected below these locations. The

  8. Ethosuximide for Essential Tremor: An Open-Label Trial

    OpenAIRE

    Gironell, Alexandre; Marin-Lahoz, Juan

    2016-01-01

    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 inci...

  9. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement

    NARCIS (Netherlands)

    Buglione, Michela; Cavagnini, Roberta; Di Rosario, Federico; Sottocornola, Lara; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Paganelli, Corrado; Majorana, Alessandra; Gastaldi, Giorgio; Bossi, Paolo; Berruti, Alfredo; Pavanato, Giovanni; Nicolai, Piero; Maroldi, Roberto; Barasch, Andrei; Russi, Elvio G.; Raber-Durlacher, Judith; Murphy, Barbara; Magrini, Stefano M.

    2016-01-01

    Radiotherapy alone or in combination with chemotherapy and/or surgery is the typical treatment for head and neck cancer patients. Acute side effects (such as oral mucositis, dermatitis, salivary changes, taste alterations, etc.), and late toxicities in particular (such as osteo-radionecrosis,

  10. Evaluation of advanced turbomachinery for underground pumped hydroelectric storage. Part 3. Multistage unregulated pump/turbines for operating heads of 1000 to 1500 m

    Energy Technology Data Exchange (ETDEWEB)

    Frigo, A.A.; Pistner, C.

    1980-08-01

    This is the final report in a series of three on studies of advanced hydraulic turbomachinery for underground pumped hydroelectric storage. All three reports address Francis-type, reversible pump/turbines. The first report covered single-stage regulated units; the second report covered two-stage regulated units; the present report covers multistage unregulated units. Multistage unregulated pump/turbines offer an economically attractive option for heads of 1000 to 1500 m. The feasibility of developing such machines for capacities up to 500 MW and operating heads up to 1500 m has been evaluated. Preliminary designs have been generated for six multistage pump/turbines. The designs are for nominal capacities of 350 and 500 MW and for operating heads of 1000, 1250, and 1500 m. Mechanical, hydraulic, and economic analyses indicate that these machines will behave according to the criteria used to design them and that they can be built at a reasonable cost with no unsolvable problems. Efficiencies of 85.8% and 88.5% in the generating and pumping modes, respectively, can be expected for the 500-MW, 1500-m unit. Performances of the other five machines are at least comparable, and usually better. Over a 1000 to 1500-m head range, specific $/kW costs of the pump/turbines in mid-1978 US dollars vary from 19.0 to 23.1 for the 500-MW machines, and from 21.0 to 24.1 for the 350-MW machines.

  11. Achieving work-life balance in the National Collegiate Athletic Association Division I setting, part II: perspectives from head athletic trainers.

    Science.gov (United States)

    Goodman, Ashley; Mazerolle, Stephanie M; Pitney, William A

    2015-01-01

    Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role. To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university. Qualitative study. Web-based management system. A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered. Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data. Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work.

  12. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2 : proposed applications and treatment protocols

    NARCIS (Netherlands)

    Zecha, J.A.E.M.; Raber-Durlacher, J.E.; Nair, R.G.; Epstein, J.B.; Elad, S.; Hamblin, M.R.; Barasch, A.; Migliorati, C.A.; Milstein, D.M.J.; Genot, M.T.; Lansaat, L.; van der Brink, R.; Arnabat-Dominguez, J.; van der Molen, L.; Jacobi, I.; van Diessen, J.; de Lange, J.; Smeele, L.E.; Schubert, M.M.; Bensadoun, R.J.

    2016-01-01

    Purpose There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together

  13. Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols

    NARCIS (Netherlands)

    Zecha, Judith A. E. M.; Raber-Durlacher, Judith E.; Nair, Raj G.; Epstein, Joel B.; Elad, Sharon; Hamblin, Michael R.; Barasch, Andrei; Migliorati, Cesar A.; Milstein, Dan M. J.; Genot, Marie-Thérèse; Lansaat, Liset; van der Brink, Ron; Arnabat-Dominguez, Josep; van der Molen, Lisette; Jacobi, Irene; van Diessen, Judi; de Lange, Jan; Smeele, Ludi E.; Schubert, Mark M.; Bensadoun, René-Jean

    2016-01-01

    There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), more recently termed photobiomodulation (PBM) for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a

  14. Building a Global Catalog of Nonvolcanic Tremor Events Using an Automatic Detection Algorithm

    Science.gov (United States)

    Bagley, B. C.; Revenaugh, J.

    2009-12-01

    Nonvolcanic tremor is characterized by a long-period seismic event containing a series of low-frequency earthquakes (LFEs). Tremor has been detected in regions of subduction (e.g. Kao et. al. 2007, 2008; Shelly 2006) and beneath the San Andreas fault near Cholame, California (e.g. Nadeau and Dolenc, 2005). In some cases tremor events seem to have periodicity, and these are often referred to as episodic tremor and slip (ETS). The origin of nonvolcanic tremor has been ascribed to shear slip along plate boundaries and/or high pore-fluid pressure. The apparent periodicity and tectonic setting associated with ETS has led to the suggestion that there may be a link between ETS and megathrust earthquakes. Until recently tremor detection has been a manual process requiring visual inspection of seismic data. In areas that have dense seismic arrays (e.g. Japan) waveform cross correlation techniques have been successfully employed (e.g. Obara, 2002). Kao et al. (2007) developed an algorithm for automatic detection of seismic tremor that can be used in regions without dense arrays. This method has been used to create the Tremor Activity Monitoring System (TAMS), which is used by the Geologic Survey of Canada to monitor northern Cascadia. So far the study of nonvolcanic tremor has been limited to regions of subduction or along major transform faults. It is unknown if tremor events occur in other tectonic settings, or if the current detection schemes will be useful for finding them. We propose to look for tremor events in non-subduction regions. It is possible that if tremor exists in other regions it will have different characteristics and may not trigger the TAMS system or be amenable to other existing detection schemes. We are developing algorithms for searching sparse array data sets for quasi-harmonic energy bursts in hopes of recognizing and cataloging nonvolcanic tremor in an expanded tectonic setting. Statistical comparisons against the TAMS algorithm will be made if

  15. Tremor-genic slow slip regions may be deeper and warmer and may slip slower than non-tremor-genic regions

    Science.gov (United States)

    Montgomery-Brown, Emily; Syracuse, Ellen M.

    2015-01-01

    Slow slip events (SSEs) are observed worldwide and often coincide with tectonic tremor. Notable examples of SSEs lacking observed tectonic tremor, however, occur beneath Kīlauea Volcano, Hawaii, the Boso Peninsula, Japan, near San Juan Bautista on the San Andreas Fault, California, and recently in Central Ecuador. These SSEs are similar to other worldwide SSEs in many ways (e.g., size or duration), but lack the concurrent tectonic tremor observed elsewhere; instead, they trigger swarms of regular earthquakes. We investigate the physical conditions that may distinguish these non-tremor-genic SSEs from those associated with tectonic tremor, including slip velocity, pressure, temperature, fluids, and fault asperities, although we cannot eliminate the possibility that tectonic tremor may be obscured in highly attenuating regions. Slip velocities of SSEs at Kīlauea Volcano (∼10−6 m/s) and Boso Peninsula (∼10−7 m/s) are among the fastest SSEs worldwide. Kīlauea Volcano, the Boso Peninsula, and Central Ecuador are also among the shallowest SSEs worldwide, and thus have lower confining pressures and cooler temperatures in their respective slow slip zones. Fluids also likely contribute to tremor generation, and no corresponding zone of high vp/vs has been noted at Kīlauea or Boso. We suggest that the relatively faster slip velocities at Kīlauea Volcano and the Boso Peninsula result from specific physical conditions that may also be responsible for triggering swarms of regular earthquakes adjacent to the slow slip, while different conditions produce slower SSE velocities elsewhere and trigger tectonic tremor.

  16. Thalamic deep brain stimulation for the treatment of tremor due to multiple sclerosis: a prospective study of tremor and quality of life.

    Science.gov (United States)

    Berk, Caglar; Carr, Jason; Sinden, Marci; Martzke, Jeff; Honey, Christopher R

    2002-10-01

    In several studies a significant reduction in tremor after thalamic deep brain stimulation (DBS) has been reported among patients with multiple sclerosis (MS). It has not been determined if this results in an improved quality of life. In this study the authors prospectively evaluated the effects of thalamic DBS on tremor and quality of life. Videotapes of the patients' tremor were made preoperatively and 2 and 12 months postoperatively, and tremor was scored by a neurologist blinded to the treatment. Patients were tested pre- and postoperatively to measure any changes in their reported ability to perform selected activities of daily living and in their health-related quality of life. Patients were asked to complete a questionnaire about their satisfaction with the surgery. Postoperative changes were examined using paired t-tests. There were significant reductions in postural, action, and overall tremor at 2 and 12 months postoperatively. The patients' reported ability to feed themselves was significantly improved 2 months after surgery (p = 0.01). There were short-term trends toward improvement in reported dressing ability, personal hygiene, and writing. There were no significant changes in the SF-36 subscales or total score. In this cohort of patients with MS who suffered from tremor, thalamic DBS significantly improved their tremor and ability to feed themselves. Patient satisfaction with the procedure, however, was variable. Preoperative patient education about what functions might (and might not) be improved is crucial to avoid unrealistic expectations. Our results indicate that younger patients with MS tremor who had a shorter disease duration and no superimposed ataxia benefited most from this surgery.

  17. Parkinsonian Rest Tremor Is Associated With Modulations of Subthalamic High-Frequency Oscillations.

    Science.gov (United States)

    Hirschmann, Jan; Butz, Markus; Hartmann, Christian J; Hoogenboom, Nienke; Özkurt, Tolga E; Vesper, Jan; Wojtecki, Lars; Schnitzler, Alfons

    2016-10-01

    High frequency oscillations (>200 Hz) have been observed in the basal ganglia of PD patients and were shown to be modulated by the administration of levodopa and voluntary movement. The objective of this study was to test whether the power of high-frequency oscillations in the STN is associated with spontaneous manifestation of parkinsonian rest tremor. The electromyogram of both forearms and local field potentials from the STN were recorded in 11 PD patients (10 men, age 58 [9.4] years, disease duration 9.2 [6.3] years). Patients were recorded at rest and while performing repetitive hand movements before and after levodopa intake. High-frequency oscillation power was compared across epochs containing rest tremor, tremor-free rest, or voluntary movement and related to the tremor cycle. We observed prominent slow (200-300 Hz) and fast (300-400 Hz) high-frequency oscillations. The ratio between slow and fast high-frequency oscillation power increased when tremor became manifest. This increase was consistent across nuclei (94%) and occurred in medication ON and OFF. The ratio outperformed other potential markers of tremor, such as power at individual tremor frequency, beta power, or low gamma power. For voluntary movement, we did not observe a significant difference when compared with rest or rest tremor. Finally, rhythmic modulations of high-frequency oscillation power occurred within the tremor cycle. Subthalamic high-frequency oscillation power is closely linked to the occurrence of parkinsonian rest tremor. The balance between slow and fast high-frequency oscillation power combines information on motor and medication state. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  18. Tremors in white rhinoceroses (Ceratotherium simum during etorphine–azaperone immobilisation

    Directory of Open Access Journals (Sweden)

    Stephanie S. de Lange

    2017-02-01

    Full Text Available Little is known about the mechanisms causing tremors during immobilisation of rhinoceros and whether cardiorespiratory supportive interventions alter their intensity. Therefore, we set out to determine the possible mechanisms that lead to muscle tremors and ascertain whether cardiorespiratory supportive interventions affect tremor intensity. We studied tremors and physiological responses during etorphine–azaperone immobilisation in eight boma-held and 14 free-living white rhinoceroses. Repeated measures analysis of variance and a Friedman test were used to determine differences in variables over time and between interventions. Spearman and Pearson correlations were used to test for associations between variables. Tremor intensity measured objectively by activity loggers correlated well (p < 0.0001; r2 = 0.9 with visual observations. Tremor intensity was greatest when animals were severely hypoxaemic and acidaemic. Tremor intensity correlated strongly and negatively with partial pressure of oxygen (PaO2 (p = 0.0003; r2 = 0.9995 and potential of hydrogen (pH (p = 0.02, r2 = 0.97. It correlated strongly and positively with adrenaline concentrations (p = 0.003; r2 = 0.96, and adrenaline correlated strongly and negatively with PaO2 (p = 0.03; r2 = 0.95 and pH (p = 0.03; r2 = 0.94. Therefore, hypoxaemia and acidaemia were likely associated with the intensity of tremors through their activation of the release of tremorgenic levels of adrenaline. Tremors can be reduced if circulating adrenaline is reduced, and this can be achieved by the administration of butorphanol plus oxygen insufflation. Furthermore, to assist with reducing the risks associated with rhinoceros immobilisation, tremor intensity could be used as a clinical indicator of respiratory and metabolic compromise.

  19. Neuroanatomical heterogeneity of essential tremor according to propranolol response.

    Directory of Open Access Journals (Sweden)

    Seok Jong Chung

    Full Text Available BACKGROUND: Recent studies have suggested that essential tremor (ET is a more complex and heterogeneous clinical entity than initially thought. In the present study, we assessed the pattern of cortical thickness and diffusion tensor white matter (WM changes in patients with ET according to the response to propranolol to explore the pathogenesis underlying the clinical heterogeneity of ET. METHODS: A total of 32 patients with drug naive ET were recruited prospectively from the Movement Disorders outpatient clinic. The patients were divided into a propranolol-responder group (n = 18 and a non-responder group (n = 14. We analyzed the pattern of cortical thickness and diffusion tensor WM changes between these two groups and performed correlation analysis between imaging and clinical parameters. RESULTS: There were no significant differences in demographic characteristics, general cognition, or results of detailed neuropsychological tests between the groups. The non-responder group showed more severe cortical atrophy in the left orbitofrontal cortex and right temporal cortex relative to responders. However, the responders exhibited significantly lower fractional anisotropy values in the bilateral frontal, corpus callosal, and right parietotemporal WM compared with the non-responder group. There were no significant clusters where the cortical thickness or WM alterations were significantly correlated with initial tremor severity or disease duration. CONCLUSIONS: The present data suggest that patients with ET have heterogeneous cortical thinning and WM alteration with respect to responsiveness to propranolol, suggesting that propranolol responsiveness may be a predictive factor to determine ET subtypes in terms of neuroanatomical heterogeneity.

  20. Linking Essential Tremor to the Cerebellum: Physiological Evidence.

    Science.gov (United States)

    Filip, Pavel; Lungu, Ovidiu V; Manto, Mario-Ubaldo; Bareš, Martin

    2016-12-01

    Essential tremor (ET), clinically characterized by postural and kinetic tremors, predominantly in the upper extremities, originates from pathological activity in the dynamic oscillatory network comprising the majority of nodes in the central motor network. Evidence indicates dysfunction in the thalamus, the olivocerebellar loops, and intermittent cortical engagement. Pathology of the cerebellum, a structure with architecture intrinsically predisposed to oscillatory activity, has also been implicated in ET as shown by clinical, neuroimaging, and pathological studies. Despite electrophysiological studies assessing cerebellar impairment in ET being scarce, their impact is tangible, as summarized in this review. The electromyography-magnetoencephalography combination provided the first direct evidence of pathological alteration in cortico-subcortical communication, with a significant emphasis on the cerebellum. Furthermore, complex electromyography studies showed disruptions in the timing of agonist and antagonist muscle activation, a process generally attributed to the cerebellum. Evidence pointing to cerebellar engagement in ET has also been found in electrooculography measurements, cerebellar repetitive transcranial magnetic stimulation studies, and, indirectly, in complex analyses of the activity of the ventral intermediate thalamic nucleus (an area primarily receiving inputs from the cerebellum), which is also used in the advanced treatment of ET. In summary, further progress in therapy will require comprehensive electrophysiological and physiological analyses to elucidate the precise mechanisms leading to disease symptoms. The cerebellum, as a major node of this dynamic oscillatory network, requires further study to aid this endeavor.

  1. Ethosuximide for Essential Tremor: An Open-Label Trial

    Science.gov (United States)

    Gironell, Alexandre; Marin-Lahoz, Juan

    2016-01-01

    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. Methods Seven patients diagnosed with ET were included in the study. The ethosuximide dose was 500 mg daily (BID). The main outcome measures were: 1) tremor clinical rating scale (TCRS) score, 2) accelerometric recordings, and 3) self-reported disability scale score. Results Five patients completed the study, and two dropped out due to adverse effects. There were no significant changes in clinical scores in motor task performance (TCRS 1+2), daily living activities (TCRS 3), or in the patients’ subjective assessment (TCRS 4) and global appraisal. There were no differences observed for accelerometry data or disability scale scores. Anxiety, nervousness, headache, and dizziness were reported by two patients while on ethosuximide, causing them to stop the trial. No patient preferred to continue ethosuximide treatment. Discussion The results of our exploratory study suggest that ethosuximide is not an effective treatment for ET. PMID:27625899

  2. Ethosuximide for Essential Tremor: An Open-Label Trial

    Directory of Open Access Journals (Sweden)

    Alexandre Gironell

    2016-07-01

    Full Text Available 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. Methods: Seven patients diagnosed with ET were included in the study. The ethosuximide dose was 500 mg daily (BID. The main outcome measures were: 1 tremor clinical rating scale (TCRS score, 2 accelerometric recordings, and 3 self-reported disability scale score. Results: Five patients completed the study, and two dropped out due to adverse effects. There were no significant changes in clinical scores in motor task performance (TCRS 1+2, daily living activities (TCRS 3, or in the patients’ subjective assessment (TCRS 4 and global appraisal. There were no differences observed for accelerometry data or disability scale scores. Anxiety, nervousness, headache, and dizziness were reported by two patients while on ethosuximide, causing them to stop the trial. No patient preferred to continue ethosuximide treatment. Discussion: The results of our exploratory study suggest that ethosuximide is not an effective treatment for ET.

  3. Mitochondrial serine protease HTRA2 p.G399S in a kindred with essential tremor and Parkinson disease.

    Science.gov (United States)

    Unal Gulsuner, Hilal; Gulsuner, Suleyman; Mercan, Fatma Nazli; Onat, Onur Emre; Walsh, Tom; Shahin, Hashem; Lee, Ming K; Dogu, Okan; Kansu, Tulay; Topaloglu, Haluk; Elibol, Bulent; Akbostanci, Cenk; King, Mary-Claire; Ozcelik, Tayfun; Tekinay, Ayse B

    2014-12-23

    Essential tremor is one of the most frequent movement disorders of humans and can be associated with substantial disability. Some but not all persons with essential tremor develop signs of Parkinson disease, and the relationship between the conditions has not been clear. In a six-generation consanguineous Turkish kindred with both essential tremor and Parkinson disease, we carried out whole exome sequencing and pedigree analysis, identifying HTRA2 p.G399S as the allele likely responsible for both conditions. Essential tremor was present in persons either heterozygous or homozygous for this allele. Homozygosity was associated with earlier age at onset of tremor (P relationship to Parkinson disease.

  4. Heterogeneity of Monosymptomatic Resting Tremor in a Prospective Study: Clinical Features, Electrophysiological Test, and Dopamine Transporter Positron Emission Tomography.

    Science.gov (United States)

    Zheng, Hua-Guang; Zhang, Rong; Li, Xin; Li, Fang-Fei; Wang, Ya-Chen; Wang, Xue-Mei; Lu, Ling-Long; Feng, Tao

    2015-07-05

    The relationship between monosymptomatic resting tremor (mRT) and Parkinson's disease (PD) remains controversial. In this study, we aimed to assess the function of presynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography (DAT-PET) and to evaluate the utility of clinical features or electrophysiological studies in differential diagnosis. Thirty-three consecutive patients with mRT were enrolled prospectively. The Unified Parkinson's Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index (SAI) was calculated, and a normal DAT-PET was defined as a SAI of hygiene score, walking in motor experiences of daily living (Part II) and motor examination (Part III) were significant different between two groups (P postural tremor tend to be higher in the SWEDDs group (P = 0.08 and P = 0.05, respectively). mRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

  5. Connectivity derived thalamic segmentation in deep brain stimulation for tremor.

    Science.gov (United States)

    Akram, Harith; Dayal, Viswas; Mahlknecht, Philipp; Georgiev, Dejan; Hyam, Jonathan; Foltynie, Thomas; Limousin, Patricia; De Vita, Enrico; Jahanshahi, Marjan; Ashburner, John; Behrens, Tim; Hariz, Marwan; Zrinzo, Ludvic

    2018-01-01

    The ventral intermediate nucleus (VIM) of the thalamus is an established surgical target for stereotactic ablation and deep brain stimulation (DBS) in the treatment of tremor in Parkinson's disease (PD) and essential tremor (ET). It is centrally placed on a cerebello-thalamo-cortical network connecting the primary motor cortex, to the dentate nucleus of the contralateral cerebellum through the dentato-rubro-thalamic tract (DRT). The VIM is not readily visible on conventional MR imaging, so identifying the surgical target traditionally involved indirect targeting that relies on atlas-defined coordinates. Unfortunately, this approach does not fully account for individual variability and requires surgery to be performed with the patient awake to allow for intraoperative targeting confirmation. The aim of this study is to identify the VIM and the DRT using probabilistic tractography in patients that will undergo thalamic DBS for tremor. Four male patients with tremor dominant PD and five patients (three female) with ET underwent high angular resolution diffusion imaging (HARDI) (128 diffusion directions, 1.5 mm isotropic voxels and b value = 1500) preoperatively. Patients received VIM-DBS using an MR image guided and MR image verified approach with indirect targeting. Postoperatively, using parallel Graphical Processing Unit (GPU) processing, thalamic areas with the highest diffusion connectivity to the primary motor area (M1), supplementary motor area (SMA), primary sensory area (S1) and contralateral dentate nucleus were identified. Additionally, volume of tissue activation (VTA) corresponding to active DBS contacts were modelled. Response to treatment was defined as 40% reduction in the total Fahn-Tolosa-Martin Tremor Rating Score (FTMTRS) with DBS-ON, one year from surgery. Three out of nine patients had a suboptimal, long-term response to treatment. The segmented thalamic areas corresponded well to anatomically known counterparts in the ventrolateral (VL

  6. Achieving Work-Life Balance in the National Collegiate Athletic Association Division I Setting, Part II: Perspectives From Head Athletic Trainers

    Science.gov (United States)

    Goodman, Ashley; Mazerolle, Stephanie M.; Pitney, William A.

    2015-01-01

    Context: Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role. Objective: To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university. Design: Qualitative study. Setting: Web-based management system. Patients or Other Participants: A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered. Data Collection and Analysis: Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data. Results: Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. Conclusions: Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work. PMID:25098746

  7. Head Injuries

    Science.gov (United States)

    ... a severe blow to the head can still knock the brain into the side of the skull ... following certain precautions and taking a break from sports and other activities that make symptoms worse. Playing ...

  8. Achieving Work-Life Balance in the National Collegiate Athletic Association Division I Setting, Part I: The Role of the Head Athletic Trainer

    Science.gov (United States)

    Mazerolle, Stephanie M.; Goodman, Ashley; Pitney, William A.

    2015-01-01

    Context: Supervisor support has been identified as key to the fulfillment of work-life balance for the athletic trainer (AT), yet limited literature exists on the perspectives of supervisors. Objective: To investigate how the head AT facilitates work-life balance among staff members within the National Collegiate Athletic Association Division I setting. Design: Qualitative study. Setting: Web-based management system. Patients or Other Participants: A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered for an asynchronous, Web-based interview. Data Collection and Analysis: Participants responded to a series of questions by journaling their thoughts and experiences. We included multiple-analyst triangulation, stakeholder checks, and peer review to establish data credibility. We analyzed the data via a general inductive approach. Results: Four prevailing themes emerged from the data: modeling work-life balance, encouraging disengagement from the AT role, cooperation and community workplace, and administrative support and understanding. Conclusions: Head ATs at the Division I level recognized the need to promote work-life balance among their staffs. They not only were supportive of policies that promote work-life balance, including spending time away from the role of the AT and teamwork among staff members, but also modeled and practiced the strategies that they promoted. PMID:25343530

  9. Achieving work-life balance in the National Collegiate Athletic Association Division I setting, part I: the role of the head athletic trainer.

    Science.gov (United States)

    Mazerolle, Stephanie M; Goodman, Ashley; Pitney, William A

    2015-01-01

    Supervisor support has been identified as key to the fulfillment of work-life balance for the athletic trainer (AT), yet limited literature exists on the perspectives of supervisors. To investigate how the head AT facilitates work-life balance among staff members within the National Collegiate Athletic Association Division I setting. Qualitative study. Web-based management system. A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered for an asynchronous, Web-based interview. Participants responded to a series of questions by journaling their thoughts and experiences. We included multiple-analyst triangulation, stakeholder checks, and peer review to establish data credibility. We analyzed the data via a general inductive approach. Four prevailing themes emerged from the data: modeling work-life balance, encouraging disengagement from the AT role, cooperation and community workplace, and administrative support and understanding. Head ATs at the Division I level recognized the need to promote work-life balance among their staffs. They not only were supportive of policies that promote work-life balance, including spending time away from the role of the AT and teamwork among staff members, but also modeled and practiced the strategies that they promoted.

  10. Silva as the Head

    DEFF Research Database (Denmark)

    Svabo, Connie

    2015-01-01

    The head of the performance design programme is substituted by a sister's academy delegate. this performance situation formed part of a week of semesterstart where the students and professors visited Sister's Academy, Malmø. I participated in the Sister's Academy as visiting researcher and here i...

  11. Adaptation of feedforward movement control is abnormal in patients with cervical dystonia and tremor.

    Science.gov (United States)

    Avanzino, Laura; Ravaschio, Andrea; Lagravinese, Giovanna; Bonassi, Gaia; Abbruzzese, Giovanni; Pelosin, Elisa

    2018-01-01

    It is under debate whether the cerebellum plays a role in dystonia pathophysiology and in the expression of clinical phenotypes. We investigated a typical cerebellar function (anticipatory movement control) in patients with cervical dystonia (CD) with and without tremor. Twenty patients with CD, with and without tremor, and 17 healthy controls were required to catch balls of different load: 15 trials with a light ball, 25 trials with a heavy ball (adaptation) and 15 trials with a light ball (post-adaptation). Arm movements were recorded using a motion capture system. We evaluated: (i) the anticipatory adjustment (just before the impact); (ii) the extent and rate of the adaptation (at the impact) and (iii) the aftereffect in the post-adaptation phase. The anticipatory adjustment was reduced during adaptation in CD patients with tremor respect to CD patients without tremor and controls. The extent and rate of adaptation and the aftereffect in the post-adaptation phase were smaller in CD with tremor than in controls and CD without tremor. Patients with cervical dystonia and tremor display an abnormal predictive movement control. Our findings point to a possible role of cerebellum in the expression of a clinical phenotype in dystonia. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  12. Wrist sensor-based tremor severity quantification in Parkinson's disease using convolutional neural network.

    Science.gov (United States)

    Kim, Han Byul; Lee, Woong Woo; Kim, Aryun; Lee, Hong Ji; Park, Hye Young; Jeon, Hyo Seon; Kim, Sang Kyong; Jeon, Beomseok; Park, Kwang S

    2018-04-01

    Tremor is a commonly observed symptom in patients of Parkinson's disease (PD), and accurate measurement of tremor severity is essential in prescribing appropriate treatment to relieve its symptoms. We propose a tremor assessment system based on the use of a convolutional neural network (CNN) to differentiate the severity of symptoms as measured in data collected from a wearable device. Tremor signals were recorded from 92 PD patients using a custom-developed device (SNUMAP) equipped with an accelerometer and gyroscope mounted on a wrist module. Neurologists assessed the tremor symptoms on the Unified Parkinson's Disease Rating Scale (UPDRS) from simultaneously recorded video footages. The measured data were transformed into the frequency domain and used to construct a two-dimensional image for training the network, and the CNN model was trained by convolving tremor signal images with kernels. The proposed CNN architecture was compared to previously studied machine learning algorithms and found to outperform them (accuracy = 0.85, linear weighted kappa = 0.85). More precise monitoring of PD tremor symptoms in daily life could be possible using our proposed method. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Effect of stretching and proprioceptive loading in hand function among patients with cerebellar tremor

    Directory of Open Access Journals (Sweden)

    Hariharasudhan Ravichandran

    2016-01-01

    Full Text Available Background and Objective: Tremor, the most common form of abnormal involuntary movement, affects the performance of activities of daily living. Evidence on effective form of physiotherapy techniques which can help manage intentional tremor and improve hand function among cerebellar dysfunction patients in inconclusive. Hence, this study aims to establish the effectiveness of stretching and proprioceptive loading among cerebellar patients with intentional tremors. The objective of this study is to compare the efficacy of stretching and proprioceptive loading among patients with cerebellar intention tremor. Materials and Methods: A total of thirty patients with intention tremor due to cerebellar lesion were recruited for this study. They were randomized into two groups, Group I received stretching exercise and Group II received proprioceptive loading exercise. Pre- and post-test outcome measures were taken at the end of duration of 3 weeks intervention. Outcome measures were Fahn's tremor rating scale and nine hole peg test. Results: Statistical analyses were done by McNemar test, Wilcoxon's signed rank test, and Mann–Whitney test. Post-test scores of both groups were compared and found that Group II treated with proprioceptive loading exercise had higher significant result than the group treated with strengthening exercise program. Conclusion: Proprioceptive loading exercise has demonstrated signifi cant effect on reducing cerebellar tremor and improving muscle coordination in reaching activities.

  14. Estimation of pathological tremor from recorded signals based on adaptive sliding fast Fourier transform

    Directory of Open Access Journals (Sweden)

    Shengxin Wang

    2016-06-01

    Full Text Available Pathological tremor is an approximately rhythmic movement and considerably affects patients’ daily living activities. Biomechanical loading and functional electrical stimulation are proposed as potential alternatives for canceling the pathological tremor. However, the performance of suppression methods is associated with the separation of tremor from the recorded signals. In this literature, an algorithm incorporating a fast Fourier transform augmented with a sliding convolution window, an interpolation procedure, and a damping module of the frequency is presented to isolate tremulous components from the measured signals and estimate the instantaneous tremor frequency. Meanwhile, a mechanism platform is designed to provide the simulation tremor signals with different degrees of voluntary movements. The performance of the proposed algorithm and existing procedures is compared with simulated signals and experimental signals collected from patients. The results demonstrate that the proposed solution could detect the unknown dominant frequency and distinguish the tremor components with higher accuracy. Therefore, this algorithm is useful for actively compensating tremor by functional electrical stimulation without affecting the voluntary movement.

  15. Atypical Porcine Pestivirus: A Possible Cause of Congenital Tremor Type A‐II in Newborn Piglets

    Directory of Open Access Journals (Sweden)

    Ad de Groof

    2016-10-01

    Full Text Available Congenital tremor type A‐II in piglets has been regarded as a transmissible disease since the 1970s, possibly caused by a very recently‐described virus: atypical porcine pestivirus (APPV. Here, we describe several strains of APPV in piglets with clinical signs of congenital tremor (10 of 10 farms tested. Piglets on a farm with no history of congenital tremor were PCR‐negative for the virus. To demonstrate a causal relationship between APPV and disease, three gilts were inoculated via intramuscular injection at day 32 of pregnancy. In two of the three litters, vertical transmission of the virus occurred. Clinical signs of congenital tremor were observed in APPV‐infected newborns, yet also two asymptomatic carriers were among the offspring. Piglets of one litter were PCR‐negative for the virus, and these piglets were all without congenital tremors. Long‐term follow up of farm piglets born with congenital tremors showed that the initially high viremia in serum declines at five months of age, but shedding of the virus in feces continues, which explains why the virus remains present at affected farms and causes new outbreaks. We conclude that trans‐placental transmission of APPV and subsequent infection of the fetuses is a very likely cause of congenital tremor type A‐II in piglets.

  16. Atypical Porcine Pestivirus: A Possible Cause of Congenital Tremor Type A-II in Newborn Piglets.

    Science.gov (United States)

    de Groof, Ad; Deijs, Martin; Guelen, Lars; van Grinsven, Lotte; van Os-Galdos, Laura; Vogels, Wannes; Derks, Carmen; Cruijsen, Toine; Geurts, Victor; Vrijenhoek, Mieke; Suijskens, Janneke; van Doorn, Peter; van Leengoed, Leo; Schrier, Carla; van der Hoek, Lia

    2016-10-04

    Congenital tremor type A-II in piglets has been regarded as a transmissible disease since the 1970s, possibly caused by a very recently-described virus: atypical porcine pestivirus (APPV). Here, we describe several strains of APPV in piglets with clinical signs of congenital tremor (10 of 10 farms tested). Piglets on a farm with no history of congenital tremor were PCR-negative for the virus. To demonstrate a causal relationship between APPV and disease, three gilts were inoculated via intramuscular injection at day 32 of pregnancy. In two of the three litters, vertical transmission of the virus occurred. Clinical signs of congenital tremor were observed in APPV-infected newborns, yet also two asymptomatic carriers were among the offspring. Piglets of one litter were PCR-negative for the virus, and these piglets were all without congenital tremors. Long-term follow up of farm piglets born with congenital tremors showed that the initially high viremia in serum declines at five months of age, but shedding of the virus in feces continues, which explains why the virus remains present at affected farms and causes new outbreaks. We conclude that trans-placental transmission of APPV and subsequent infection of the fetuses is a very likely cause of congenital tremor type A-II in piglets.

  17. Biomechanical Loading as an Alternative Treatment for Tremor: A Review of Two Approaches

    Directory of Open Access Journals (Sweden)

    Eduardo Rocon

    2012-10-01

    Full Text Available Background: Tremor is the most common movement disorder and strongly increases in incidence and prevalence with aging. Although not life threatening, upper-limb tremors hamper the independence of 65% of people suffering from them affected persons, greatly impacting their quality of life. Current treatments include pharmacotherapy and surgery (thalamotomy and deep brain stimulation. However, these options are not sufficient for approximately 25% of patients. Therefore, further research and new therapeutic options are required to effectively manage pathological tremor.Methods: This paper presents findings of two research projects in which two different wearable robots for tremor management were developed based on force loading and validated. The first consisted of a robotic exoskeleton that applied forces to tremulous limbs and consistently attenuated mild and severe tremors. The second was a neuroprosthesis based on transcutaneous neurostimulation. A total of 22 patients suffering from parkinsonian or essential tremor (ET of different severities were recruited for experimental validation, and both systems were evaluated using standard tasks employed for neurological examination. The inclusion criterion was a postural and/or kinetic pathological upper-limb tremor resistant to medication.Results: The results demonstrate that both approaches effectively suppressed tremor in most patients, although further research is required. The work presented here is based on clinical evidence from a small number of patients (n = 10 for robotic exoskeleton and n = 12 for the neuroprosthesis, but most had a positive response to the approaches. In summary, biomechanical loading is non-invasive and painless. It may be effective in patients who are insufficiently responsive (or have adverse reactions to drugs or in whom surgery is contraindicated.Discussion: This paper identifies and evaluates biomechanical loading approaches to tremor management and

  18. Teleseismically-induced tremor near Parkfield, CA - a cacophony or a symphony?

    Science.gov (United States)

    Vidale, J. E.; Peng, Z.; Creager, K. C.; Bodin, P.

    2007-12-01

    The tremor triggered near Parkfield, CA by the 2002 Denali and 2004 Sumatra earthquakes was strong and well recorded by the dense regional CISN and the borehole HRSN networks. Peng et al. (this meeting) survey tremors triggered by a larger set of 12 regional and teleseismic events, providing a broader context. In the case of both the 2002 M7.9 Denali and 2004 M9.1 Sumatra earthquakes, the tremor emanates from at least two source regions deep within the SAF. The first source region is 40 km NW of the SAFOD in the creeping section of the SAF, and the second region is 40 km SE of the SAFOD near Cholame, close to the location where most of the non-triggered tremor has been found previously (Nadeau and Dolenc, Science, 2005). The Denali earthquake triggered tremor is in phase with the surface waves for about 400s. The northern region started tremoring first by about 100s, and both regions quieted before the end of the surface waves. The wavetrain for the 2004 M9.1 Sumatra earthquake was long enough that tremors were also excited by the weak diffracted P waves, and tremor turned up the volume for an hour upon the arrival of the surface waves, underwent a sudden and curious hiatus for 500s before the end of the surface waves, then re-started and continued for at least an hour after the passage of the surface waves. It is easy to suggest that the tremor was accompanied by deep slip on the SAF, but creep and strain data indicate any slip was too small to generate a detectable surface deformation. These observations suggest a component of driven, instantaneous, perhaps Coulomb-friction response with an added dose of self-sustaining, dribbling activity more suggestive of the oozing of fluids.

  19. Linear and nonlinear tremor acceleration characteristics in patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Meigal, A Yu; Rissanen, S M; Airaksinen, O; Tarvainen, M P; Georgiadis, S D; Karjalainen, P A; Kankaanpää, M

    2012-01-01

    The purpose of the study was to evaluate linear and nonlinear tremor characteristics of the hand in patients with Parkinson's disease (PD) and to compare the results with those of healthy old and young control subjects. Furthermore, the aim was to study correlation between tremor characteristics and clinical signs. A variety of nonlinear (sample entropy, cross-sample entropy, recurrence rate, determinism and correlation dimension) and linear (amplitude, spectral peak frequency and total power, and coherence) hand tremor parameters were computed from acceleration measurements for PD patients (n = 30, 68.3 ± 7.8 years), and old (n = 20, 64.2 ± 7.0 years) and young (n = 20, 18.4 ± 1.1 years) control subjects. Nonlinear tremor parameters such as determinism, sample entropy and cross-sample entropy were significantly different between the PD patients and healthy controls. These parameters correlated with the Unified Parkinson's disease rating scale (UPDRS), tremor and finger tapping scores, but not with the rigidity scores. Linear tremor parameters such as the amplitude and the maximum power (power corresponding to peak frequency) also correlated with the clinical findings. No major difference was detected in the tremor characteristics between old and young control subjects. The study revealed that tremor in PD patients is more deterministic and regular when compared to old or young healthy controls. The nonlinear tremor parameters can differentiate patients with PD from healthy control subjects and these parameters may have potential in the assessment of the severity of PD (UPDRS). (paper)

  20. Illicit stimulant use in humans is associated with a long-term increase in tremor.

    Directory of Open Access Journals (Sweden)

    Stanley C Flavel

    Full Text Available Use of illicit stimulants such as methamphetamine, cocaine, and ecstasy is a significant health problem. The United Nations Office on Drugs and Crime estimates that 14-57 million people use stimulants each year. Chronic use of illicit stimulants can cause neurotoxicity in animals and humans but the long-term functional consequences are not well understood. Stimulant users self-report problems with tremor whilst abstinent. Thus, the aim of the current study was to investigate the long-term effect of stimulant use on human tremor during rest and movement. We hypothesized that individuals with a history of stimulant use would exhibit abnormally large tremor during rest and movement. Tremor was assessed in abstinent ecstasy users (n = 9; 22 ± 3 yrs and abstinent users of amphetamine-like drugs (n = 7; 33 ± 9 yrs and in two control groups: non-drug users (n = 23; 27 ± 8 yrs and cannabis users (n = 12; 24 ± 7 yrs. Tremor was measured with an accelerometer attached to the index finger at rest (30 s and during flexion and extension of the index finger (30 s. Acceleration traces were analyzed with fast-Fourier transform. During movement, tremor amplitude was significantly greater in ecstasy users than in non-drug users (frequency range 3.9-13.3 Hz; P<0.05, but was unaffected in cannabis users or users of amphetamine-like drugs. The peak frequency of tremor did not significantly differ between groups nor did resting tremor. In conclusion, abstinent ecstasy users exhibit an abnormally large tremor during movement. Further work is required to determine if the abnormality translates to increased risk of movement disorders in this population.

  1. Interarytenoid muscle botox injection for treatment of adductor spasmodic dysphonia with vocal tremor.

    Science.gov (United States)

    Kendall, Katherine A; Leonard, Rebecca J

    2011-01-01

    Up to one-third of patients presenting with adductor spasmodic dysphonia will have an associated vocal tremor. These patients may not respond fully to treatment using thyroarytenoid (TA) muscle botulinum toxin (Botox) injection. Treatment failures are attributed to the involvement of multiple muscle groups in the tremor. This study evaluates the results of combined interarytenoid (IA) and TA muscle Botox injection in a group of 27 patients with adductor spasmodic dysphonia and vocal tremor and in four patients with severe vocal tremor alone. Patient-satisfaction data were reviewed retrospectively. Pre- and postinjection acoustic data were collected prospectively. Acoustic measures of fundamental frequency and cycle-by-cycle variability in frequency (jitter) and intensity (shimmer) were obtained from 15 patients' sustained vowel productions. Measures were collected after TA muscle injection, alone, and after combined TA and IA (TA+IA) muscle injections. In addition, two experienced voice clinicians blindly assessed tremor severity from recordings made for each patient in the two conditions. Patients were also queried regarding their satisfaction with the results of the injections and whether they desired to continue receiving TA+IA treatment. Significant improvement in all acoustic measures except for % jitter was observed after the TA+IA muscle injections. Listeners identified voice samples after TA+IA muscle injections as demonstrating less tremor in 73% of the paired comparisons. Sixty-seven percent of the patients with spasmodic dysphonia and vocal tremor wished to continue to receive IA muscle injections. Only one patient with severe vocal tremor wished to continue with injections. The addition of an IA muscle Botox injection to the treatment of patients with a combination adductor spasmodic dysphonia and vocal tremor may improve voice outcomes. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  2. What many years of tremor reveals about the Mexican Sweet Spot

    Science.gov (United States)

    Husker, A. L.; Avila, L.; Gonzalez, G.; Frank, W.; Kostoglodov, V.

    2017-12-01

    Different temporary seismic deployments have detected and located tectonic tremor in Mexico. These different temporary studies have lasted for a maximum of a few years. However, the long-term SSE's occur every 4 years. The permanent network is too sparse to locate SSEs, however one station is located in the main tremor region and has very low noise. We use spectral detection to create a catalog from its installation in March 2009 to the present. The catalog corresponds with the catalog determined during the temporary GGAP seismic network deployment, which gives us confidence that the single station detection works. Two separate large long term SSEs (2009-2010 and 2014) occur in this time span. We find a good correlation between the tremor and slip at the beginning of the SSEs. However, we find differences in both in the later stages of the SSEs. The 2009-2010 SSE appeared to be ending towards the end of 2009, however it was reactivated by the Feb. 27, 2010 M8.8 Chilean earthquake. The tremor showed a small many day burst (similar to other bursts) associated with the earthquake, but did not resume the high continuous tremor rate associated with the beginning of the SSE or seen during other large SSEs. The tremor rate at the end of the 2014 SSE stayed high for many months after the SSE and did not return to the background inter-SSE rate until the middle of 2015, about 6 months after the SSE ended. The background tremor rate is roughly 1 hour/day and remains constant over the entire period. This rate is actually comprised of many bursts that can last for up to 2 weeks with up to 80 hours of tremor during that time. The very constant long-term tremor rate made up of bursts can be explained by a simple stick-slip model.

  3. Spectrogram analysis of selected tremor signals using short-time Fourier transform and continuous wavelet transform

    Directory of Open Access Journals (Sweden)

    D. Seidl

    1999-06-01

    Full Text Available Among a variety of spectrogram methods Short-Time Fourier Transform (STFT and Continuous Wavelet Transform (CWT were selected to analyse transients in non-stationary tremor signals. Depending on the properties of the tremor signal a more suitable representation of the signal is gained by CWT. Three selected broadband tremor signals from the volcanos Mt. Stromboli, Mt. Semeru and Mt. Pinatubo were analyzed using both methods. The CWT can also be used to extend the definition of coherency into a time-varying coherency spectrogram. An example is given using array data from the volcano Mt. Stromboli.

  4. Evaluation of precipitates used in strainer head loss testing: Part III. Long-term aluminum hydroxide precipitation tests in borated water

    International Nuclear Information System (INIS)

    Bahn, Chi Bum; Kasza, Ken E.; Shack, William J.; Natesan, Ken; Klein, Paul

    2011-01-01

    Research highlights: → Aluminum hydroxide precipitation boundary is similar to that for amorphous phase. → Various precipitation tests are combined into one map in temperature-'pH + p[Al] T '. → Flocculation tendency of precipitates depend on pH and total Al concentration. → DLVO theory explains qualitatively the dependency of flocculation tendency on pH. - Abstract: Long-term aluminum (Al) hydroxide precipitation tests were conducted in slightly alkaline solutions containing 2500 ppm boron. The solution temperature was cycled to obtain a temperature history more representative of emergency core cooling system temperatures after a loss-of-coolant accident. The observed Al precipitation boundary was close to predicted results for amorphous precipitates, which are higher than the solubility expected for crystalline forms. Bench-scale and loop head loss test results under various conditions were successfully combined into single map in a temperature - 'pH + p[Al] T ' domain, which yielded two bounding lines for Al hydroxide solubility in borated alkaline water that depend on whether or not loop head loss tests with Al alloy coupons are included. Precipitates were observed to form either as fine, cloudy suspensions, which showed very little tendency to settle, or as flocculated precipitates. The flocculation tendency of the precipitates can be qualitatively explained by a colloid stability theory or a phase diagram for protein solutions.

  5. An Unwilling Partnership With the Great Society Part I: Head Start and the Beginning of Change in the White Medical Community.

    Science.gov (United States)

    deShazo, Richard D; Minor, Wilson F Bill; Smith, Robert; Skipworth, Leigh Baldwin

    2016-07-01

    By 1965, the policies and programs of Lyndon B. Johnson's Great Society brought optimism to black physicians and a new wave of resistance against black civil rights advocates in the American South. The largest of the first Head Start programs, Child Development Group of Mississippi (CDGM), had its roots in Freedom Summer 1964 and the Medical Committee for Human Rights. Like other proposed programs with strong medical components, CDGM was caught in a legislative Bermuda triangle created by the powerful Mississippi congressional delegation to maintain white supremacy and plantation economics. Physician-led investigations exposed the extraordinary level of poor health among Mississippi's black children, supported Head Start as a remedy, and awakened the white medical establishment to health disparities of the Jim Crow period. It was also the beginning of positive change in the previously silent white medical community in the South and their support of civil justice in health. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  6. Probabilistic mapping of deep brain stimulation effects in essential tremor

    Directory of Open Access Journals (Sweden)

    Till A Dembek

    2017-01-01

    Discussion: Our results support the assumption, that the ZI might be a very effective target for tremor suppression. However stimulation inside the ZI and in its close vicinity was also related to the occurrence of stimulation-induced side-effects, so it remains unclear whether the VIM or the ZI is the overall better target. The study demonstrates the use of PSMs for target selection and evaluation. While their accuracy has to be carefully discussed, they can improve the understanding of DBS effects and can be of use for other DBS targets in the therapy of neurological or psychiatric disorders as well. Furthermore they provide a priori information about expected DBS effects in a certain region and might be helpful to clinicians in programming DBS devices in the future.

  7. Eyeblink conditioning is impaired in subjects with essential tremor.

    Science.gov (United States)

    Kronenbuerger, Martin; Gerwig, Marcus; Brol, Beate; Block, Frank; Timmann, Dagmar

    2007-06-01

    Several lines of evidence point to an involvement of the olivo-cerebellar system in the pathogenesis of essential tremor (ET), with clinical signs of cerebellar dysfunction being present in some subjects in the advanced stage. Besides motor coordination, the cerebellum is critically involved in motor learning. Evidence of motor learning deficits would strengthen the hypothesis of olivo-cerebellar involvement in ET. Conditioning of the eyeblink reflex is a well-established paradigm to assess motor learning. Twenty-three ET subjects (13 males, 10 females; mean age 44.3 +/- 22.3 years, mean disease duration 17.4 +/- 17.3 years) and 23 age-matched healthy controls were studied on two consecutive days using a standard delay eyeblink conditioning protocol. Six ET subjects exhibited accompanying clinical signs of cerebellar dysfunction. Care was taken to examine subjects without medication affecting central nervous functioning. Seven ET subjects and three controls on low-dose beta-blocker treatments, which had no effect on eyeblink conditioning in animal studies, were allowed into the study. The ability to acquire conditioned eyeblink responses was significantly reduced in ET subjects compared with controls. Impairment of eyeblink conditioning was not due to low-dose beta-blocker medication. Additionally, acquisition of conditioned eyeblink response was reduced in ET subjects regardless of the presence of cerebellar signs in clinical examination. There were no differences in timing or extinction of conditioned responses between groups and conditioning deficits did not correlate with the degree of tremor or ataxia as rated by clinical scores. The findings of disordered eyeblink conditioning support the hypothesis that ET is caused by a functional disturbance of olivo-cerebellar circuits which may cause cerebellar dysfunction. In particular, results point to an involvement of the olivo-cerebellar system in early stages of ET.

  8. A 15 year catalog of more than 1 million low-frequency earthquakes: Tracking tremor and slip along the deep San Andreas Fault

    Science.gov (United States)

    Shelly, David R.

    2017-05-01

    Low-frequency earthquakes (LFEs) are small, rapidly recurring slip events that occur on the deep extensions of some major faults. Their collective activation is often observed as a semicontinuous signal known as tectonic (or nonvolcanic) tremor. This manuscript presents a catalog of more than 1 million LFEs detected along the central San Andreas Fault from 2001 to 2016. These events have been detected via a multichannel matched-filter search, cross-correlating waveform templates representing 88 different LFE families with continuous seismic data. Together, these source locations span nearly 150 km along the central San Andreas Fault, ranging in depth from 16 to 30 km. This accumulating catalog has been the source for numerous studies examining the behavior of these LFE sources and the inferred slip behavior of the deep fault. The relatively high temporal and spatial resolutions of the catalog have provided new insights into properties such as tremor migration, recurrence, and triggering by static and dynamic stress perturbations. Collectively, these characteristics are inferred to reflect a very weak fault likely under near-lithostatic fluid pressure, yet the physical processes controlling the stuttering rupture observed as tremor and LFE signals remain poorly understood. This paper aims to document the LFE catalog assembly process and associated caveats, while also updating earlier observations and inferred physical constraints. The catalog itself accompanies this manuscript as part of the electronic supplement, with the goal of providing a useful resource for continued future investigations.

  9. Investigation into Mechanism of Floor Dynamic Rupture by Evolution Characteristics of Stress and Mine Tremors: A Case Study in Guojiahe Coal Mine, China

    Directory of Open Access Journals (Sweden)

    Guangjian Liu

    2018-01-01

    Full Text Available In order to explore the mechanism of floor dynamic rupture, the current study adopts a thin plate model to further investigate the condition of floor failure. One of the possible explanations could be floor buckling due to high horizontal stress and dynamic disturbance ultimately leading to rapid and massive release of elastic energy thus inducing dynamic rupture. Seismic computed tomography and 3D location were employed to explore the evolution characteristics of floor stress distribution and positions of mine tremors. In the regions of floor dynamic rupture, higher P-wave velocity was recorded prior to the dynamic rupture. On the contrary, relatively lower reading was observed after the dynamic rupture thus depicting a high stress concentration condition. Meanwhile, evolution of mine tremors revealed the accumulation and subsequent release of energy during the dynamic rupture process. It was further revealed that dynamic rupture was induced due to the superposition of static and dynamic stresses: (i the high static stress concentration due to frontal and lateral abutment stress from coal pillar and (ii dynamic stress from the fracture and caving of coal pillar, hard roof, and key stratum. In the later part of this study, the floor dynamic rupture occurrence process would be reproduced through numerical simulations within a 0.6 sec time frame. The above-mentioned findings would be used to propose a feasible mechanism for prewarning and prevention of floor dynamic rupture using seismic computed tomography and mine tremors 3D location.

  10. Large Contrast Between the Moment Magnitude of Tremor and the Moment Magnitude of Slip in ETS Events

    Science.gov (United States)

    Kao, H.; Wang, K.; Dragert, H.; Rogers, G. C.; Kao, J. Y.

    2009-12-01

    We have developed an algorithm to estimate the moment magnitudes (Mw) of seismic tremors that are recorded during episodic tremor and slip (ETS) events beneath the northern Cascadia margin. The tremor “cloud” during an ETS episode consists of numerous individual tremor bursts. For each tremor burst, the hypocenter is first determined by the Source-Scanning Algorithm [Kao and Shan, 2004]. From the derived source location, we calculate a set of synthetic seismograms for each station based on a fixed seismic moment but different focal mechanisms. The maximum tremor amplitude observed at each station is then compared to that of the synthetics to give an estimate of the corresponding seismic moment of the tremor burst. The seismic moment averaged over all stations is used to calculate the final tremor burst Mw. We have applied this method to local earthquakes for calibration and the results are very consistent with the magnitudes listed in the catalogue. For each of the 8 northern Cascadia ETS episodes whose GPS coverage is sufficient for slip distribution inversion, the cumulative tremor Mw for the entire tremor cloud, determined from the combined moments of all individual tremor bursts in the ETS episode, is ~3 orders less than the corresponding slip Mw in the same episode (e.g., 3.7 vs. 6.7). This result suggests that aseismic slip is the predominant mode of deformation during ETS. The majority of individual tremor bursts in northern Cascadia have Mw ranging between 1.0 and 1.7 with the mean of 1.34. Only 5% of all tremors are larger than 2.0 with the largest being ~2.5.

  11. Impaired emotion processing in functional (psychogenic tremor: A functional magnetic resonance imaging study

    Directory of Open Access Journals (Sweden)

    Alberto J. Espay

    2018-01-01

    Conclusions: In response to emotional stimuli, functional tremor is associated with alterations in activation and functional connectivity in networks involved in emotion processing and theory of mind. These findings may be relevant to the pathophysiology of functional movement disorders.

  12. Precise tremor source locations and amplitude variations along the lower-crustal central San Andreas Fault

    Science.gov (United States)

    Shelly, David R.; Hardebeck, Jeanne L.

    2010-01-01

    We precisely locate 88 tremor families along the central San Andreas Fault using a 3D velocity model and numerous P and S wave arrival times estimated from seismogram stacks of up to 400 events per tremor family. Maximum tremor amplitudes vary along the fault by at least a factor of 7, with by far the strongest sources along a 25 km section of the fault southeast of Parkfield. We also identify many weaker tremor families, which have largely escaped prior detection. Together, these sources extend 150 km along the fault, beneath creeping, transitional, and locked sections of the upper crustal fault. Depths are mostly between 18 and 28 km, in the lower crust. Epicenters are concentrated within 3 km of the surface trace, implying a nearly vertical fault. A prominent gap in detectible activity is located directly beneath the region of maximum slip in the 2004 magnitude 6.0 Parkfield earthquake.

  13. Adrenergic beta 2-selective blocker in isoprenaline-enhanced essential tremor.

    Science.gov (United States)

    Teräväinen, H; Huttunen, J

    1987-01-01

    A beta 2-selective adrenergic-receptor-blocking drug, ICI 118.551, 150 mg/day, prevented almost as effectively as the nonselective antagonist propranolol, 240 mg/day, the isoprenaline enhancement of essential tremor amplitude.

  14. Evaluation of the impact of water harvesting techniques on the evolution of piezometric head of Ain El Bidha groundwater in Kairouan at the Central part of Tunisia

    Science.gov (United States)

    Mechergui, M. Mohamed; Henda Saoudi, Mme

    2016-04-01

    This study aims to assess the impact of water harvesting constructed hydraulic structures (big and small dams, terraces, seuils for recharge…) on the evolution of piezometric head of Ain El Beidha groundwater table. The measurements of depth of water table, taken at the end of rain season and at the end of irrigation season, in many piezometers and monitoring wells, for a long period of observation before and after implementation of all the hydraulic structures, were used with the cumulative rain to the highest water table to diagnostic the effect of natural recharge and constructed hydraulic structures. According to the analysis of curves illustrating the evolution of piezometric head and rainfall over time, it was shown that despite the fact that the same amount of rain fall on the total area in the limits of Ain El Beidha groundwater table, the piezometers respond differently. This is because there are many sources of recharge and many factors affecting the recharge. First of all, the aquifer is divided in four compartments (the calcareous formation of Djebel El Houyareb, the plio-quaternary formation, the Miocene formation: Baglia and Saouaf). All those respond differently to the recharge by their capacity of infiltration and their hydrodynamic characteristics. The recharge of the groundwater table was increased by the implementation of small soil and water conservation structures, artificial lakes, El Haouareb Dam, run off in the natural Oued bads and seuils for recharge installed in the bads of oueds. The different piezometric drown maps were used to determine the flow direction and hydraulic gradient in order to identify the recharge areas, while tracking maps for three equal piezometric heads 210 m 300 m and 370 m established over different years made it possible to assess the impact of hydraulic structures, namely the effect of SWC and Ben Zitoun Lake. To illustrate the impact of El Houareb dam on the groundwater, the piezometric maps and local values

  15. Detailed Tremor Migration Styles in Guerrero, Mexico Imaged with Cross-station Cross-correlations

    Science.gov (United States)

    Peng, Y.; Rubin, A. M.

    2015-12-01

    Tremor occurred downdip of the area that slipped the most during the 2006 slow slip event (SSE) in Guerrero, Mexico, as opposed to Cascadia, where tremor locations and rupture zones of SSEs largely overlap. Here we obtain high resolution tremor locations by applying cross-station cross-correlations [Armbruster et al., 2014] to seismic data from the Meso-America Subduction Experiment deployment. A few 3-station detectors are adopted to capture detailed deformation styles in the tremor "transient zone" and the downdip "sweet spot" as defined in Frank et al., 2014. Similar to Cascadia, tremor activities in our study region were comprised mostly of short tremor bursts lasting minutes to hours. Many of these bursts show clear migration patterns with propagation velocities of hundreds of km/day, comparable to those in Cascadia. However, the propagation of the main tremor front was often not in a simple unilateral fashion. Before the 2006 SSE, we observe 4 large tremor episodes during which both the transient zone and the sweet spot participated, consistent with previous findings [Frank et al., 2014]. The transient zone usually became active a few days after the sweet spot. We find many along-dip migrations with recurrence intervals of about a half day within a region about 10 km along strike and 35 km along dip in the sweet spot, suggesting possible tidal modulation, after the main front moved beyond this region. These migrations appear not to originate at the main front, in contrast to tremor migrations from a few km to tens of km across observed in Cascadia [Rubin and Armbruster, 2013; Peng et al., 2015; Peng and Rubin, submitted], but possibly similar to Shikoku, Japan [Shelly et al., 2007]. We do not observe obvious half-day periodicity for the migrations farther downdip within the sweet spot. During the SSE, the recurrence interval of tremor episodes decreased significantly in both the transient zone and the sweet spot, with that of the former being much shorter

  16. A Kinematic Model of Slow Slip Constrained by Tremor-Derived Slip Histories in Cascadia

    Science.gov (United States)

    Schmidt, D. A.; Houston, H.

    2016-12-01

    We explore new ways to constrain the kinematic slip distributions for large slow slip events using constraints from tremor. Our goal is to prescribe one or more slip pulses that propagate across the fault and scale appropriately to satisfy the observations. Recent work (Houston, 2015) inferred a crude representative stress time history at an average point using the tidal stress history, the static stress drop, and the timing of the evolution of tidal sensitivity of tremor over several days of slip. To convert a stress time history into a slip time history, we use simulations to explore the stressing history of a small locked patch due to an approaching rupture front. We assume that the locked patch releases strain through a series of tremor bursts whose activity rate is related to the stressing history. To test whether the functional form of a slip pulse is reasonable, we assume a hypothetical slip time history (Ohnaka pulse) timed with the occurrence of tremor to create a rupture front that propagates along the fault. The duration of the rupture front for a fault patch is constrained by the observed tremor catalog for the 2010 ETS event. The slip amplitude is scaled appropriately to match the observed surface displacements from GPS. Through a forward simulation, we evaluate the ability of the tremor-derived slip history to accurately predict the pattern of surface displacements observed by GPS. We find that the temporal progression of surface displacements are well modeled by a 2-4 day slip pulse, suggesting that some of the longer duration of slip typically found in time-dependent GPS inversions is biased by the temporal smoothing. However, at some locations on the fault, the tremor lingers beyond the passage of the slip pulse. A small percentage (5-10%) of the tremor appears to be activated ahead of the approaching slip pulse, and tremor asperities experience a driving stress on the order of 10 kPa/day. Tremor amplitude, rather than just tremor counts, is needed

  17. Head Start.

    Science.gov (United States)

    Greenman, Geri

    2000-01-01

    Discusses an art project in which students created drawings of mop heads. Explains that the approach of drawing was more important than the subject. States that the students used the chiaroscuro technique, used by Rembrandt and Caravaggio, in which light appears out of the darkness. (CMK)

  18. Current Assessment of Integrated Content of Long-Lived Radionuclides in Soils of the Head Part of the East Ural Radioactive Trace - Current Assessment of Integrated Stocks of Long-Lived Radionuclides in Soils of the Head Part of the East-Ural Radioactive Trace

    Energy Technology Data Exchange (ETDEWEB)

    Antonov, Konstantin L. [Institute of Industrial Ecology UB RAS, 620990 Kovalevskoy St., 20, Ekaterinburg (Russian Federation); Molchanova, Inna V.; Mikhailovskaya, Lyudmila N.; Pozolotina, Vera N.; Antonova, Elena V. [Institute of Plant and Animal Ecology UB RAS, 8 Marta St., 202, 620144 Ekaterinburg (Russian Federation)

    2014-07-01

    The East Ural Radioactive Trace is a result of the accident at the Production Association Mayak in 1957(the Kyshtym accident). The {sup 90}Sr was the main contaminant among long-lived radionuclides. Most of it was concentrated in the zone closest to the accident epicentre to the north-west (a narrow sector of about 15 deg., 35 km long). Later, in 1967, the EURT area was contaminated again with air-borne radioactive sediments from Lake Karachay, which had been used by the PA Mayak for storage of liquid radioactive waste. At this case the primary contaminant was {sup 137}Cs most of which was spread within 60 deg. sector oriented in the same direction (Aarkrog et al., 1997; Romanov et al., 1990). Our earlier radioecological studies included the assessment of integrated quantities of {sup 90}Sr, {sup 137}Cs, and {sup 239,240}Pu within the central axis of the trace (Pozolotina et al., 2008; Molchanova et al., 2009). The aim of this investigation was the current assessment of integrated stocks of {sup 90}Sr, {sup 137}Cs, and {sup 239,240}Pu in soils of the head part of the EURT along the central axis and the adjacent areas, to map the contamination data of the studied area using established geostatistical models by ArcGIS 9.3 (ESRI, USA). An inventory of the existing data (38 sampling locations) was performed earlier (Molchanova et al., 2009). Currently the database has information on 102 soil profile cuts. Taking into account the presence of global trends and anisotropy in the source data, ordinary kriging interpolation method was used. Geostatistical data analysis was performed for the determination of the basic parameters of spatial dependencies and the integral assessment of long-lived radionuclides in soils of the central, east peripheral, and west one parts of the trace. This analysis employed simplified geometric models (sector- and rectangle-shaped areas). The Monte Carlo technique was used for quantitatively assesses the uncertainty of the integrated stocks to

  19. A Cerebellar Tremor in a Patient with Human Immunodeficiency Virus-1 Associated with Progressive Multifocal Leukoencephalopathy

    Directory of Open Access Journals (Sweden)

    Hee-Jin Kim

    2009-10-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the central nervous system (CNS caused by JC virus infection in oligodendrocytes, especially in patients with acquired immunodeficiency syndrome (AIDS. Movement disorders associated with PML are very rare. Here, we report a case of PML in an AIDS patient who presented with a cerebellar tremor, caused by lesions in the cerebellar outflow tract. A cerebellar tremor can be a rare clinical manifestation in patients with PML.

  20. A Cerebellar Tremor in a Patient with Human Immunodeficiency Virus-1 Associated with Progressive Multifocal Leukoencephalopathy

    Science.gov (United States)

    Kim, Hee-Jin; Lee, Jae-Jung; Lee, Phil Hyu

    2009-01-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by JC virus infection in oligodendrocytes, especially in patients with acquired immunodeficiency syndrome (AIDS). Movement disorders associated with PML are very rare. Here, we report a case of PML in an AIDS patient who presented with a cerebellar tremor, caused by lesions in the cerebellar outflow tract. A cerebellar tremor can be a rare clinical manifestation in patients with PML. PMID:24868366

  1. Tremor irregularity, torque steadiness and rate of force development in Parkinson's disease

    DEFF Research Database (Denmark)

    Rose, Martin Høyer; Løkkegaard, Annemette; Sonne-Holm, Stig

    2013-01-01

    with idiopathic PD and 15 neurologically healthy matched controls performed isometric maximal contractions (extension/flexion) as well as steady submaximal and powerful isometric knee extensions. The patients with PD showed decreased isometric tremor irregularity. Torque steadiness was reduced in PD...... that both knee isometric tremor Approximate Entropy and torque steadiness clearly differentiate between patients with PD and healthy controls. Furthermore, severely compromised RFD was found in patients with PD and was associated with decreased agonist muscle activation....

  2. Validation of a new tool for automatic assessment of tremor frequency from video recordings

    Czech Academy of Sciences Publication Activity Database

    Uhríková, Z.; Šprdlík, Otakar; Hoskovcová, M.; Komárek, A.; Ulmanová, O.; Hlaváč, V.; Nugent, Ch. D.; Růžička, E.

    2011-01-01

    Roč. 198, č. 1 (2011), s. 110-113 ISSN 0165-0270 R&D Projects: GA MŠk(CZ) 1M0567 Institutional research plan: CEZ:AV0Z10750506 Keywords : Tremor frequency * essential tremor * video analysis * Fourier transformation * accelerometry Subject RIV: BC - Control Systems Theory Impact factor: 1.980, year: 2011 http://library.utia.cas.cz/separaty/2011/TR/sprdlik-0359324.pdf

  3. How to tackle tremor – systematic review of the literature and diagnostic work-up

    Directory of Open Access Journals (Sweden)

    Arthur W.G. Buijink

    2012-10-01

    Full Text Available BackgroundTremor is the most prevalent movement disorder in clinical practice. It is defined as involuntary, rhythmic, oscillatory movements. The diagnostic process of patients with tremor can be laborious and challenging, and a clear, systematic overview of available diagnostic techniques is lacking. Tremor can be a symptom of many diseases, but can also represent a distinct disease entity.ObjectiveThe objective of this review is to give a clear, systematic and step-wise overview of the diagnostic work-up of a patient with tremor. The clinical relevance and value of available laboratory tests in patients with tremor will be explored.MethodsWe systematically searched through EMBASE. The retrieved articles were supplemented by articles containing relevant data or provided important background information. Studies that were included investigated the value and/or usability of diagnostic tests for tremor.ResultsIn most patients, history and clinical examination by an experienced movement disorders neurologist are sufficient to establish a correct diagnosis, and further ancillary examinations will not be needed. Ancillary investigation should always be guided by tremor type(s present and other associated signs and symptoms. The main ancillary examination techniques currently are electromyography and SPECT imaging. Unfortunately, many techniques have not been studied in large prospective, diagnostic studies to be able to determine important variables like sensitivity and specificity.ConclusionWhen encountering a patient with tremor, history and careful clinical examination should guide the diagnostic process. Adherence to the diagnostic work-up provided in this review will help the diagnostic process of these patients.

  4. Tremor analysis by decomposition of acceleration into gravity and inertial acceleration using inertial measurement unit

    Czech Academy of Sciences Publication Activity Database

    Šprdlík, Otakar; Hurák, Z.; Hoskovcová, M.; Ulmanová, O.; Růžička, E.

    2011-01-01

    Roč. 6, č. 3 (2011), s. 269-289 ISSN 1746-8094 R&D Projects: GA MŠk(CZ) 1M0567 Institutional research plan: CEZ:AV0Z10750506 Keywords : Tremor * Accelerometer * Inertial measurementunit * Gravitational artifact * Regression * Tremor ratingscale Subject RIV: BC - Control Systems Theory Impact factor: 1.000, year: 2011 http://library.utia.cas.cz/separaty/2011/TR/sprdlik-0350248.pdf

  5. Vertical components of surface vibrations induced by mining tremors in the Upper Silesian Coalfield, Poland

    International Nuclear Information System (INIS)

    Maciag, E.; Kowalski, W.

    1997-01-01

    Characteristics of vertical components of surface vibration is epicentral zones due to mining tremors in the Upper Silesian Coalfield (USC) are analysed. Both maximum acceleration amplitudes and dominant frequencies of vertical (Z) and horizontal (N-S and E-W) components of vibrations are compared. The role played by the vertical components of vibrations in estimates of hazard for surface structures excited by mining tremors is discussed. 8 refs., 7 figs

  6. Ambient seismic noise interferometry in Hawai'i reveals long-range observability of volcanic tremor

    Science.gov (United States)

    Ballmer, Silke; Wolfe, Cecily; Okubo, Paul G.; Haney, Matt; Thurber, Clifford H.

    2013-01-01

    The use of seismic noise interferometry to retrieve Green's functions and the analysis of volcanic tremor are both useful in studying volcano dynamics. Whereas seismic noise interferometry allows long-range extraction of interpretable signals from a relatively weak noise wavefield, the characterization of volcanic tremor often requires a dense seismic array close to the source. We here show that standard processing of seismic noise interferometry yields volcanic tremor signals observable over large distances exceeding 50 km. Our study comprises 2.5 yr of data from the U.S. Geological Survey Hawaiian Volcano Observatory short period seismic network. Examining more than 700 station pairs, we find anomalous and temporally coherent signals that obscure the Green's functions. The time windows and frequency bands of these anomalous signals correspond well with the characteristics of previously studied volcanic tremor sources at Pu'u 'Ō'ō and Halema'uma'u craters. We use the derived noise cross-correlation functions to perform a grid-search for source location, confirming that these signals are surface waves originating from the known tremor sources. A grid-search with only distant stations verifies that useful tremor signals can indeed be recovered far from the source. Our results suggest that the specific data processing in seismic noise interferometry—typically used for Green's function retrieval—can aid in the study of both the wavefield and source location of volcanic tremor over large distances. In view of using the derived Green's functions to image heterogeneity and study temporal velocity changes at volcanic regions, however, our results illustrate how care should be taken when contamination by tremor may be present.

  7. Development of a system for measurement and analysis of tremor using a three-axis accelerometer.

    Science.gov (United States)

    Mamorita, N; Iizuka, T; Takeuchi, A; Shirataka, M; Ikeda, N

    2009-01-01

    The aim of the study was to develop a low-cost and compact system for analysis of tremor using a three-axis accelerometer (the Wii Remote (Nintendo)). To analyze tremor, we hypothesized that the influence of gravitational acceleration should be separated from that of movement. This hypothesis was tested experimentally and we also attempted to record and analyze tremor using our system in a clinical ward. A system for tremor measurement and analysis was developed using the three-axis accelerometer built into the Wii Remote. The frequency and amplitude of mechanical oscillation were calculated using methods for frequency analysis of the axis of largest variance and an estimation of tremor amplitude. The system consists of a program for measurement and analysis of Wii Remote acceleration (Tremor Analyzer), a Wii Remote, a Bluetooth USB adapter and a Web camera. The Tremor Analyzer has a GUI (graphical user interface) that is divided into five seg- ments. The sampling period of the analyzer is 30 msec. To confirm the hypothesis, mechanical oscillations were fed to the Wii Remote. The peak frequency of the power spectrum and the frequency of the oscillation generator were in good agreement, except at 1 Hz (0.01 G) and 2 Hz (0.02 G). With a change in the sum of squares of the three axes from 1.0 to 1.8 (G), the estimated and generated amplitude (0.3 cm) were in close agreement. This system using a Wii Remote is capable of analyzing frequency and estimated amplitude of tremor between 3 Hz and 15 Hz.

  8. Deep Brain Stimulation Salvages a Flourishing Dental Practice: A Dentist with Essential Tremor Recounts his Experience

    OpenAIRE

    Giacopuzzi, Guy; Lising, Melanie; Halpern, Casey H

    2016-01-01

    In recounting his experience with deep brain stimulation (DBS), a practicing dentist challenged with long-standing bilateral essential tremor of the hands?shares insights into his diagnosis, treatments, and ultimately successful DBS surgery at Stanford University Medical Center, CA, USA. Now nearly one year after his surgery, his practice continues to flourish and he encourages others in his profession to consider the possibility of DBS as a definitive?treatment for tremors of the hand, which...

  9. Validation of a telephone screening tool for spasmodic dysphonia and vocal fold tremor.

    Science.gov (United States)

    Johnson, David M; Hapner, Edie R; Klein, Adam M; Pethan, Madeleine; Johns, Michael M

    2014-11-01

    The objective of this study was to ascertain whether clinicians can reliably distinguish between spasmodic dysphonia (SD)/vocal tremor and other voice disorders by telephone, despite this modality's limited frequency response. Randomized, single-blinded, and prospective study. Voice-disordered patients with (n = 22) and without (n = 17) SD and/or vocal tremor recorded standardized utterances via landline telephone. A laryngologist and two speech-language pathologists blinded to the diagnoses rated each recording as "yes" or "no" to "SD or tremor present?," and if "yes" categorized into adductor, abductor, tremor only, or adductor with tremor subtypes. Twenty-one recordings were presented twice at random so intrarater reliability could be assessed. All ratings were compared with gold standard diagnosis by a second laryngologist who performed a full examination, including videostroboscopy, on each patient. For the comparison "SD or tremor" yes versus no, sensitivity, specificity, positive predictive value, and negative predictive value are 90%, 95%, 96%, and 89%, respectively. Interrater reliability (Cohen kappa) compared with the gold standard ranged from 0.70 to 0.93 (substantial to almost perfect agreement). Cronbach alpha among three raters was 0.90 for this comparison. Intrarater reliability (number matched/number inspected) was very high, ranging from 0.97 to 1.0. Comparing gold standard and telephone rating of SD/tremor subtypes, kappa ranged from 0.48 to 0.60 (moderate agreement). Cronbach alpha among three raters was 0.88 for this comparison. Intrarater reliability ranged from 0.84 to 0.97. SD and tremor can be reliably distinguished from other voice disorders over the telephone. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  10. Long-Term Efficacy of Constant Current Deep Brain Stimulation in Essential Tremor.

    Science.gov (United States)

    Rezaei Haddad, Ali; Samuel, Michael; Hulse, Natasha; Lin, Hsin-Ying; Ashkan, Keyoumars

    2017-07-01

    Ventralis intermedius deep brain stimulation is an established intervention for medication-refractory essential tremor. Newer constant current stimulation technology offers theoretical advantage over the traditional constant voltage systems in terms of delivering a more biologically stable therapy. There are no previous reports on the outcomes of constant current deep brain stimulation in the treatment of essential tremor. This study aimed to evaluate the long-term efficacy of ventralis intermedius constant current deep brain stimulation in patients diagnosed with essential tremor. Essential tremor patients implanted with constant current deep brain stimulation for a minimum of three years were evaluated. Clinical outcomes were assessed using the Fahn-Tolosa-Marin tremor rating scale at baseline and postoperatively at the time of evaluation. The quality of life in the patients was assessed using the Quality of Life in Essential Tremor questionnaire. Ten patients were evaluated with a median age at evaluation of 74 years (range 66-79) and a mean follow up time of 49.7 (range 36-78) months since starting stimulation. Constant current ventralis intermedius deep brain stimulation was well tolerated and effective in all patients with a mean score improvement from 50.7 ± 5.9 to 17.4 ± 5.7 (p = 0.0020) in the total Fahn-Tolosa-Marin rating scale score (65.6%). Furthermore, the total combined mean Quality of Life in Essential Tremor score was improved from 56.2 ± 4.9 to 16.8 ± 3.5 (p value = 0.0059) (70.1%). This report shows that long-term constant current ventralis intermedius deep brain stimulation is a safe and effective intervention for essential tremor patients. © 2017 International Neuromodulation Society.

  11. Changes of Physiological Tremor Following Maximum Intensity Exercise in Male and Female Young Swimmers

    Directory of Open Access Journals (Sweden)

    Gajewski Jan

    2015-12-01

    Full Text Available Purpose. The aim of this study was to determine the changes in postural physiological tremor following maximum intensity effort performed on arm ergometer by young male and female swimmers. Methods. Ten female and nine male young swimmers served as subjects in the study. Forearm tremor was measured accelerometrically in the sitting position before the 30-second Wingate Anaerobic Test on arm ergometer and then 5, 15 and 30 minutes post-test. Results. Low-frequency tremor log-amplitude (L1−5 increased (repeated factor: p < 0.05 from −7.92 ± 0.45 to −7.44 ± 0.45 and from −6.81 ± 0.52 to −6.35 ± 0.58 in women and men, respectively (gender: p < 0.05 5 minute post-test. Tremor log-amplitude (L15−20 increased (repeated factor: p < 0.001 from −9.26 ± 0.70 to −8.59 ± 0.61 and from −8.79 ± 0.65 to −8.39 ± 0.79 in women and men, respectively 5 minute post-test. No effect of gender was found for high frequency range.The increased tremor amplitude was observed even 30 minute post-exercise. Mean frequency of tremor spectra gradually decreased post-exercises (p < 0.001. Conclusions. Exercise-induced changes in tremor were similar in males and females. A fatigue produced a decrement in the mean frequency of tremor what suggested decreased muscle stiffness post-exercise. Such changes intremorafter exercise may be used as the indicator of fatigue in the nervous system.

  12. Autosomal dominant cortical tremor, myoclonus, and epilepsy (ADCME: Probable first family from India

    Directory of Open Access Journals (Sweden)

    Chandra Mohan Sharma

    2014-01-01

    Full Text Available Autosomal dominant cortical tremor, myoclonus, and epilepsy (ADCME is an extremely rare syndrome characterized by familial occurrence of postural and action-induced tremors of the hands but showing electrophysiologic findings of cortical reflex myoclonus. Patients also have cognitive decline and tonic-clonic seizures, often precipitated by sleep deprivation or photic stimulation. We describe probably the first family from India of this ill-defined syndrome.

  13. Quantification of a Secondary Task-Specific Tremor in a Violinist after a Temporal Lobectomy

    Directory of Open Access Journals (Sweden)

    André eLee

    2014-07-01

    Full Text Available Task-specific tremors occur mainly during certain tasks and may be highly disabling. In this case study, we report on a 66-year-old violinist who developed a task-specific tremor of the right arm only while playing the violin four weeks after a temporal lobectomy, which had been performed as a result of his temporal lobe epilepsy. Since a similar case, to our knowledge, has not been reported so far, our aim was to quantitatively assess and describe the tremor by measuring (a the electromyography (EMG activity of the wrist flexor and extensor as well as (b an accelerometer signal of the hand. We found a tremor-related frequency of about 7 Hz. Furthermore, at a similar frequency of about 7 Hz, there was coherence between the tremor acceleration and EMG-activity of the wrist flexor and extensor as well as between the tremor acceleration and coactivation. The tremorgenesis remains unclear, and possible explanations can only be speculative.

  14. Three-dimensional modeling of physiological tremor for hand-held surgical robotic instruments.

    Science.gov (United States)

    Tatinati, Sivanagaraja; Yan Naing Aye; Pual, Anand; Wei Tech Ang; Veluvolu, Kalyana C

    2016-08-01

    Hand-held robotic instruments are developed to compensate physiological tremor in real-time while augmenting the required precision and dexterity into normal microsurgical work-flow. The hardware (sensors and actuators) and software (causal linear filters) employed for tremor identification and filtering introduces time-varying unknown phase-delay that adversely affects the device performance. The current techniques that focus on three-dimensions (3D) tip position control involves modeling and canceling the tremor in 3-axes (x, y, and z axes) separately. Our analysis with the tremor data recorded from surgeons and novice subjects show that there exists significant correlation in tremor motion across the dimensions. Motivated by this, a new multi-dimensional modeling approach based on extreme learning machines (ELM) is proposed in this paper to correct the phase delay and to accurately model tremulous motion in three dimensions simultaneously. A study is conducted with tremor data recorded from the microsurgeons to analyze the suitability of proposed approach.

  15. Methodology for estimating human perception to tremors in high-rise buildings

    Science.gov (United States)

    Du, Wenqi; Goh, Key Seng; Pan, Tso-Chien

    2017-07-01

    Human perception to tremors during earthquakes in high-rise buildings is usually associated with psychological discomfort such as fear and anxiety. This paper presents a methodology for estimating the level of perception to tremors for occupants living in high-rise buildings subjected to ground motion excitations. Unlike other approaches based on empirical or historical data, the proposed methodology performs a regression analysis using the analytical results of two generic models of 15 and 30 stories. The recorded ground motions in Singapore are collected and modified for structural response analyses. Simple predictive models are then developed to estimate the perception level to tremors based on a proposed ground motion intensity parameter—the average response spectrum intensity in the period range between 0.1 and 2.0 s. These models can be used to predict the percentage of occupants in high-rise buildings who may perceive the tremors at a given ground motion intensity. Furthermore, the models are validated with two recent tremor events reportedly felt in Singapore. It is found that the estimated results match reasonably well with the reports in the local newspapers and from the authorities. The proposed methodology is applicable to urban regions where people living in high-rise buildings might feel tremors during earthquakes.

  16. Successful Treatment of Rubral Tremor by High-Dose Trihexyphenidyl: A Case Report

    Directory of Open Access Journals (Sweden)

    Li-Min Liou

    2006-03-01

    Full Text Available A 24-year-old male suffered from acute-onset right-sided hemiparesis, dysarthria, and ophthalmoplegia in February 2001. Brain magnetic resonance imaging revealed a cavernous angioma with hemorrhage over the left thalamus. Moreover, some rhythmic, coarse, low-frequency (2-3 Hz oscillation over the right wrist and elbow was noted 1 month later. Action tremor was more predominant than resting tremor. Rubral tremor was diagnosed on the basis of the clinical presentation and tremography analysis. Rubral tremor is not unusual, and pharmacotherapy is nearly always ineffective in clinical practice. Deep brain stimulation, thalamotomy, and pallidotomy are all considered effective according to recent research. However, they are either very expensive or invasive, and involve surgical risks. In our patient, we tried valproate, clonazepam, and verapamil one after another, but all in vain. Finally, titration of trihexyphenidyl provided significant benefit. The tremor was successfully controlled by a single high daily dose of trihexyphenidyl (38 mg without severe or uncomfortable side effects. Here, we report a case of successful monotherapy of rubral tremor with high-dose trihexyphenidyl.

  17. Simulations of tremor-related creep reveal a weak crustal root of the San Andreas Fault

    Science.gov (United States)

    Shelly, David R.; Bradley, Andrew M.; Johnson, Kaj M.

    2013-01-01

    Deep aseismic roots of faults play a critical role in transferring tectonic loads to shallower, brittle crustal faults that rupture in large earthquakes. Yet, until the recent discovery of deep tremor and creep, direct inference of the physical properties of lower-crustal fault roots has remained elusive. Observations of tremor near Parkfield, CA provide the first evidence for present-day localized slip on the deep extension of the San Andreas Fault and triggered transient creep events. We develop numerical simulations of fault slip to show that the spatiotemporal evolution of triggered tremor near Parkfield is consistent with triggered fault creep governed by laboratory-derived friction laws between depths of 20–35 km on the fault. Simulated creep and observed tremor northwest of Parkfield nearly ceased for 20–30 days in response to small coseismic stress changes of order 104 Pa from the 2003 M6.5 San Simeon Earthquake. Simulated afterslip and observed tremor following the 2004 M6.0 Parkfield earthquake show a coseismically induced pulse of rapid creep and tremor lasting for 1 day followed by a longer 30 day period of sustained accelerated rates due to propagation of shallow afterslip into the lower crust. These creep responses require very low effective normal stress of ~1 MPa on the deep San Andreas Fault and near-neutral-stability frictional properties expected for gabbroic lower-crustal rock.

  18. Episodic tremor and slip explained by fluid-enhanced microfracturing and sealing

    Science.gov (United States)

    Bernaudin, M.; Gueydan, F.

    2017-12-01

    A combination of non-volcanic tremor and transient slow slip events behaviors is commonly observed at plate interface, between locked/seismogenic zone at low depths and stable/ductile creep zone at larger depths. This association defines Episodic Tremor and Slip, systematically highlighted by over-pressurized fluids and near failure shear stress conditions. Here we propose a new mechanical approach that provides for the first time a mechanical and field-based explanation of the observed association between non-volcanic tremor and slow slip events. In contrast with more classical rate-and-state models, this physical model uses a ductile rheology with grain size sensitivity, fluid-driven microfracturing and sealing (e.g. grain size reduction and grain growth) and related pore fluid pressure fluctuations. We reproduce slow slip events by transient ductile strain localization as a result of fluid-enhanced microfracturing and sealing. Moreover, occurrence of macrofracturing during transient strain localization and local increase in pore fluid pressure well simulate non-volcanic tremor. Our model provides therefore a field-based explanation of episodic tremor and slip and moreover predicts the depth and temperature ranges of their occurrence in subduction zones. It implies furthermore that non-volcanic tremor and slow slip events are physically related.

  19. Gabapentin can improve postural stability and quality of life in primary orthostatic tremor.

    Science.gov (United States)

    Rodrigues, Julian P; Edwards, Dylan J; Walters, Susan E; Byrnes, Michelle L; Thickbroom, Gary; Stell, Rick; Mastaglia, Frank L

    2005-07-01

    Primary orthostatic tremor (OT) is characterized by leg tremor and instability on standing. High frequency (13-18 Hz) tremor bursting is present in leg muscles during stance, and posturography has shown greater than normal sway. We report on an open-label add-on study of gabapentin in 6 patients with OT. Six patients were studied with surface electromyography, force platform posturography, and a modified Parkinson's disease questionnaire (PDQ-39) quality of life (QOL) scale before and during treatment with gabapentin 300 mg t.d.s. If on other medications for OT, these were continued unchanged. Of the 6 patients, 4 reported a subjective benefit of 50 to 75% with gabapentin, 3 of whom showed reduced tremor amplitude and postural sway of up to 70%. Dynamic balance improved in all 3 patients who completed the protocol. QOL data from 5 patients showed improvement in all cases. No adverse effects were noted. Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway. The findings confirm previous reports of symptomatic benefit with gabapentin and provide justification for larger controlled clinical trials. Further work is required to establish the optimal dosage and to validate the methods used to quantify the response to treatment. Copyright 2005 Movement Disorder Society.

  20. Frictional-faulting model for harmonic tremor before Redoubt Volcano eruptions

    Science.gov (United States)

    Dmitrieva, Ksenia; Hotovec-Ellis, Alicia J.; Prejean, Stephanie G.; Dunham, Eric M.

    2013-01-01

    Seismic unrest, indicative of subsurface magma transport and pressure changes within fluid-filled cracks and conduits, often precedes volcanic eruptions. An intriguing form of volcano seismicity is harmonic tremor, that is, sustained vibrations in the range of 0.5–5 Hz. Many source processes can generate harmonic tremor. Harmonic tremor in the 2009 eruption of Redoubt Volcano, Alaska, has been linked to repeating earthquakes of magnitudes around 0.5–1.5 that occur a few kilometres beneath the vent. Before many explosions in that eruption, these small earthquakes occurred in such rapid succession—up to 30 events per second—that distinct seismic wave arrivals blurred into continuous, high-frequency tremor. Tremor abruptly ceased about 30 s before the explosions. Here we introduce a frictional-faulting model to evaluate the credibility and implications of this tremor mechanism. We find that the fault stressing rates rise to values ten orders of magnitude higher than in typical tectonic settings. At that point, inertial effects stabilize fault sliding and the earthquakes cease. Our model of the Redoubt Volcano observations implies that the onset of volcanic explosions is preceded by active deformation and extreme stressing within a localized region of the volcano conduit, at a depth of several kilometres.

  1. Long-term detection of Parkinsonian tremor activity from subthalamic nucleus local field potentials.

    Science.gov (United States)

    Houston, Brady; Blumenfeld, Zack; Quinn, Emma; Bronte-Stewart, Helen; Chizeck, Howard

    2015-01-01

    Current deep brain stimulation paradigms deliver continuous stimulation to deep brain structures to ameliorate the symptoms of Parkinson's disease. This continuous stimulation has undesirable side effects and decreases the lifespan of the unit's battery, necessitating earlier replacement. A closed-loop deep brain stimulator that uses brain signals to determine when to deliver stimulation based on the occurrence of symptoms could potentially address these drawbacks of current technology. Attempts to detect Parkinsonian tremor using brain signals recorded during the implantation procedure have been successful. However, the ability of these methods to accurately detect tremor over extended periods of time is unknown. Here we use local field potentials recorded during a deep brain stimulation clinical follow-up visit 1 month after initial programming to build a tremor detection algorithm and use this algorithm to detect tremor in subsequent visits up to 8 months later. Using this method, we detected the occurrence of tremor with accuracies between 68-93%. These results demonstrate the potential of tremor detection methods for efficacious closed-loop deep brain stimulation over extended periods of time.

  2. Effect of mental fatigue on induced tremor in human knee extensors.

    Science.gov (United States)

    Budini, Francesco; Lowery, Madeleine; Durbaba, Rade; De Vito, Giuseppe

    2014-06-01

    In this study, the effects of mental fatigue on mechanically induced tremor at both a low (3-6Hz) and high (8-12Hz) frequency were investigated. The two distinct tremor frequencies were evoked using two springs of different stiffness, during 20s sustained contractions of the knee extensor muscles at 30% maximum voluntary contraction (MVC) before and after 100min of a mental fatigue task, in 12 healthy (29±3.7years) participants. Mental fatigue resulted in a 6.9% decrease in MVC and in a 9.4% decrease in the amplitude of the agonist muscle EMG during sustained 30% MVC contractions in the induced high frequency only. Following the mental fatigue task, the coefficient of variation and standard deviation of the force signal decreased at 8-12Hz induced tremor by 31.7% and 35.2% respectively, but not at 3-6Hz induced tremor. Similarly, the maximum value and area underneath the peak in the power spectrum of the force signal decreased by 55.5% and 53.1% respectively in the 8-12Hz range only. In conclusion, mental fatigue decreased mechanically induced 8-12Hz tremor and had no effect on induced 3-6Hz tremor. We suggest that the reduction could be attributed to the decreased activation of the agonist muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Forecast for Artificial Muscle Tremor Behavior Based on Dynamic Additional Grey Catastrophe Prediction

    Directory of Open Access Journals (Sweden)

    Yu Fu

    2018-02-01

    Full Text Available Recently, bio-inspired artificial muscles based on ionic polymers have shown a bright perspective in engineering and medical research, but the inherent tremor behavior can cause instability of output response. In this paper, dynamic additional grey catastrophe prediction (DAGCP is proposed to forecast the occurrence time of tremor behavior, providing adequate preparation time for the suppression of the chitosan-based artificial muscles. DAGCP constructs various dimensions of time subsequence models under different starting points based on the threshold of tremor occurrence times and peak-to-peak values in unit time. Next, the appropriate subsequence is selected according to grey correlation degree and prediction accuracy, then it is updated with the newly generated values to achieve a real-time forecast of forthcoming tremor time. Compared with conventional grey catastrophe prediction (GCP, the proposed method has the following advantages: (1 the degradation of prediction accuracy caused by the immobilization of original parameters is prevented; (2 the dynamic input, real-time update and gradual forecast of time sequence are incorporated into the model. The experiment results show that the novel DAGCP can predict forthcoming tremor time earlier and more accurately than the conventional GCP. The generation mechanism of tremor behavior is illustrated as well.

  4. A zero phase adaptive fuzzy Kalman filter for physiological tremor suppression in robotically assisted minimally invasive surgery.

    Science.gov (United States)

    Sang, Hongqiang; Yang, Chenghao; Liu, Fen; Yun, Jintian; Jin, Guoguang; Chen, Fa

    2016-12-01

    Hand physiological tremor of surgeons can cause vibration at the surgical instrument tip, which may make it difficult for the surgeon to perform fine manipulations of tissue, needles, and sutures. A zero phase adaptive fuzzy Kalman filter (ZPAFKF) is proposed to suppress hand tremor and vibration of a robotic surgical system. The involuntary motion can be reduced by adding a compensating signal that has the same magnitude and frequency but opposite phase with the tremor signal. Simulations and experiments using different filters were performed. Results show that the proposed filter can avoid the loss of useful motion information and time delay, and better suppress minor and varying tremor. The ZPAFKF can provide less error, preferred accuracy, better tremor estimation, and more desirable compensation performance, to suppress hand tremor and decrease vibration at the surgical instrument tip. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  5. Diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT: A clinical follow up study

    Directory of Open Access Journals (Sweden)

    Manuel eMenéndez-González

    2014-04-01

    Full Text Available The [123I]ioflupane - a dopamine transporter radioligand - SPECT (DaT-SPECT has proven to be useful in the differential diagnosis of tremor. Here, we investigate the diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT. Therefore, 30 patients with tremor and normal DaT-SPECT were followed up for 2 years. In 18 cases we were able to make a diagnosis. The residual 12 patients underwent a second DaT-SPECT, were then followed for additional 12 months and thereafter the diagnosis was reconsidered again. The final diagnoses included cases of essential tremor, dystonic tremor, multisystem atrophy, vascular parkinsonism, progressive supranuclear palsy, corticobasal degeneration, fragile X–associated tremor ataxia syndrome, psychogenic parkinsonism, iatrogenic parkinsonism and Parkinson’s disease. However, for 6 patients the diagnosis remained uncertain. Larger series are needed to better establish the relative frequency of the different conditions behind these cases.

  6. Diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT: a clinical follow up study.

    Science.gov (United States)

    Menéndez-González, Manuel; Tavares, Francisco; Zeidan, Nahla; Salas-Pacheco, José M; Arias-Carrión, Oscar

    2014-01-01

    The [(123)I]ioflupane-a dopamine transporter radioligand-SPECT (DaT-SPECT) has proven to be useful in the differential diagnosis of tremor. Here, we investigate the diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT. Therefore, 30 patients with tremor and normal DaT-SPECT were followed up for 2 years. In 18 cases we were able to make a diagnosis. The residual 12 patients underwent a second DaT-SPECT, were then followed for additional 12 months and thereafter the diagnosis was reconsidered again. The final diagnoses included cases of essential tremor, dystonic tremor, multisystem atrophy, vascular parkinsonism, progressive supranuclear palsy, corticobasal degeneration, fragile X-associated tremor ataxia syndrome, psychogenic parkinsonism, iatrogenic parkinsonism and Parkinson's disease. However, for 6 patients the diagnosis remained uncertain. Larger series are needed to better establish the relative frequency of the different conditions behind these cases.

  7. A study of the exposure of subjects to RF radiation during MRI examinations. Measurement of the SAR of head parts and the evaluation of the measured values

    International Nuclear Information System (INIS)

    Yamada, Masayuki; Koga, Sukehiko; Sugie, Masami; Kinoshita, Kazuo; Anno, Hirofumi; Katada, Kazuhiro.

    1996-01-01

    Recently, as the fast spin echo technique has become prevailing among all the techniques in this line, there has been an increasing interest in the exposure of subjects to radiofrequency (RF) radiation during magnetic resonance imaging (MRI) examinations. On the other hand, there have been no reports about the safety of the MRI examination in Japan. For this reason, in this study, the authors aimed to evaluate the extent of the exposure of subjects to RF radiation during MRI examinations, and measured the specific absorption rate (SAR) of spherical phantoms, which assumed to be adult heads, by using the procedures set forth in two safety guidelines respectively: the 1988 Guideline of the Food and Drug Administration (FDA), and the 1995 Standards of the International Electrotechnical Commission (IEC). As a result of the measurement, it was found that the highest value of the SAR was 1.361 W/kg, which stayed far below the upper limits set forth by the respective safety guidelines referred to in the above. However, the measured values of the SAR varied depending on the respective measuring procedures. As both the measuring procedures are equivalent theoretically, the authors consider the variance to be very important. (author)

  8. Muscle-Cooling Intervention to Reduce Fatigue and Fatigue-Induced Tremor in Novice and Experienced Surgeons: A Preliminary Investigation

    OpenAIRE

    Jensen, Lauren; Dancisak, Michael; Korndorffer, James

    2016-01-01

    A localized, intermittent muscle-cooling protocol was implemented to determine cooling garment efficacy in reducing upper extremity muscular fatigue and tremor in novice ( n  = 10) and experienced surgeons ( n  = 9). Subjects wore a muscle-cooling garment while performing multiple trials of a forearm exercise and paired suturing task to induce muscular fatigue and exercise-induced tremor. A reduction in tremor amplitude and an extension in time to fatigue were expected with muscle...

  9. Contribution of inter-muscular synchronization in the modulation of tremor intensity in Parkinson?s disease

    OpenAIRE

    He, Xin; Hao, Man-Zhao; Wei, Ming; Xiao, Qin; Lan, Ning

    2015-01-01

    Background Involuntary central oscillations at single and double tremor frequencies drive the peripheral neuromechanical system of muscles and joints to cause tremor in Parkinson?s disease (PD). The central signal of double tremor frequency was found to correlate more directly to individual muscle EMGs (Timmermann et al. 2003). This study is aimed at investigating what central components of oscillation contribute to inter-muscular synchronization in a group of upper extremity muscles during t...

  10. Electrocorticography reveals beta desynchronization in the basal ganglia-cortical loop during rest tremor in Parkinson's disease.

    Science.gov (United States)

    Qasim, Salman E; de Hemptinne, Coralie; Swann, Nicole C; Miocinovic, Svjetlana; Ostrem, Jill L; Starr, Philip A

    2016-02-01

    The pathophysiology of rest tremor in Parkinson's disease (PD) is not well understood, and its severity does not correlate with the severity of other cardinal signs of PD. We hypothesized that tremor-related oscillatory activity in the basal-ganglia-thalamocortical loop might serve as a compensatory mechanism for the excessive beta band synchronization associated with the parkinsonian state. We recorded electrocorticography (ECoG) from the sensorimotor cortex and local field potentials (LFP) from the subthalamic nucleus (STN) in patients undergoing lead implantation for deep brain stimulation (DBS). We analyzed differences in measures of network synchronization during epochs of spontaneous rest tremor, versus epochs without rest tremor, occurring in the same subjects. The presence of tremor was associated with reduced beta power in the cortex and STN. Cortico-cortical coherence and phase-amplitude coupling (PAC) decreased during rest tremor, as did basal ganglia-cortical coherence in the same frequency band. Cortical broadband gamma power was not increased by tremor onset, in contrast to the movement-related gamma increase typically observed at the onset of voluntary movement. These findings suggest that the cortical representation of rest tremor is distinct from that of voluntary movement, and support a model in which tremor acts to decrease beta band synchronization within the basal ganglia-cortical loop. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Non-contact measurement of tremor for the characterisation of Parkinsonian individuals: comparison between Kinect and Laser Doppler vibrometer

    Science.gov (United States)

    Casacanditella, L.; Cosoli, G.; Ceravolo, MG; Tomasini, EP

    2017-08-01

    Parkinson’s disease is a progressive neurodegenerative disorder affecting the central nervous system. One of its main and most evident symptoms is the tremor, which usually manifests at rest with varying intensity during time. An important diagnostic challenge is the differential diagnosis between Parkinson’s disease and the other most widely represented tremor syndrome, i.e. Essential (or senile) tremor. At present there are no standard methods for the quantification of tremor and the diagnosis of both Parkinson’s disease and Essential tremor is mainly done on the base of clinical criteria and by using rating scales. The aim of this work is to objectively and non-invasively assess the tremor linked to the quoted diseases, using non-contact techniques: Laser Doppler Vibrometer (LDV) and Kinect for Windows device. Two subjects with Parkinson’s disease and one with Essential tremor were tested in different conditions: at rest, during a cognitive task, with forward stretched arms and in “Wing position”. The results from data processing in terms of tremor frequency seem to be comparable, with a mean deviation of 0.31 Hz. Furthermore, the values computed are consistent with what is stated in the literature (i.e. 4-12 Hz). So, both LDV and Kinect device can be considered suitable to be used as an objective means for the assessment and monitoring of Parkinson’s disease tremor, helping the clinician in the choice of the most suitable treatment for the patients.

  12. Effect of nipradilol, a beta-adrenergic blocker with vasodilating activity, on oxotremorine-induced tremor in mice.

    Science.gov (United States)

    Iwata, S; Nomoto, M; Fukuda, T

    1996-10-01

    The effect of nipradilol, a nonselective beta-adrenergic receptor blocker with nitroglycerin-like vasodilating activity, on oxotremorine-induced tremor was studied in mice. General tremor in mice was elicited by 0.5 mg/kg oxotremorine. The tremor was quantified using a capacitance transducer, then analyzed by a signal processor. The strength of the tremor was expressed in "points". The point values of the tremor (mean +/- SE) in control mice for 5 mg/kg (+/-)-propranolol, 2.5 mg/kg arotinolol, 0.5 mg/kg nipradilol, 1.0 mg/kg nipradilol and 2.5 mg/kg nipradilol were 87 +/- 16, 42 +/- 6, 38 +/- 6, 99 +/- 28, 28 +/- 6 and 31 +/- 7, respectively. The strength of the tremor was reduced by all beta-blockers. Although 1.0 mg/kg nipradilol significantly reduced the tremor, further inhibition of the tremor was not obtained with dosages up to 2.5 mg/kg of the drug. In conclusion, nipradilol was effective for suppressing oxotremorine-induced tremor, as were other beta-blockers.

  13. Differential diagnosis between Parkinson's disease and essential tremor using the smartphone's accelerometer.

    Directory of Open Access Journals (Sweden)

    Sergi Barrantes

    Full Text Available The differential diagnosis between patients with essential tremor (ET and those with Parkinson's disease (PD whose main manifestation is tremor may be difficult unless using complex neuroimaging techniques such as 123I-FP-CIT SPECT. We considered that using smartphone's accelerometer to stablish a diagnostic test based on time-frequency differences between PD an ET could support the clinical diagnosis.The study was carried out in 17 patients with PD, 16 patients with ET, 12 healthy volunteers and 7 patients with tremor of undecided diagnosis (TUD, who were re-evaluated one year after the first visit to reach the definite diagnosis. The smartphone was placed over the hand dorsum to record epochs of 30 s at rest and 30 s during arm stretching. We generated frequency power spectra and calculated receiver operating characteristics curves (ROC curves of total spectral power, to establish a threshold to separate subjects with and without tremor. In patients with PD and ET, we found that the ROC curve of relative energy was the feature discriminating better between the two groups. This threshold was then used to classify the TUD patients.We could correctly classify 49 out of 52 subjects in the category with/without tremor (97.96% sensitivity and 83.3% specificity and 27 out of 32 patients in the category PD/ET (84.38% discrimination accuracy. Among TUD patients, 2 of 2 PD and 2 of 4 ET were correctly classified, and one patient having PD plus ET was classified as PD.Based on the analysis of smartphone accelerometer recordings, we found several kinematic features in the analysis of tremor that distinguished first between healthy subjects and patients and, ultimately, between PD and ET patients. The proposed method can give immediate results for the clinician to gain valuable information for the diagnosis of tremor. This can be useful in environments where more sophisticated diagnostic techniques are unavailable.

  14. Semiautomated tremor detection using a combined cross-correlation and neural network approach

    Science.gov (United States)

    Horstmann, Tobias; Harrington, Rebecca M.; Cochran, Elizabeth S.

    2013-01-01

    Despite observations of tectonic tremor in many locations around the globe, the emergent phase arrivals, low‒amplitude waveforms, and variable event durations make automatic detection a nontrivial task. In this study, we employ a new method to identify tremor in large data sets using a semiautomated technique. The method first reduces the data volume with an envelope cross‒correlation technique, followed by a Self‒Organizing Map (SOM) algorithm to identify and classify event types. The method detects tremor in an automated fashion after calibrating for a specific data set, hence we refer to it as being “semiautomated”. We apply the semiautomated detection algorithm to a newly acquired data set of waveforms from a temporary deployment of 13 seismometers near Cholame, California, from May 2010 to July 2011. We manually identify tremor events in a 3 week long test data set and compare to the SOM output and find a detection accuracy of 79.5%. Detection accuracy improves with increasing signal‒to‒noise ratios and number of available stations. We find detection completeness of 96% for tremor events with signal‒to‒noise ratios above 3 and optimal results when data from at least 10 stations are available. We compare the SOM algorithm to the envelope correlation method of Wech and Creager and find the SOM performs significantly better, at least for the data set examined here. Using the SOM algorithm, we detect 2606 tremor events with a cumulative signal duration of nearly 55 h during the 13 month deployment. Overall, the SOM algorithm is shown to be a flexible new method that utilizes characteristics of the waveforms to identify tremor from noise or other seismic signals.

  15. Migrating tremors illuminate complex deformation beneath the seismogenic San Andreas fault.

    Science.gov (United States)

    Shelly, David R

    2010-02-04

    The San Andreas fault is one of the most extensively studied faults in the world, yet its physical character and deformation mode beneath the relatively shallow earthquake-generating portion remain largely unconstrained. Tectonic 'non-volcanic' tremor, a recently discovered seismic signal probably generated by shear slip on the deep extension of some major faults, can provide new insight into the deep fate of such faults, including that of the San Andreas fault near Parkfield, California. Here I examine continuous seismic data from mid-2001 to 2008, identifying tremor and decomposing the signal into different families of activity based on the shape and timing of the waveforms at multiple stations. This approach allows differentiation between activities from nearby patches of the deep fault and begins to unveil rich and complex patterns of tremor occurrence. I find that tremor exhibits nearly continuous migration, with the most extensive episodes propagating more than 20 kilometres along fault strike at rates of 15-80 kilometres per hour. This suggests that the San Andreas fault remains a localized through-going structure, at least to the base of the crust, in this area. Tremor rates and recurrence behaviour changed markedly in the wake of the 2004 magnitude-6.0 Parkfield earthquake, but these changes were far from uniform within the tremor zone, probably reflecting heterogeneous fault properties and static and dynamic stresses decaying away from the rupture. The systematic recurrence of tremor demonstrated here suggests the potential to monitor detailed time-varying deformation on this portion of the deep San Andreas fault, deformation which unsteadily loads the shallower zone that last ruptured in the 1857 magnitude-7.9 Fort Tejon earthquake.

  16. Flued head replacement alternatives

    International Nuclear Information System (INIS)

    Smetters, J.L.

    1987-01-01

    This paper discusses flued head replacement options. Section 2 discusses complete flued head replacement with a design that eliminates the inaccessible welds. Section 3 discusses alternate flued head support designs that can drastically reduce flued head installation costs. Section 4 describes partial flued head replacement designs. Finally, Section 5 discusses flued head analysis methods. (orig./GL)

  17. Transcranial sonography on Parkinson′s disease and essential tremor

    Directory of Open Access Journals (Sweden)

    Ahmad Chitsaz

    2013-01-01

    Full Text Available Background: The study on transcranial sonocraphy (TCS as a diagnostic test for Parkinson′s disease (PD has been neglected in some hospitals. The current study was conducted as the first study to investigate the utility of TCS for diagnosis of PD and its ability to distinguish PD from essential tremor (ET in an Iranian population. Materials and Methods: TCS of substantia nigra (SN was performed on 50 PD, 48 ET, and 50 healthy controls by two blinded investigators. Results: Bilateral SN margin over 0.20 cm 2 was found in 39 (90% and 7 (15% in PD and ET patients, respectively. Furthermore, 4 (8% of healthy control displayed this particular echo feature as well (false positives. SN hyperechogenicity ≥0.20 cm 2 was considered as a cut-off point to detected PD. Accordingly, TCS proved 90% (95% confidence interval [CI]: 77.85-97.35 sensitive and 92% ( 95% CI: 80.75-97.73 specific for the detection of PD by visualizing the SN. Conclusion: SN hyperechogenicity ≥20 cm 2 is a specific feature of PD. Since, the symptoms of PD and ET might be overlapping; this method seems to be reliable to confirm PD diagnosis in doubtful clinical cases. Further studies in years to come are warranted to shed light on standardized data for Iranian to enhance the validity of TCS.

  18. LINGO-1 and Neurodegeneration: Pathophysiologic Clues for Essential Tremor?

    Directory of Open Access Journals (Sweden)

    Zhou Zhi-dong

    2012-03-01

    Full Text Available Essential tremor (ET, one of the most common adult-onset movement disorders, has been associated with cerebellar Purkinje cell degeneration and formation of brainstem Lewy bodies. Recent findings suggest that genetic variants of the leucine-rich repeat and Ig domain containing 1 (LINGO-1 gene could be risk factors for ET. The LINGO-1 protein contains both leucine-rich repeat (LRR and immunoglobulin (Ig-like domains in its extracellular region, as well as a transmembrane domain and a short cytoplasmic tail. LINGO-1 can form a ternary complex with Nogo-66 receptor (NgR1 and p75. Binding of LINGO-1 with NgR1 can activate the NgR1 signaling pathway, leading to inhibition of oligodendrocyte differentiation and myelination in the central nervous system. LINGO-1 has also been found to bind with epidermal growth factor receptor (EGFR and induce downregulation of the activity of EGFR–PI3K–Akt signaling, which might decrease Purkinje cell survival. Therefore, it is possible that genetic variants of LINGO-1, either alone or in combination with other genetic or environmental factors, act to increase LINGO-1 expression levels in Purkinje cells and confer a risk to Purkinje cell survival in the cerebellum. Here, we provide a concise summary of the link between LINGO-1 and neurodegeneration and discuss various hypotheses as to how this could be potentially relevant to ET pathogenesis.

  19. Structural study of Purkinje cell axonal torpedoes in essential tremor.

    Science.gov (United States)

    Louis, Elan D; Yi, Hong; Erickson-Davis, Cordelia; Vonsattel, Jean-Paul G; Faust, Phyllis L

    2009-02-06

    Essential tremor (ET) is one of the most common neurological diseases. A basic understanding of its neuropathology is now emerging. Aside from Purkinje cell loss, a prominent finding is an abundance of torpedoes (rounded swellings of Purkinje cell axons). Such swellings often result from the mis-accumulation of cell constituents. Identifying the basic nature of these accumulations is an important step in understanding the underlying disease process. Torpedoes, only recently identified in ET, have not yet been characterized ultrastructurally. Light and electron microscopy were used to characterize the structural constituents of torpedoes in ET. Formalin-fixed cerebellar cortical tissue from four prospectively collected ET brains was sectioned and immunostained with a monoclonal phosphorylated neurofilament antibody (SMI-31, Covance, Emeryville, CA). Using additional sections from three ET brains, torpedoes were assessed using electron microscopy. Immunoreactivity for phosphorylated neurofilament protein revealed clear labeling of torpedoes in each case. Torpedoes were strongly immunoreactive; in many instances, two or more torpedoes were noted in close proximity to one another. On electron microscopy, torpedoes were packed with randomly arranged 10-12nm neurofilaments. Mitochondria and smooth endoplasmic reticulum were abundant as well, particularly at the periphery of the torpedo. We demonstrated that the torpedoes in ET represent the mis-accumulation of disorganized neurofilaments and other organelles. It is not known where in the pathogenic cascade these accumulations occur (i.e., whether these accumulations are the primary event or a secondary/downstream event) and this deserves further study.

  20. An automatic tsunami warning system: TREMORS application in Europe

    Science.gov (United States)

    Reymond, D.; Robert, S.; Thomas, Y.; Schindelé, F.

    1996-03-01

    An integrated system named TREMORS (Tsunami Risk Evaluation through seismic Moment of a Real-time System) has been installed in EVORA station, in Portugal which has been affected by historical tsunamis. The system is based on a three component long period seismic station linked to a compatible IBM_PC with a specific software. The goals of this system are the followings: detect earthquake, locate them, compute their seismic moment, give a seismic warning. The warnings are based on the seismic moment estimation and all the processing are made automatically. The finality of this study is to check the quality of estimation of the main parameters of interest in a goal of tsunami warning: the location which depends of azimuth and distance, and at last the seismic moment, M 0, which controls the earthquake size. The sine qua non condition for obtaining an automatic location is that the 3 main seismic phases P, S, R must be visible. This study gives satisfying results (automatic analysis): ± 5° errors in azimuth and epicentral distance, and a standard deviation of less than a factor 2 for the seismic moment M 0.

  1. Attention in essential tremor: evidence from event-related potentials.

    Science.gov (United States)

    Pauletti, C; Mannarelli, D; Locuratolo, N; Vanacore, N; De Lucia, M C; Mina, C; Fattapposta, F

    2013-07-01

    Clinically subtle executive dysfunctions have recently been described in essential tremor (ET), though the presence of attentional deficits is still unclear. We investigated the psychophysiological aspects of attention in ET, using event-related potentials (ERPs). Twenty-one non-demented patients with ET and 21 age- and sex-matched healthy controls underwent a psychophysiological evaluation. P300 components and the Contingent Negative Variation (CNV) were recorded. The latencies and amplitudes of the P3a and P3b subcomponents and CNV areas were evaluated. Possible correlations between clinical parameters and ERP data were investigated. P3a latency was significantly longer in the ET group (p attentive circuits, while the memory context-updating process appears to be spared. This selective cognitive dysfunction does not appear to interfere with the attentional set linked to the expectancy evaluated during a complex choice-reaction time task, which is preserved in ET. This multitask psychophysiological approach reveals the presence of a peculiar attentional deficit in patients with ET, thus expanding the clinical features of this disease.

  2. Linking Essential Tremor to the Cerebellum: Neurochemical Evidence.

    Science.gov (United States)

    Marin-Lahoz, Juan; Gironell, Alexandre

    2016-06-01

    The pathophysiology and the exact anatomy of essential tremor (ET) is not well known. One of the pillars that support the cerebellum as the main anatomical locus in ET is neurochemistry. This review examines the link between neurochemical abnormalities found in ET and cerebellum. The review is based on published data about neurochemical abnormalities described in ET both in human and in animal studies. We try to link those findings with cerebellum. γ-aminobutyric acid (GABA) is the main neurotransmitter involved in the pathophysiology of ET. There are several studies about GABA that clearly points to a main role of the cerebellum. There are few data about other neurochemical abnormalities in ET. These include studies with noradrenaline, glutamate, adenosine, proteins, and T-type calcium channels. One single study reveals high levels of noradrenaline in the cerebellar cortex. Another study about serotonin neurotransmitter results negative for cerebellum involvement. Finally, studies on T-type calcium channels yield positive results linking the rhythmicity of ET and cerebellum. Neurochemistry supports the cerebellum as the main anatomical locus in ET. The main neurotransmitter involved is GABA, and the GABA hypothesis remains the most robust pathophysiological theory of ET to date. However, this hypothesis does not rule out other mechanisms and may be seen as the main scaffold to support findings in other systems. We clearly need to perform more studies about neurochemistry in ET to better understand the relations among the diverse systems implied in ET. This is mandatory to develop more effective pharmacological therapies.

  3. Boxing-related head injuries.

    Science.gov (United States)

    Jayarao, Mayur; Chin, Lawrence S; Cantu, Robert C

    2010-10-01

    Fatalities in boxing are most often due to traumatic brain injury that occurs in the ring. In the past 30 years, significant improvements in ringside and medical equipment, safety, and regulations have resulted in a dramatic reduction in the fatality rate. Nonetheless, the rate of boxing-related head injuries, particularly concussions, remains unknown, due in large part to its variability in clinical presentation. Furthermore, the significance of repeat concussions sustained when boxing is just now being understood. In this article, we identify the clinical manifestations, pathophysiology, and management of boxing-related head injuries, and discuss preventive strategies to reduce head injuries sustained by boxers.

  4. Posture, head stability, and orientation recovery during vestibular regeneration in pigeons.

    Science.gov (United States)

    Dickman, J David; Lim, Insook

    2004-09-01

    Compensatory behavior such as oculomotor, gaze, and postural responses that occur during movement largely depend upon a functioning vestibular system. In the present study, the initial loss and subsequent recovery of postural and head stability in pigeons undergoing vestibular regeneration were examined. Adult pigeons were trained to manipulate a straight run chamber to peck an illuminated key for fluid reward. Six behavioral measures assessing performance, posture, and head stability were quantified. These included run latency, steps (walking), path negotiation (lane changes), gaze saccades, head bobs, and head shakes. Once normative values were obtained for four birds, complete lesion of all receptor cells and denervation of the epithelia in the vestibular endorgans were produced using a single intralabyrinthine application of streptomycin sulfate. Each bird was then tested at specific times during regeneration and the same behavioral measures examined. At 7 days post-streptomycin treatment (PST), all birds exhibited severe postural and head instability, with tremors, head shakes, staggering, and circling predominating. No normal trial runs, walking, gaze saccades, or head bobs were present. Many of these dysfunctions persisted through 3-4 weeks PST. Gradually, tremor and head shakes diminished and were replaced with an increasing number of normal head bobs during steps and gaze saccades. Beginning at 4 weeks PST, but largely inaccurate, was the observed initiation of directed steps, less staggering, and some successful path negotiation. As regeneration progressed, spatial orientation and navigation ability increased and, by 49 days PST, most trials were successful. By 70 days PST, all birds had recovered to pretreatment levels. Thus, it was observed that ataxia must subside, coincident with normalized head and postural stability prior to the recovery of spatial orientation and path navigation recovery. Parallels in recovery were drawn to hair cell regeneration

  5. Goniometer head

    International Nuclear Information System (INIS)

    Dzhazairov-Kakhramanov, V.; Berger, V.D.; Kadyrzhanov, K.K.; Zarifov, R.A.

    1994-01-01

    The goniometer head is an electromechanical instrument that performs the independent transfer of a testing sample on three coordinate axes (X, Y, Z) within limits of ±8 mm and independent rotation relative of these directions. The instrument comprises a sample holder, bellows component and three electrometer drives. The sample holder rotates around the axes X and Y, and is installed on the central arm which rotates around axis Z. One characteristic of this instrument is its independence which allows its use in any camera for researches in the field of radiation physics. 2 figs

  6. Deep Brain Stimulation for Essential Tremor: Aligning Thalamic and Posterior Subthalamic Targets in 1 Surgical Trajectory.

    Science.gov (United States)

    Bot, Maarten; van Rootselaar, Fleur; Contarino, Maria Fiorella; Odekerken, Vincent; Dijk, Joke; de Bie, Rob; Schuurman, Richard; van den Munckhof, Pepijn

    2017-12-21

    Ventral intermediate nucleus (VIM) deep brain stimulation (DBS) and posterior subthalamic area (PSA) DBS suppress tremor in essential tremor (ET) patients, but it is not clear which target is optimal. Aligning both targets in 1 surgical trajectory would facilitate exploring stimulation of either target in a single patient. To evaluate aligning VIM and PSA in 1 surgical trajectory for DBS in ET. Technical aspects of trajectories, intraoperative stimulation findings, final electrode placement, target used for chronic stimulation, and adverse and beneficial effects were evaluated. In 17 patients representing 33 trajectories, we successfully aligned VIM and PSA targets in 26 trajectories. Trajectory distance between targets averaged 7.2 (range 6-10) mm. In all but 4 aligned trajectories, optimal intraoperative tremor suppression was obtained in the PSA. During follow-up, active electrode contacts were located in PSA in the majority of cases. Overall, successful tremor control was achieved in 69% of patients. Stimulation-induced dysarthria or gait ataxia occurred in, respectively, 56% and 44% of patients. Neither difference in tremor suppression or side effects was noted between aligned and nonaligned leads nor between the different locations of chronic stimulation. Alignment of VIM and PSA for DBS in ET is feasible and enables intraoperative exploration of both targets in 1 trajectory. This facilitates positioning of electrode contacts in both areas, where multiple effective points of stimulation can be found. In the majority of aligned leads, optimal intraoperative and chronic stimulation were located in the PSA. Copyright © 2017 by the Congress of Neurological Surgeons

  7. Frequency and Factors of Tremor, Palpitation, and Cramp in Patients with COPD and Asthma

    Directory of Open Access Journals (Sweden)

    Sema Demir

    2015-04-01

    Full Text Available Objective: To evaluate the frequency and predictability of side effects, including tremor, cramp, and palpitation, due to treatment in patients with chronic obstructive pulmonary disease and asthma. Methods: We prepared a standard questionnaire for 299 patients concerning their diagnosis, treatment, and side effects of the treatment in February 2007 at Hacettepe University, Faculty of Medicine, Department of Pulmonary Diseases. We prospectively examined the clinical status of the patients and side effects of the treatment at the 15th, 30th, and 180th days of the treatment. Results: In our study, there were 38 (12.7% patients with drug-induced tremor. Of these, 27 (71.1% had asthma (p=0.004 and 18 (47.4% had anamnestic palpitation. Drug-induced tremor risk was 15.3 times higher in patients who used a beta-mimetic compared with those who used any drugs. Cramp risk increased with beta-mimetic use only. In our study, drug-induced tremor was still present at the 180th day of examination in 32 (84.2% patients. Conclusion: This study demonstrated that side effects, including tremor, palpitation, and cramp, were more common in our patients compared with those in other studies. These side effects were directly related to the primary disease and the use of beta-2-agonists. Another finding of our study is that tolerance did not develop as much as that reported in literature.

  8. Weighted wrist cuffs for tremor reduction during eating in adults with static brain lesions.

    Science.gov (United States)

    McGruder, Juli; Cors, Denise; Tiernan, Anne M; Tomlin, George

    2003-01-01

    This study examined whether weighting the forearm during feeding decreased tremors and increased functional feeding in adults with intention tremor caused by static brain lesions. Five individuals with various diagnoses, ages 30-81, were videotaped during 8 or 16 meal sessions, alternating treatment and control conditions within each meal. In this single-case design, treatment consisted of application of a weighted fabric wrist cuff and the baseline (control) condition employed an identical cuff with the weights removed. Dependent variables studied were time to acquire and deliver a bite, grams of food eaten, number of times food was spilled, number of times a compensatory technique was used, participant self-rating, and investigator rating of the severity of the tremor. All five participants demonstrated improvement during treatment in one or more of the dependent variables. t Tests of the means of baseline and treatment half-sessions incorporating conservative control of Type I error revealed the following statistically significant improvements under the weighted condition: Participants 3, 4, and 5 took less time to acquire a bite; Participants 4 and 5 made fewer spills; Participants 3 and 5 showed a diminished tremor. There were no statistically significant decreases in function on any variable for any participants during the weighted condition. The application of weight to the wrist of a person with upper-extremity tremor is accompanied by some functional improvement in self-feeding for some individuals. The size of benefit seems to be sensitive to the amount of weight used.

  9. The effect of a therapeutic lithium level on a stroke-related cerebellar tremor.

    Science.gov (United States)

    Orleans, Rachel A; Dubin, Marc J; Kast, Kristopher A

    2018-01-24

    Lithium is a mood stabiliser used in the treatment of acute mania, bipolar disorder and as augmentation for unipolar major depression. Tremor is a common adverse effect associated with lithium at both therapeutic and toxic serum levels. We present a case of dose-dependent changes in the quality and intensity of a stroke-related, chronic cerebellar tremor with lithium treatment at serum levels within the therapeutic range. On admission, the patient in this case had a baseline fine, postural tremor, which increased in frequency and evolved to include myoclonic jerks once lithium therapy was initiated. Although the patient's serum lithium level was never in the toxic range, his tremor returned to baseline on reduction of his serum lithium level. This case highlights that a pre-existing, baseline tremor may lower the threshold for developing myoclonus. It also suggests that caution may be warranted with lithium therapy in the setting of known cerebellar disease. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Metoprolol and propranolol in essential tremor: a double-blind, controlled study.

    Science.gov (United States)

    Calzetti, S; Findley, L J; Gresty, M A; Perucca, E; Richens, A

    1981-01-01

    Single oral doses of propranolol (120 mg), metoprolol (150 mg) and placebo were given in a randomised, double-blind fashion to 23 patients with essential tremor. Both beta blockers were significantly more effective than placebo in reducing the magnitude of tremor. The decrease in tremor produced by metoprolol (47, sem 9%, n = 23) was not significantly different from that observed propranolol (55, sem 5%, n = 23). Tachycardia on standing was antagonised by both drugs to a similar extent. These findings suggest that metoprolol may represent a valuable alternative to propranolol in the treatment of essential tremor. The data is consistent with the hypothesis that the tremorolytic effect of beta blockers in these patients may be unrelated to peripheral beta-2 adreno-receptor blockade, being possibly mediated by other central or peripheral modes of action of these drugs. However, it cannot be excluded that at the dose used, metoprolol had lost its relative cardio-selectivity and that the reduction in tremor was mediated by competitive antagonism at beta-2 receptor sites in skeletal muscle. PMID:7031187

  11. Focused Ultrasound for Essential Tremor: Review of the Evidence and Discussion of Current Hurdles

    Directory of Open Access Journals (Sweden)

    Mohammad Rohani

    2017-05-01

    Full Text Available Background. While there is no breakthrough progress in the medical treatment of essential tremor (ET, in the past decades several remarkable achievements happened in the surgical field, such as radiofrequency thalamotomy, thalamic deep brain stimulation and gamma knife thalamotomy. The most recent advance in this area is magnetic resonance-guided focused ultrasound (MRgFUS. Methods. Purpose of this review is to discuss the new developments and trials of MRgFUS in the treatment of ET and other tremor disorders. Results. MRgFUS is an incision-less surgery performed without anesthesia and ionizing radiation (no risk of cumulative dose and delayed side effects. Studies have shown the safety and effectiveness of unilateral MRgFUS-thalamotomy in the treatment of ET. It has been successfully used in few patients with Parkinson's disease-related tremor and fewer patients with Fragile X-associated Tremor/Ataxia Syndrome. Safety and long-term effects of the procedure are still unclear, as temporary and permanent adverse events have been reported as well as reoccurrence of tremor. Discussion. MRgFUS is a promising new surgical approach with still a number of unknowns and unsolved issues. It represents a valuable option particularly for patients who refused or could not be candidate for other procedures, deep brain stimulation in particular. 

  12. Network-Based Detection and Classification of Seismovolcanic Tremors: Example From the Klyuchevskoy Volcanic Group in Kamchatka

    Science.gov (United States)

    Soubestre, Jean; Shapiro, Nikolai M.; Seydoux, Léonard; de Rosny, Julien; Droznin, Dmitry V.; Droznina, Svetlana Ya.; Senyukov, Sergey L.; Gordeev, Evgeniy I.

    2018-01-01

    We develop a network-based method for detecting and classifying seismovolcanic tremors. The proposed approach exploits the coherence of tremor signals across the network that is estimated from the array covariance matrix. The method is applied to four and a half years of continuous seismic data recorded by 19 permanent seismic stations in the vicinity of the Klyuchevskoy volcanic group in Kamchatka (Russia), where five volcanoes were erupting during the considered time period. We compute and analyze daily covariance matrices together with their eigenvalues and eigenvectors. As a first step, most coherent signals corresponding to dominating tremor sources are detected based on the width of the covariance matrix eigenvalues distribution. Thus, volcanic tremors of the two volcanoes known as most active during the considered period, Klyuchevskoy and Tolbachik, are efficiently detected. As a next step, we consider the daily array covariance matrix's first eigenvector. Our main hypothesis is that these eigenvectors represent the principal components of the daily seismic wavefield and, for days with tremor activity, characterize dominant tremor sources. Those daily first eigenvectors, which can be used as network-based fingerprints of tremor sources, are then grouped into clusters using correlation coefficient as a measure of the vector similarity. As a result, we identify seven clusters associated with different periods of activity of four volcanoes: Tolbachik, Klyuchevskoy, Shiveluch, and Kizimen. The developed method does not require a priori knowledge and is fully automatic; and the database of the network-based tremor fingerprints can be continuously enriched with newly available data.

  13. Rigidity decreases resting tremor intensity in Parkinson's disease: A [(123)I]beta-CIT SPECT study in early, nonmedicated patients

    NARCIS (Netherlands)

    Winogrodzka, A.; Wagenaar, R. C.; Bergmans, P.; Vellinga, A.; Booij, J.; van Royen, E. A.; van Emmerik, R. E.; Stoof, J. C.; Wolters, E. C.

    2001-01-01

    Tremor is one of the clinical hallmarks of Parkinson's disease (PD). Although it is accepted that other classic symptoms of PD such as rigidity and bradykinesia result from a degeneration of the nigrostriatal system and subsequent reduction in striatal dopamine, the pathophysiology of resting tremor

  14. Deep Brain Stimulation for Tremor Associated with Underlying Ataxia Syndromes: A Case Series and Discussion of Issues

    Directory of Open Access Journals (Sweden)

    Genko Oyama

    2014-07-01

    Full Text Available Background: Deep brain stimulation (DBS has been utilized to treat various symptoms in patients suffering from movement disorders such as Parkinson's disease, dystonia, and essential tremor. Though ataxia syndromes have not been formally or frequently addressed with DBS, there are patients with ataxia and associated medication refractory tremor or dystonia who may potentially benefit from therapy.Methods: A retrospective database review was performed, searching for cases of ataxia where tremor and/or dystonia were addressed by utilizing DBS at the University of Florida Center for Movement Disorders and Neurorestoration between 2008 and 2011. Five patients were found who had DBS implantation to address either medication refractory tremor or dystonia. The patient's underlying diagnoses included spinocerebellar ataxia type 2 (SCA2, fragile X associated tremor ataxia syndrome (FXTAS, a case of idiopathic ataxia (ataxia not otherwise specified [NOS], spinocerebellar ataxia type 17 (SCA17, and a senataxin mutation (SETX.Results: DBS improved medication refractory tremor in the SCA2 and the ataxia NOS patients. The outcome for the FXTAS patient was poor. DBS improved dystonia in the SCA17 and SETX patients, although dystonia did not improve in the lower extremities of the SCA17 patient. All patients reported a transient gait dysfunction postoperatively, and there were no reports of improvement in ataxia‐related symptoms.Discussion: DBS may be an option to treat tremor, inclusive of dystonic tremor in patients with underlying ataxia; however, gait and other symptoms may possibly be worsened.Erratum published on July 27, 2016

  15. Visual function alterations in essential tremor: A case report

    Directory of Open Access Journals (Sweden)

    David P. Piñero

    2015-09-01

    Full Text Available Our purpose is to report alterations in contrast sensitivity function (CSF and in the magno, parvo and koniocellular visual pathways by means of a multichannel perimeter in case of an essential tremor (ET. A complete evaluation of the visual function was performed in a 69-year old patient, including the analysis of the chromatic discrimination by the Fansworth–Munsell 100 hue test, the measurement of the CSF by the CSV-1000E test, and the detection of potential alteration patterns in the magno, parvo and koniocellular visual pathways by means of a multichannel perimeter. Visual acuity and intraocular pressure (IOP were within the ranges of normality in both eyes. No abnormalities were detected in the fundoscopic examination and in the optical coherence tomography (OCT exam. The results of the color vision examination were also within the ranges of normality. A significant decrease in the achromatic CSFs for right eye (RE and left eye (LE was detected for all spatial frequencies. The statistical global values provided by the multichannel perimeter confirms that there were significant absolute sensitivity losses compared to the normal pattern in RE. In the LE, only a statistically significant decrease in sensitivity was detected for the blue-yellow (BY channel. The pattern standard deviation (PSD values obtained in our patient indicated that there were significant localized losses compared to the normality pattern in the achromatic channel of the RE and in the red-green (RG channel of the LE. Some color vision alterations may be present in ET that cannot be detected with conventional color vision tests, such as the FM 100 Hue.

  16. Linking Essential Tremor to the Cerebellum: Neuropathological Evidence.

    Science.gov (United States)

    Louis, Elan D

    2016-06-01

    A fundamental question about essential tremor (ET) is whether its associated pathological changes and disease mechanisms are linkable to a specific brain region. To that end, recent tissue-based studies have made significant strides in elucidating changes in the ET brain. Emerging from these studies is increasing neuropathological evidence linking ET to the cerebellum. These studies have systematically identified a broad range of structural, degenerative changes in the ET cerebellum, spanning across all Purkinje cell compartments. These include the dendritic compartment (where there is an increase in number of Purkinje cell dendritic swellings, a pruning of the dendritic arbor, and a reduction in spine density), the cell body (where, aside from reductions in Purkinje cell linear density in some studies, there is an increase in the number of heterotopic Purkinje cell soma), and the axonal compartment (where a plethora of changes in axonal morphology have been observed, including an increase in the number of thickened axonal profiles, torpedoes, axonal recurrent collaterals, axonal branching, and terminal axonal sprouting). Additional changes, possibly due to secondary remodeling, have been observed in neighboring neuronal populations. These include a hypertrophy of basket cell axonal processes and changes in the distribution of climbing fiber-Purkinje cell synapses. These changes all distinguish ET from normal control brains. Initial studies further indicate that the profile (i.e., constellation) of these changes may separate ET from other diseases of the cerebellum, thereby serving as a disease signature. With the discovery of these changes, a new model of ET has arisen, which posits that it may be a neurodegenerative disorder centered in the cerebellar cortex. These newly emerging neuropathological studies pave the way for anatomically focused, hypothesis-driven, molecular mechanistic studies of disease pathogenesis.

  17. Blood harmane concentrations and dietary protein consumption in essential tremor.

    Science.gov (United States)

    Louis, E D; Zheng, W; Applegate, L; Shi, L; Factor-Litvak, P

    2005-08-09

    Beta-carboline alkaloids (e.g., harmane) are highly tremorogenic chemicals. Animal protein (meat) is the major dietary source of these alkaloids. The authors previously demonstrated that blood harmane concentrations were elevated in patients with essential tremor (ET) vs controls. Whether this difference is due to greater animal protein consumption by patients or their failure to metabolize harmane is unknown. The aim of this study was to determine whether patients with ET and controls differ with regard to 1) daily animal protein consumption and 2) the correlation between animal protein consumption and blood harmane concentration. Data on current diet were collected with a semiquantitative food frequency questionnaire and daily calories and consumption of animal protein and other food types was calculated. Blood harmane concentrations were log-transformed (logHA). The mean logHA was higher in 106 patients than 161 controls (0.61 +/- 0.67 vs 0.43 +/- 0.72 g(-10)/mL, p = 0.035). Patients and controls consumed similar amounts of animal protein (50.2 +/- 19.6 vs 49.4 +/- 19.1 g/day, p = 0.74) and other food types (animal fat, carbohydrates, vegetable fat) and had similar caloric intakes. In controls, logHA was correlated with daily consumption of animal protein (r = 0.24, p = 0.003); in patients, there was no such correlation (r = -0.003, p = 0.98). The similarity between patients and controls in daily animal protein consumption and the absence of the normal correlation between daily animal protein consumption and logHA in patients suggests that another factor (e.g., a metabolic defect) may be increasing blood harmane concentration in patients.

  18. Selective adrenergic beta-2-receptor blocking drug, ICI-118.551, is effective in essential tremor.

    Science.gov (United States)

    Teräväinen, H; Huttunen, J; Larsen, T A

    1986-07-01

    Eighteen patients with essential tremor were treated for 2 days with a non-selective adrenergic beta-blocking drug (dl-propranolol, 80 mg X 3), a beta-2-selective blocker (ICI-118.551, 50 mg X 3) and placebo (X 3) in a randomized double blind cross-over study. Postural hand tremor was recorded with an accelerometer before administration of the drugs and at the end of each treatment period. Compared with placebo, both the beta-blocking drugs caused a statistically significant decrease in tremor intensity and they possessed approximately similar antitremor potency. Subjective benefit was reported by 12 of the 18 patients receiving ICI-118.551, 13 when on propranolol and 3 when on placebo.

  19. Could Wearable and Mobile Technology Improve the Management of Essential Tremor?

    Science.gov (United States)

    Daneault, Jean-Francois

    2018-01-01

    Essential tremor (ET) is the most common movement disorder. Individuals exhibit postural and kinetic tremor that worsens over time and patients may also exhibit other motor and non-motor symptoms. While millions of people are affected by this disorder worldwide, several barriers impede an optimal clinical management of symptoms. In this paper, we discuss the impact of ET on patients and review major issues to the optimal management of ET; from the side-effects and limited efficacy of current medical treatments to the limited number of people who seek treatment for their tremor. Then, we propose seven different areas within which mobile and wearable technology may improve the clinical management of ET and review the current state of research in these areas. PMID:29725318

  20. Relationship between eruption plume heights and seismic source amplitudes of eruption tremors and explosion events

    Science.gov (United States)

    Mori, A.; Kumagai, H.

    2016-12-01

    It is crucial to analyze and interpret eruption tremors and explosion events for estimating eruption size and understanding eruption phenomena. Kumagai et al. (EPS, 2015) estimated the seismic source amplitudes (As) and cumulative source amplitudes (Is) for eruption tremors and explosion events at Tungurahua, Ecuador, by the amplitude source location (ASL) method based on the assumption of isotropic S-wave radiation in a high-frequency band (5-10 Hz). They found scaling relations between As and Is for eruption tremors and explosion events. However, the universality of these relations is yet to be verified, and the physical meanings of As and Is are not clear. In this study, we analyzed the relations between As and Is for eruption tremors and explosion events at active volcanoes in Japan, and estimated As and Is by the ASL method. We obtained power-law relations between As and Is, in which the powers were different between eruption tremors and explosion events. These relations were consistent with the scaling relations at Tungurahua volcano. Then, we compared As with maximum eruption plume heights (H) during eruption tremors analyzed in this study, and found that H was proportional to 0.21 power of As. This relation is similar to the plume height model based on the physical process of plume rise, which indicates that H is proportional to 0.25 power of volumetric flow rate for plinian eruptions. This suggests that As may correspond to volumetric flow rate. If we assume a seismic source with volume changes and far-field S-wave, As is proportional to the source volume rate. This proportional relation and the plume height model give rise to the relation that H is proportional to 0.25 power of As. These results suggest that we may be able to estimate plume heights in realtime by estimating As during eruptions from seismic observations.

  1. Using Tectonic Tremor to Constrain Seismic-wave Attenuation in Cascadia

    Science.gov (United States)

    Littel, G.; Thomas, A.; Baltay, A.

    2017-12-01

    In addition to fast, seismic slip, many subduction zones also host slow, largely aseismic slip, accompanied by a weak seismic signal known as tectonic tremor. Tremor is a small amplitude, low-frequency seismic signal that originates at the plate interface, down-dip of where large earthquakes typically occur. The Cascadia subduction zone has not seen a large megathrust earthquake since 1700, yet its recurrence interval of 350-500 years motivates heightened interest in understanding the seismic hazard of the region. Of great importance is to understand the degree to which waves are attenuated as they leave the plate interface and travel towards populated regions of interest. Ground motion prediction equations (GMPEs) relate ground motion to a number of parameters, including earthquake magnitude, depth, style of faulting, and anelastic attenuation, and are typically determined empirically from earthquake ground motion recordings. In Cascadia, however, earthquakes of the moderate size typically used to constrain GMPEs occur relatively infrequently compared to tectonic tremor events, which, in contrast, occur periodically approximately every 10-19 months. Studies have shown that the abundant tectonic tremor in Cascadia, despite its small amplitudes, can be used to constrain seismic wave attenuation in GMPEs. Here we quantify seismic wave attenuation and determine its spatial variations in Cascadia by performing an inversion using tremor ground motion amplitudes, taken as peak ground acceleration (PGA) and peak ground velocity (PGV) from 1 min window waveforms of each individual tremor event. We estimate the anelastic attenuation parameter for varying regional sections along the Cascadia margin. Changes in seismic-wave attenuation along the Cascadia Subduction Zone could result in significantly different ground motions in the event of a very large earthquake, hence quantifying attenuation may help to better estimate the severity of shaking in densely populated

  2. Quantification of Parkinson Tremor Intensity Based On EMG Signal Analysis Using Fast Orthogonal Search Algorithm

    Directory of Open Access Journals (Sweden)

    H. Rezghian Moghadam

    2018-06-01

    Full Text Available The tremor injury is one of the common symptoms of Parkinson's disease. The patients suffering from Parkinson's disease have difficulty in controlling their movements owing to tremor. The intensity of the disease can be determined through specifying the range of intensity values of involuntary tremor in Parkinson patients. The level of disease in patients is determined through an empirical range of 0-5. In the early stages of Parkinson, resting tremor can be very mild and intermittent. So, diagnosing the levels of disease is difficult but important since it has only medication therapy. The aim of this study is to quantify the intensity of tremor by the analysis of electromyogram signal. The solution proposed in this paper is to employ a polynomial function model to estimate the Unified Parkinson's Disease Rating Scale (UPDRS value. The algorithm of Fast Orthogonal Search (FOS, which is based on identification of orthogonal basic functions, was utilized for model identification. In fact, some linear and nonlinear features extracted from wrist surface electromyogram signal were considered as the input of the model identified by FOS, and the model output was the UPDRS value. In this research, the proposed model was designed based on two different structures which have been called the single structure and parallel structure. The efficiency of designed models with different structures was evaluated. The evaluation results using K-fold cross validation approach showed that the proposed model with a parallel structure could determine the tremor severity of the Parkinson's disease with accuracy of 99.25% ±0.41, sensitivity of 97.17% ±1.9 and specificity of 99.72% ±0.18.

  3. Parkinsonism in fragile X-associated tremor/ataxia syndrome (FXTAS): revisited.

    Science.gov (United States)

    Niu, Yu-Qiong; Yang, Jin-Chen; Hall, Deborah A; Leehey, Maureen A; Tassone, Flora; Olichney, John M; Hagerman, Randi J; Zhang, Lin

    2014-04-01

    Parkinsonian features have been used as a minor diagnostic criterion for fragile X-associated tremor/ataxia syndrome (FXTAS). However, prior studies have examined parkinsonism (defined as having bradykinesia with at least rest tremor or postural instability) mostly in premutation carriers without a diagnosis of FXTAS. The current study was intended to elaborate this important aspect of the FXTAS spectrum, and to quantify the relationships between parkinsonism, FXTAS clinical staging and genetic/molecular measures. Thirty eight (38) FXTAS patients and 10 age-matched normal controls underwent a detailed neurological examination that included all but one item (i.e. rigidity) of the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). The FXTAS patient group displayed substantially higher prevalence of parkinsonian features including body bradykinesia (57%) and rest tremor (26%), compared to the control group. Furthermore, parkinsonism was identified in 29% of FXTAS patients. Across all patients, body bradykinesia scores significantly correlated with FXTAS clinical stage, FMR1 mRNA level, and ataxic gait of cerebellar origin, while postural instability was associated with intention tremor. Parkinsonian features in FXTAS appear to be characterized as bradykinesia concurrent with cerebellar gait ataxia, postural instability accompanied by intention tremor, and frequent rest tremor, representing distinctive patterns that highlight the need for further clinical studies including genetic testing for the FMR1 premutation. The association between FMR1 mRNA level and bradykinesia implicates pathophysiological mechanisms which may link FMR1 mRNA toxicity, dopamine deficiency and parkinsonism in FXTAS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Infrasonic harmonic tremor and degassing bursts from Halema'uma'u Crater, Kilauea Volcano, Hawaii

    Science.gov (United States)

    Fee, David; Garcés, Milton; Patrick, Matt; Chouet, Bernard; Dawson, Phil; Swanson, Donald A.

    2010-01-01

    The formation, evolution, collapse, and subsequent resurrection of a vent within Halema'uma'u Crater, Kilauea Volcano, produced energetic and varied degassing signals recorded by a nearby infrasound array between 2008 and early 2009. After 25 years of quiescence, a vent-clearing explosive burst on 19 March 2008 produced a clear, complex acoustic signal. Near-continuous harmonic infrasonic tremor followed this burst until 4 December 2008, when a period of decreased degassing occurred. The tremor spectra suggest volume oscillation and reverberation of a shallow gas-filled cavity beneath the vent. The dominant tremor peak can be sustained through Helmholtz oscillations of the cavity, while the secondary tremor peak and overtones are interpreted assuming acoustic resonance. The dominant tremor frequency matches the oscillation frequency of the gas emanating from the vent observed by video. Tremor spectra and power are also correlated with cavity geometry and dynamics, with the cavity depth estimated at ~219 m and volume ~3 x 106 m3 in November 2008. Over 21 varied degassing bursts were observed with extended burst durations and frequency content consistent with a transient release of gas exciting the cavity into resonance. Correlation of infrasound with seismicity suggests an open system connecting the atmosphere to the seismic excitation process at depth. Numerous degassing bursts produced very long period (0.03-0.1 Hz) infrasound, the first recorded at Kilauea, indicative of long-duration atmospheric accelerations. Kilauea infrasound appears controlled by the exsolution of gas from the magma, and the interaction of this gas with the conduits and cavities confining it.

  5. Nintendo Wii assessment of Hoehn and Yahr score with Parkinson's disease tremor.

    Science.gov (United States)

    Koçer, Abdulkadir; Oktay, Ayse Betul

    2016-01-01

    Diagnosis of Parkinson's Disease (PD) by analyzing the resting tremor were much studied by using different accelerometer based methods, however the quantitative assessment of Hoehn and Yahr Scale (HYS) score with a machine learning based system has not been previously addressed. In this study, we aimed to propose a system to automatically assess the HYS score of patients with PD. The system was evaluated and tested on a dataset containing 55 subjects where 35 of them were patients and 20 of them were healthy controls. The resting tremor data were gathered with the 3 axis accelerometer of the Nintendo Wii (Wiimote). The clinical disability of the PD was graded from 1 to 5 by the HYS and tremor was recorded twice from the more affected side in each patient and from the dominant extremity in each control for a 60 seconds period. The HYS scores were learned with Support Vector Machines (SVM) from the features of the tremor data. Thirty-two of the subjects with PD were classified correctly and 18 of the normal subjects were also classified correctly by our system. The system had average 0.89 accuracy rate (Range: 81-100% changing according to grading by HYS). We compared quantitative measurements of hand tremor in PD patients, with staging of PD based on accelerometer data gathered using the Wii sensor. Our results showed that the machine learning based system with simple features could be helpful for diagnosis of PD and estimate HYS score. We believed that this portable and easy-to-use Wii sensor measure might also be applicable in the continuous monitoring of the resting tremor with small modifications in routine clinical use.

  6. Discovery of non-volcanic tremor and contribution to earth science by NIED Hi-net

    Science.gov (United States)

    Obara, K.

    2015-12-01

    Progress of seismic observation network brings breakthroughs in the earth science at each era. High sensitivity seismograph network (Hi-net) was constructed by National Research Institute for Earth Science and Disaster Prevention (NIED) as a national project in order to improve the detection capability of microearthquake after disastrous 1995 Kobe earthquake. Hi-net has been contributing to not only monitoring of seismicity but also producing many research results like as discoveries of non-volcanic tremor and other slow earthquakes. More important thing is that we have continued to make efforts to monitor all of data visually and effectively. The discovery of tremor in southwest Japan stimulated PGC researchers to search similar seismic signature in Cascadia because of a couple of common features in the tremor in Japan and slow slip event (SSE) they already discovered in Cascadia. At last, episodic tremor and slip (ETS) was discovered, then the SSE associated with tremor was also detected in Japan by using the tilting data measured by high-sensitivity accelerometer attached with the Hi-net. This coupling phenomena strengthened the connection between seismology and geodesy. Widely separated spectrum of tremor and SSE motivated us to search intervened phenomena, then we found very low frequency earthquake during ETS episode. These slow earthquakes obey a scaling law different from ordinary earthquake. This difference is very important to resolve the earthquake physics. Hi-net is quite useful for not only three-dimensional imaging of underground structure beneath the Japan Islands, but also resolving deep Earth interior by using teleseismic events or ambient noises and source rupture process of large earthquakes by using back-projection analysis as a remote array. Hi-net will continue to supply unexpected new discoveries. I expect that multiple installation of similar dense seismic array in the world will give us great opportunity to discover more important and

  7. Characteristics of Helicopter-Generated and Volcano-Related Seismic Tremor Signals

    Science.gov (United States)

    Eibl, Eva P. S.; Lokmer, Ivan; Bean, Christopher J.; Akerlie, Eggert; Vogfjörd, Kristin S.

    2017-04-01

    In volcanic environments it is crucial to distinguish between man-made seismic signals and signals created by the volcano. We compare volcanic, seismic signals with helicopter generated, seismic signals recorded in the last 2.5 years in Iceland. In both cases a long-lasting, emergent seismic signal, that can be referred to as seismic tremor, was generated. In the case of a helicopter, the rotating blades generate pressure pulses that travel through the air and excite Rayleigh waves at up to 40 km distance depending on wind speed, wind direction and topographic features. The longest helicopter related seismic signal we recorded was at the order of 40 minutes long. The tremor usually has a fundamental frequency of more than 10 Hz and overtones at integers of the fundamental frequency. Changes in distance lead to either increases or decreases of the frequency due to the Doppler Effect and are strongest for small source-receiver distances. The volcanic tremor signal was recorded during the Bardarbunga eruption at Holuhraun in 2014/15. For volcano-related seismic signals it is usually more difficult to determine the source process that generated the tremor. The pre-eruptive tremor persists for 2 weeks, while the co-eruptive tremor lasted for 6 months. We observed no frequency changes, most energy between 1 and 2 Hz and no or very little energy above 5 Hz. We compare the different characteristics of helicopter-related and volcano-related seismic signals and discuss how they can be distinguished. In addition we discuss how we can determine if a frequency change is related to a moving source or change in repeat time or a change in the geometry of the resonating body.

  8. Study of relation between Neck Shaft Angle (NSA and mineral density of the femoral head among old post menopausal women in east part of mazandaran province

    Directory of Open Access Journals (Sweden)

    Majid Malekzadeh Shafaroudi

    2016-09-01

    Full Text Available Background: Diversity in Proximal Femur Geometric Parameters (PFGPs will be led to frequency changes in hip fractures. The purpose of the present study is to investigate of the relation between Bone Mineral Density (BMD in proximal femur with Neck Shaft Angle (NSA in both of osteoporotic and normal groups among old postmenopausal women in eastern part of Mazandaran province as a appropriate indicator to predict hip fractures occurance. Materials and Methods: Among 5103 postmenopausal women reffered to bone densitometry center, for 221 postmenopausal women who had inclusion criteria to this study, simultaneously by using densitometry system and completing a standard questionnaire, history of disease and demographic information including body mass index (BMI were recorded for each patient. Obtained information from densitometers was analyzed by the statistical software SPSS version 16 and Pearson correlation coefficient test was used. Results: Geometric parameters of 221 post-menopausal women aged 50 to 60 were analyzed. The mean of neck shaft angle (NSA were recorded for osteoporotic group 121.55 and for control group 121.44. Pearson correlation coefficient t-test results showed a negative significant correlation between mineral density in the femoral neck in osteoporotic group and NSA (P<0.05. Considering the effect of weight and BMI in strength and bone density in the femoral neck, the mean of BMI and weight in osteoporotic group was lower compared to control group. Conclusion: according to the findings of this study, NSA is effective in predicting of the proximal femur BMD in osteoporotic group.

  9. Tectonic Tremor analysis with the Taiwan Chelungpu-Fault Drilling Program (TCDP) downhole seismometer array

    Science.gov (United States)

    Lin, Y.; Hillers, G.; Ma, K.; Campillo, M.

    2011-12-01

    We study tectonic tremor activity in the Taichung area, Taiwan, analyzing continuous seismic records from 6 short-period sensors of the TCDP borehole array situated around 1 km depth. The low background noise level facilitates the detection of low-amplitude tectonic tremor and low-frequency earthquake (LFE) waveforms. We apply a hierarchical analysis to first detect transient amplitude increases, and to subsequently verify its tectonic origin, i.e. to associate it with tremor signals. The frequency content of tremor usually exceeds the background noise around 2-8 Hz; hence, in the first step, we use BHS1, BHS4 and BHS7 (top, center, bottom sensor) records to detect amplitude anomalies in this frequency range. We calculate the smoothed spectra of 30 second non-overlapping windows taken daily from 5 night time hours to avoid increased day time amplitudes associated with cultural activities. Amplitude detection is then performed on frequency dependent median values of 5 minute advancing, 10 minute long time windows, yielding a series of threshold dependent increased-energy spectra-envelopes, indicating teleseismic waveforms, potential tremor records, or other transients related to anthropogenic or natural sources. To verify the transients' tectonic origin, potential tremor waveforms detected by the amplitude method are manually picked in the time domain. We apply the Brown et al. (2008) LFE matched filter technique to three-component data from the 6 available sensors. Initial few-second templates are taken from the analyst-picked, minute-long segments, and correlated component-wise with 24-h data. Significantly increased similarity between templates and matched waveform segments is detected using the array-average 7-fold MAD measure. Harvested waveforms associated with this initial `weak' detection are stacked, and the thus created master templates are used in an iterative correlation procedure to arrive at robust LFE detections. The increased similarity of waveforms

  10. Deep Brain Stimulation Salvages a Flourishing Dental Practice: A Dentist with Essential Tremor Recounts his Experience.

    Science.gov (United States)

    Giacopuzzi, Guy; Lising, Melanie; Halpern, Casey H

    2016-10-22

    In recounting his experience with deep brain stimulation (DBS), a practicing dentist challenged with long-standing bilateral essential tremor of the hands shares insights into his diagnosis, treatments, and ultimately successful DBS surgery at Stanford University Medical Center, CA, USA. Now nearly one year after his surgery, his practice continues to flourish and he encourages others in his profession to consider the possibility of DBS as a definitive treatment for tremors of the hand, which may salvage their practice.

  11. Study of Tectonic Tremor in Depth: Triggering Stress Observation and Model of the Triggering Mechanism

    Science.gov (United States)

    Wang, Tien-Huei

    Non-volcanic tremor (NVT) has been discovered in recent years due to advances in seismic instruments and increased density of seismic networks. The NVT is a special kind of seismic signal indicative of the physical conditions and the failure mechanism on the source on the fault where NVT occurs. The detection methods used and the sensitivity of them relies on the density, distance and instrumentation of the station network available. How accurately the tremor is identified in different regions varies greatly among different studies. Therefore, there has not been study that rigorously documents tectonic tremors in different regions under limited methods and data. Meanwhile, many incidences of NVTs are observed during or after small but significant strain change induced by teleseismic, regional or local earthquake. The understanding of the triggering mechanisms critical for tremor remains unclear. In addition, characteristics of the triggering of NVT in different regions are rarely compared because of the short time frame after the discovery of the triggered NVTs. We first explore tectonic tremor based on observations to learn about its triggering, frequency of occurrence, location and spectral characteristics. Then, we numerically model the triggering of instability on the estimated tremor-source, under assumptions fine-tuned according to previous studies (Thomas et al., 2009; Miyazawa et al., 2005; Hill, 2008; Ito, 2009; Rubinstein et al., 2007; Peng and Chao, 2008). The onset of the slip reveals that how and when the external loading triggers tremor. It also holds the information to the background stress conditions under which tremor source starts with. We observe and detect tremor in two regions: Anza and Cholame, along San Jacinto Fault (SJF) and San Andreas Fault (SAF) respectively. These two sections of the faults, relative to general fault zone on which general earthquakes occur, are considered transition zones where slip of slow rates occurs. Slip events

  12. Diffusion tractography imaging-guided frameless linear accelerator stereotactic radiosurgical thalamotomy for tremor: case report.

    Science.gov (United States)

    Kim, Won; Sharim, Justin; Tenn, Stephen; Kaprealian, Tania; Bordelon, Yvette; Agazaryan, Nzhde; Pouratian, Nader

    2018-01-01

    Essential tremor and Parkinson's disease-associated tremor are extremely prevalent within the field of movement disorders. The ventral intermediate (VIM) nucleus of the thalamus has been commonly used as both a neuromodulatory and neuroablative target for the treatment of these forms of tremor. With both deep brain stimulation and Gamma Knife radiosurgery, there is an abundance of literature regarding the surgical planning, targeting, and outcomes of these methodologies. To date, there have been no reports of frameless, linear accelerator (LINAC)-based thalomotomies for tremor. The authors report the case of a patient with tremor-dominant Parkinson's disease, with poor tremor improvement with medication, who was offered LINAC-based thalamotomy. High-resolution 0.9-mm isotropic MR images were obtained, and simulation was performed via CT with 1.5-mm contiguous slices. The VIM thalamic nucleus was determined using diffusion tensor imaging (DTI)-based segmentation on FSL using probabilistic tractography. The supplemental motor and premotor areas were the cortical target masks. The authors centered their isocenter within the region of the DTI-determined target and treated the patient with 140 Gy in a single fraction. The DTI-determined target had coordinates of 14.2 mm lateral and 8.36 mm anterior to the posterior commissure (PC), and 3 mm superior to the anterior commissure (AC)-PC line, which differed by 3.30 mm from the original target determined by anatomical considerations (15.5 mm lateral and 7 mm anterior to the PC, and 0 mm superior to the AC-PC line). There was faint radiographic evidence of lesioning at the 3-month follow-up within the target zone, which continued to consolidate on subsequent scans. The patient experienced continued right upper-extremity resting tremor improvement starting at 10 months until it was completely resolved at 22 months of follow-up. Frameless LINAC-based thalamotomy guided by DTI-based thalamic segmentation is a feasible method

  13. Complex Non-volcanic Tremor in Guerrero Mexico Triggered by the 2010 Mw 8.8 Chilean Earthquake

    Science.gov (United States)

    Zigone, D.; Campillo, M.; Husker, A. L.; Kostoglodov, V.; Payero, J. S.; Frank, W.; Shapiro, N. M.; Voisin, C.; Cougoulat, G.; Cotte, N.

    2010-12-01

    In this study we analyze the tremors triggered in Guerrero region (Mexico) by the 2010 magnitude 8.8 Chilean Earthquake using mini-seismic array data from the French-Mexican G-GAP project and broadband data from the Servicio Sismologico Nacional of Mexico. The strong dynamic shaking by the earthquake produced the first observed triggered non-volcanic tremors (NVT) in Mexico so far with at least 3 different types of tremors at different time scales. There was a slow slip event (SSE) occurring at the time of the earthquake, which may have increased the probability of tremor triggering in the region. The first type of observed triggered tremors occurred during the S waves, Love waves and Rayleigh waves as already reported in other subductions zones and continental faults (Miyazawa and Mori, 2005, 2006; Rubinstein et al., 2007; Gomberg et al., 2008; Peng et al, 2009…). The greatest amount of energy and duration accompanies the long-period Rayleigh waves, with smaller bursts during the S and Love waves. For this particular tremor we observed the dispersion of Rayleigh waves in the envelopes of triggered tremors, which indicates a very strong modulation of the source by the passing surface wave. An unexpected short-term tremor occurred approximately one hour later of the arrival of the surface waves on the coastal stations. The NVT has only been previously observed at distances > 100 km inland. It also has a shorter frequency range (3-6 Hz) than other NVT (1-10 Hz) observed in the region. Finally, we observed a significant increase of so-called ambient tremor activity with higher intensity than all triggered NVT during the days after the earthquake. This study adds new types of tremors to the lexicon of triggered NVT observed in the world.

  14. Limited role of I-123 IPT SPECT in differentiating essential tremor from early stage of Parkinson's disease

    International Nuclear Information System (INIS)

    Yoo, Y. H.; Yoon, M. J.; Lee, J. D.; Kim, J. H.; Lee, E.; Kim, H. S.; Choi, T. H.

    2002-01-01

    The study was to assess clinically applicable cut-off value in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups on I-123 IPT SPECT using dual head gamma camera both quantitatively and qualitatively. 50 NL (mean age 27.9), 20 early PD patients (mean age 58.2), 30 advanced PD patients (mean age 63.1) and 20 ET patients (mean age 39.9) were included and performed brain SPECT 2 hours after administration of I-123 IPT using dual head gamma camera. Recostructed SPECT data were assessed for specific/nonspecific binding ratio of striatum using (RBG-OCC/OCC, LBG-OCC/OCC) ratio. RBG-OCC/OCC and LBG-OCC/OCC ratio was decreased with increasing grade of H-Y stage in PD. Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific bonding ratio were observed between early PD group and ET group. Suggested cut-off value of striatal binding ratio which can diagnose PD would be 2.1. Although I-123 IPT SPECT may be a useful method for the diagnosis of advanced PD and objective evaluation of progress of clinical stages, care should be made in the differential diagnosis of subclinical and early stage of PD and other motor distubances mimicking PD such as ET in view of significant overlap in striatal I-123 IPT specific/nonspecific binding ratio

  15. Is HEADS in our heads?

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Hertz, Pernille Grarup; Blix, Charlotte

    2016-01-01

    contraception], Safety, Self-harm) interview is a feasible way of exploring health risk behaviors and resilience. OBJECTIVE: The purpose of this study was to evaluate how often HEADS topics were addressed according to young patients and staff in pediatric and adult outpatient clinics. METHODS: We conducted...... care professionals participated. We found only small reported differences between staff and young patients regarding whether home, education, and activity were addressed. However, staff reported twice the rate of addressing smoking, alcohol, illegal drugs, sexuality, and contraception compared to young...... patients. Young patients reported that smoking, alcohol, illegal drugs, sexuality, and contraception were addressed significantly more at adult clinics in comparison to pediatric clinics. After controlling for age, gender and duration of illness, according to young patients, adjusted odds ratios...

  16. Identification of a Divergent Lineage Porcine Pestivirus in Nursing Piglets with Congenital Tremors and Reproduction of Disease following Experimental Inoculation.

    Science.gov (United States)

    Arruda, Bailey L; Arruda, Paulo H; Magstadt, Drew R; Schwartz, Kent J; Dohlman, Tyler; Schleining, Jennifer A; Patterson, Abby R; Visek, Callie A; Victoria, Joseph G

    2016-01-01

    Congenital tremors is a sporadic disease of neonatal pigs characterized by action-related repetitive myoclonus. A majority of outbreaks of congenital tremors have been attributed to an unidentified virus. The objectives of this project were to 1) detect potential pathogen(s) in samples from piglets with congenital tremors and 2) develop an infection model to reproduce disease. Using next-generation sequencing, a divergent lineage pestivirus was detected in piglets with congenital tremors. The virus was originally most closely related to a bat pestivirus but is now more closely related to a recently published novel porcine pestivirus provisionally named atypical porcine pestivirus. A quantitative real-time PCR detected the virus in samples from neonatal piglets with congenital tremors from two separate farms, but not in samples from unaffected piglets from the same farm. To fulfill the second objective, pregnant sows were inoculated with either serum containing the pestivirus or PBS (control) by intravenous and intranasal routes simultaneously with direct inoculation of fetal amniotic vesicles by ultrasound-guided surgical technique. Inoculations were performed at either 45 or 62 days of gestation. All sows inoculated with the novel pestivirus farrowed piglets affected with congenital tremors while PBS-inoculated control piglets were unaffected. Tremor severity for each piglet was scored from videos taken 0, 1 and 2 days post-farrowing. Tremor severity remained relatively constant from 0 to 2 days post-farrowing for a majority of piglets. The prevalence of congenital tremors in pestivirus-inoculated litters ranged from 57% (4 out of 7 affected piglets) to 100% (10 out of 10 affected piglets). The virus was consistently detected by PCR in tissues from piglets with congenital tremors but was not detected in control piglets. Samples positive by PCR in greater than 90% of piglets sampled included brainstem (37 out of 41), mesenteric lymph node (37 out of 41

  17. Identification of a Divergent Lineage Porcine Pestivirus in Nursing Piglets with Congenital Tremors and Reproduction of Disease following Experimental Inoculation.

    Directory of Open Access Journals (Sweden)

    Bailey L Arruda

    Full Text Available Congenital tremors is a sporadic disease of neonatal pigs characterized by action-related repetitive myoclonus. A majority of outbreaks of congenital tremors have been attributed to an unidentified virus. The objectives of this project were to 1 detect potential pathogen(s in samples from piglets with congenital tremors and 2 develop an infection model to reproduce disease. Using next-generation sequencing, a divergent lineage pestivirus was detected in piglets with congenital tremors. The virus was originally most closely related to a bat pestivirus but is now more closely related to a recently published novel porcine pestivirus provisionally named atypical porcine pestivirus. A quantitative real-time PCR detected the virus in samples from neonatal piglets with congenital tremors from two separate farms, but not in samples from unaffected piglets from the same farm. To fulfill the second objective, pregnant sows were inoculated with either serum containing the pestivirus or PBS (control by intravenous and intranasal routes simultaneously with direct inoculation of fetal amniotic vesicles by ultrasound-guided surgical technique. Inoculations were performed at either 45 or 62 days of gestation. All sows inoculated with the novel pestivirus farrowed piglets affected with congenital tremors while PBS-inoculated control piglets were unaffected. Tremor severity for each piglet was scored from videos taken 0, 1 and 2 days post-farrowing. Tremor severity remained relatively constant from 0 to 2 days post-farrowing for a majority of piglets. The prevalence of congenital tremors in pestivirus-inoculated litters ranged from 57% (4 out of 7 affected piglets to 100% (10 out of 10 affected piglets. The virus was consistently detected by PCR in tissues from piglets with congenital tremors but was not detected in control piglets. Samples positive by PCR in greater than 90% of piglets sampled included brainstem (37 out of 41, mesenteric lymph node (37 out of 41

  18. Head Impact Laboratory (HIL)

    Data.gov (United States)

    Federal Laboratory Consortium — The HIL uses testing devices to evaluate vehicle interior energy attenuating (EA) technologies for mitigating head injuries resulting from head impacts during mine/...

  19. Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6 year follow-up

    NARCIS (Netherlands)

    Hariz, M. I.; Krack, P.; Alesch, F.; Augustinsson, L.-E.; Bosch, A.; Ekberg, R.; Johansson, F.; Johnels, B.; Meyerson, B. A.; N'Guyen, J.-P.; Pinter, M.; Pollak, P.; von Raison, F.; Rehncrona, S.; Speelman, J. D.; Sydow, O.; Benabid, A.-L.

    2008-01-01

    To evaluate the results of ventral intermediate (Vim) thalamic deep brain stimulation (DBS) in patients with tremor predominant Parkinson's disease (PD) at 6 years post surgery. This was a prolonged follow-up study of 38 patients from eight centres who participated in a multicentre study, the 1 year

  20. Usefulness of intermuscular coherence and cumulant analysis in the diagnosis of postural tremor

    NARCIS (Netherlands)

    van der Stouwe, A. M. M.; Conway, B. A.; Elting, J. W.; Tijssen, M. A. J.; Maurits, N. M.

    Objective: To investigate the potential value of two advanced EMG measures as additional diagnostic measures in the polymyographic assessment of postural upper-limb tremor. Methods: We investigated coherence as a measure of dependency between two EMG signals, and cumulant analysis to reveal patterns

  1. Randomised controlled trial of escitalopram for cervical dystonia with dystonic jerks/tremor

    NARCIS (Netherlands)

    Zoons, Evelien; Booij, Jan; Delnooz, Catherine C. S.; Dijk, Joke M.; Dreissen, Yasmine E. M.; Koelman, Johannes H. T. M.; van der Salm, Sandra M. A.; Skorvanek, Matej; Smit, Marenka; Aramideh, Majid; Bienfait, Henriette; Boon, Agnita J. W.; Brans, Jeroen W. M.; Hoogerwaard, Edo; Hovestadt, Ad; Kamphuis, Daan J.; Munts, Alexander G.; Speelman, Johannes D.; Tijssen, Marina A. J.

    2018-01-01

    Trials for additional or alternative treatments for cervical dystonia (CD) are scarce since the introduction of botulinum neurotoxin (BoNT). We performed the first trial to investigate whether dystonic jerks/tremor in patients with CD respond to the selective serotonin reuptake inhibitor (SSRI)

  2. GABA(A) receptor- and GABA transporter polymorphisms and risk for essential tremor

    DEFF Research Database (Denmark)

    Thier, S; Kuhlenbäumer, G; Lorenz, D

    2011-01-01

    Background:  Clinical features and animal models of essential tremor (ET) suggest gamma-aminobutyric acid A receptor (GABA(A) R) subunits and GABA transporters as putative candidate genes. Methods:  A total of 503 ET cases and 818 controls were investigated for an association between polymorphisms...

  3. Functional MRI for immediate monitoring stereotactic thalamotomy in a patient with essential tremor

    International Nuclear Information System (INIS)

    Hesselmann, Volker; Schaaf, Maike; Krug, Barbara; Lackner, Klaus; Maarouf, Mohammed; Hunsche, Stefan; Sturm, Volker; Lasek, Kathrin; Wedekind, Christoph

    2006-01-01

    The effect of stereotactic thalamotomy was assessed with pre- and postoperative functional magnetic resonance imaging (fMRI) under motor stimulation. A patient with unilateral essential tremor (ET) of the left arm underwent stereotactically guided thalamotomy of the right ventral intermediate thalamic nucleus (VIM). FMRI was done directly before and after surgery on a 1.5-Tesla scanner. The stimulation paradigm was maintainance of the affected arm in an extended position and hand clenching being performed in a block design manner. Statistical analysis was done with Brain Voyager 2000. After thalamotomy the tremor diminished completely. As a difference between the pre- and postoperative fMRI, a significant activation was found in the VIM contralateral to the activation site, adjacent to the inferior olivary nucleus contralateral to the activation site and in the dorsal cingulum. In conclusion, fMRI can detect the functional effect of thalamotomy for tremor treatment. Direct postoperative fMRI provides a sufficient method for estimating the effect of thalamotomy immediately after intervention. The importance of the intermediate thalamic nucleus and the olivary nucleus in tremor generation is supported by our findings. (orig.)

  4. Polymorphisms in the glial glutamate transporter SLC1A2 are associated with essential tremor

    DEFF Research Database (Denmark)

    Thier, Sandra; Lorenz, Delia; Nothnagel, Michael

    2012-01-01

    Sporadic, genetically complex essential tremor (ET) is one of the most common movement disorders and may lead to severe impairment of the quality of life. Despite high heritability, the genetic determinants of ET are largely unknown. We performed the second genome-wide association study (GWAS...

  5. 5-hydroxytryptamine and Lyme disease. Opportunity for a novel therapy to reduce the cerebellar tremor?

    Science.gov (United States)

    Maximov, G K; Maximov, K G; Chokoeva, A A; Lotti, T; Wollina, U; Patterson, J W; Guarneri, C; Tana, C; Fioranelli, M; Roccia, M G; Kanazawa, N; Tchernev, G

    2016-01-01

    Lyme boreliosis is caused by the spirochete Borrelia burdorferi, which is transmitted by ticks. A 59 year-old woman developed pyrexia, strong headaches, ataxia, dysarthria and tremor of the limbs after a tick bite. She was unable to work and eat on her own. She was hospitalized three times and diagnosed with cerebellar intention tremor, cerebellar ataxia, dysarthria, bilateral horizontal gaze paralysis and a central lesion of the left facial nerve. There were no pyramidal, sensory or psychiatric disturbances. The brain MRI showed multifocal leucoencephalopathy with many hyperintense areas in both hemispheres, as well as in the left superior pedunculus cerebellaris. Diagnosis was confirmed by serologic examination. Treatment with cephtriaxone, doxycycline, methylprednisolone, cephixime and ciprofloxacine was administered without effect on the tremor, ataxia and horizontal gaze paralysis. Treatment was then administered with 5-hydroxytriptamine (5-HT) in increased doses. The result of the three-month treatment with 5-HT was a gradual diminution of the tremor and the ataxia and an increase in the ability to eat, walk and work independently.

  6. Precursory tremor of the Askja Caldera landslide, July 2014 - seismic signal analysis and numerical modelling

    Science.gov (United States)

    Lipovsky, B. P.; Schöpa, A.; Chao, W. A.; Hovius, N.; White, R. S.; Green, R. G.

    2017-12-01

    Seismic records can contain valuable information about triggers and precursors of slope failures that might become useful for early-warning purposes. We investigated the seismic data of 52 stations from the University of Cambridge, UK, with respect to the tremor signals preceding a 20-80x106 m3 landslide at the Askja caldera in the Icelandic highlands on 21 July 2014. The landslide created a tsunami in the caldera lake, which inundated the shore up to 60 m high reaching famous tourist spots. This shows the high hazard potential of the site that motivated this study. About 30 min before the landslide, the seismic ground velocities >1 Hz of stations up to 30 km away from the landslide source area started to increase and the tremor signal reached up to three times the background noise level about 7 min before the landslide. In the spectral domain, the tremor is visible as a continuous, harmonic signal with a fundamental frequency of 2.5 Hz and overtones at 5 and 7.5 Hz. About 10 min before the landslide, the activated frequency bands changed their spectral content and up and down gliding is observed contemporaneously. The tremor signal ceases about 5 min before the high-energy failure of the landslide. We interpret the harmonic tremor before the landslide as stick-slip motion on fault patches at the boundaries of the landslide mass. Individual stick-slip events cannot be distinguished in the seismic data and thus have already merged into continuous tremor as they occur very close in time. As up and down gliding of the frequency bands occurs at the same time we favour an explanation where several fault patches are active simultaneously. One patch might accelerate and create up gliding signals and another patch might decelerate and create down gliding. We matched synthetic seismograms produced by numerical simulations of stick-slip movement and the seismic observations. The results show that a patch with a radius of 45 m and a realistic landslide thickness of 30 m can

  7. Alarm systems detect volcanic tremor and earthquake swarms during Redoubt eruption, 2009

    Science.gov (United States)

    Thompson, G.; West, M. E.

    2009-12-01

    We ran two alarm algorithms on real-time data from Redoubt volcano during the 2009 crisis. The first algorithm was designed to detect escalations in continuous seismicity (tremor). This is implemented within an application called IceWeb which computes reduced displacement, and produces plots of reduced displacement and spectrograms linked to the Alaska Volcano Observatory internal webpage every 10 minutes. Reduced displacement is a measure of the amplitude of volcanic tremor, and is computed by applying a geometrical spreading correction to a displacement seismogram. When the reduced displacement at multiple stations exceeds pre-defined thresholds and there has been a factor of 3 increase in reduced displacement over the previous hour, a tremor alarm is declared. The second algorithm was to designed to detect earthquake swarms. The mean and median event rates are computed every 5 minutes based on the last hour of data from a real-time event catalog. By comparing these with thresholds, three swarm alarm conditions can be declared: a new swarm, an escalation in a swarm, and the end of a swarm. The end of swarm alarm is important as it may mark a transition from swarm to continuous tremor. Alarms from both systems were dispatched using a generic alarm management system which implements a call-down list, allowing observatory scientists to be called in sequence until someone acknowledged the alarm via a confirmation web page. The results of this simple approach are encouraging. The tremor alarm algorithm detected 26 of the 27 explosive eruptions that occurred from 23 March - 4 April. The swarm alarm algorithm detected all five of the main volcanic earthquake swarm episodes which occurred during the Redoubt crisis on 26-27 February, 21-23 March, 26 March, 2-4 April and 3-7 May. The end-of-swarm alarms on 23 March and 4 April were particularly helpful as they were caused by transitions from swarm to tremor shortly preceding explosive eruptions; transitions which were

  8. 76 FR 70009 - Head Start Program

    Science.gov (United States)

    2011-11-09

    ... importance of the early years of a child's growth and development. On December 12, 2007, the Improving Head... education, serving nearly one million of our nation's most vulnerable young children and their families. It... Administration for Children and Families 45 CFR Part 1307 Head Start Program; Final Rule #0;#0;Federal Register...

  9. CaV3.1 is a tremor rhythm pacemaker in the inferior olive

    Science.gov (United States)

    Park, Young-Gyun; Park, Hye-Yeon; Lee, C. Justin; Choi, Soonwook; Jo, Seonmi; Choi, Hansol; Kim, Yang-Hann; Shin, Hee-Sup; Llinas, Rodolfo R.; Kim, Daesoo

    2010-01-01

    The rhythmic motor pathway activation by pacemaker neurons or circuits in the brain has been proposed as the mechanism for the timing of motor coordination, and the abnormal potentiation of this mechanism may lead to a pathological tremor. Here, we show that the potentiation of CaV3.1 T-type Ca2+ channels in the inferior olive contributes to the onset of the tremor in a pharmacological model of essential tremor. After administration of harmaline, 4- to 10-Hz synchronous neuronal activities arose from the IO and then propagated to cerebellar motor circuits in wild-type mice, but those rhythmic activities were absent in mice lacking CaV3.1 gene. Intracellular recordings in brain-stem slices revealed that the CaV3.1-deficient inferior olive neurons lacked the subthreshold oscillation of membrane potentials and failed to trigger 4- to 10-Hz rhythmic burst discharges in the presence of harmaline. In addition, the selective knockdown of CaV3.1 gene in the inferior olive by shRNA efficiently suppressed the harmaline-induced tremor in wild-type mice. A mathematical model constructed based on data obtained from patch-clamping experiments indicated that harmaline could efficiently potentiate CaV3.1 channels by changing voltage-dependent responsiveness in the hyperpolarizing direction. Thus, CaV3.1 is a molecular pacemaker substrate for intrinsic neuronal oscillations of inferior olive neurons, and the potentiation of this mechanism can be considered as a pathological cause of essential tremor. PMID:20498062