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

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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.

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

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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.

Cortical tremor: a variant of cortical reflex myoclonus.

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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.

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

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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.

Psychogenic Stress in Hospitalized Dogs: Cross Species Comparisons, Implications for Health Care, and the Challenges of Evaluation

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Jessica P. Hekman

2014-06-01

Full Text Available Evidence to support the existence of health consequences of psychogenic stress has been documented across a range of domestic species. A general understanding of methods of recognition and means of mitigation of psychogenic stress in hospitalized animals is arguably an important feature of the continuing efforts of clinicians to improve the well-being and health of dogs and other veterinary patients. The intent of this review is to describe, in a variety of species: the physiology of the stress syndrome, with particular attention to the hypothalamic-pituitary-adrenal axis; causes and characteristics of psychogenic stress; mechanisms and sequelae of stress-induced immune dysfunction; and other adverse effects of stress on health outcomes. Following that, we describe general aspects of the measurement of stress and the role of physiological measures and behavioral signals that may predict stress in hospitalized animals, specifically focusing on dogs.

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

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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

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

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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

Strategies to Improve Regeneration of the Soft Palate Muscles After Cleft Palate Repair

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Carvajal Monroy, Paola L.; Grefte, Sander; Kuijpers-Jagtman, Anne Marie; Wagener, Frank A.D.T.G.

2012-01-01

Children with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. These patients are unable to separate the nasal from the oral cavity leading to air loss during speech. Although surgical repair ameliorates soft palate function by joining the clefted muscles of the soft palate, optimal function is often not achieved. The regeneration of muscles in the soft palate after surgery is hampered because of (1) their low intrinsic regenerative capacity, (2) the muscle properties related to clefting, and (3) the development of fibrosis. Adjuvant strategies based on tissue engineering may improve the outcome after surgery by approaching these specific issues. Therefore, this review will discuss myogenesis in the noncleft and cleft palate, the characteristics of soft palate muscles, and the process of muscle regeneration. Finally, novel therapeutic strategies based on tissue engineering to improve soft palate function after surgical repair are presented. PMID:22697475

Reversible Holmes' tremor due to spontaneous intracranial hypotension.

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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.

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

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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

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

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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.

Surface-wave potential for triggering tectonic (nonvolcanic) tremor

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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.

The Dancing Manias: Psychogenic Illness as a Social Phenomenon.

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Lanska, Douglas J

2018-01-01

The dancing mania erupted in the 14th century in the wake of the Black Death, and recurred for centuries in central Europe - particularly Germany, the Netherlands, and Belgium - finally abating in the early 17th century. The term "dancing mania" was derived from "choreomania," a concatenation of choros (dance) and mania (madness). A variant, tarantism, was prevalent in southern Italy from the 15th to the 17th centuries, and was attributed at the time to bites from the tarantula spider. Affected individuals participated in continuous, prolonged, erratic, often frenzied and sometimes erotic, dancing. In the 14th century, the dancing mania was linked to a corruption of the festival of St. John's Day by ancient pagan customs, but by the 16th century it was commonly considered an ordeal sent by a saint, or a punishment from God for people's sins. Consequently, during outbreaks in the 14th and 15th centuries, the dancing mania was considered an issue for magistrates and priests, not physicians, even though the disorder proved intractable to decrees and exorcisms. However, in the 16th century Paracelsus discounted the idea that the saints caused or interceded in the cure of the dancing mania; he instead suggested a psychogenic or malingered etiology, and this reformulation brought the dancing mania within the purview of physicians. Paracelsus advocated various mystical, psychological, and pharmacological approaches, depending on the presumptive etiologic factors with individual patients. Only music provided any relief for tarantism. Later authors suggested that the dancing mania was a mass stress-induced psychosis, a mass psychogenic illness, a culturally determined form of ritualized behavior, a manifestation of religious ecstasy, or even the result of food poisoning caused by the toxic and psychoactive chemical products of ergot fungi. In reality, dancing manias did not have a single cause, but component causes likely included psychogenic illness, malingering, and

[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.

Sustained Medication Reduction Following Unilateral VIM Thalamic Stimulation for Essential Tremor

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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. 

Rethinking the Psychogenic Model of Complex Regional Pain Syndrome: Somatoform Disorders and Complex Regional Pain Syndrome

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Hill, Renee J.; Chopra, Pradeep; Richardi, Toni

2012-01-01

Abstract Explaining the etiology of Complex Regional Pain Syndrome (CRPS) from the psychogenic model is exceedingly unsophisticated, because neurocognitive deficits, neuroanatomical abnormalities, and distortions in cognitive mapping are features of CRPS pathology. More importantly, many people who have developed CRPS have no history of mental illness. The psychogenic model offers comfort to physicians and mental health practitioners (MHPs) who have difficulty understanding pain maintained by newly uncovered neuro inflammatory processes. With increased education about CRPS through a biopsychosocial perspective, both physicians and MHPs can better diagnose, treat, and manage CRPS symptomatology. PMID:24223338

Trauma, stress, and preconscious threat processing in patients with psychogenic nonepileptic seizures

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Bakvis, P.; Roelofs, K.; Kuyk, J.; Edelbroek, P.M.; Swinkels, W.A.M.; Spinhoven, P.

2009-01-01

Psychogenic nonepileptic seizures (PNES) have long been considered as paroxysmal dissociative symptoms characterized by an alteration of attentional functions caused by severe stress or trauma. Although interpersonal trauma is common in PNES, the proposed relation between trauma and attentional

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

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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

Autosomal dominant cortical tremor, myoclonus and epilepsy.

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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.

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

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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.

Fragile X-associated tremor/ataxia syndrome.

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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.

Treatment of lithium induced tremor with atenolol.

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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.

Tremor da escrita: relato de caso

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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.

Cleft Lip and Cleft Palate

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... health conditions > Cleft lip and cleft palate Cleft lip and cleft palate E-mail to a friend Please fill in ... repair cleft lip and palate. What are cleft lip and cleft palate? Cleft lip is a birth defect in which ...

Tremor - self-care

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... 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 ...

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

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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

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

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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

[Psychogenic paroxysmal disorders in children].

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Mulas, F; Morant, A

Paroxystic psychic disorders which imitate organic disorders of the nervous system may have peripheral effects, present as changes in level of consciousness or appear as paroxystic behaviour changes. The types of crises of psychological origin are: tantrums, panic attacks, crises of psychopathic rage, onanism or masturbation, epileptic pseudocrises or pseudoconvulsions and Munchausen's syndrome. In general psychic crises are not frequent in infancy: tantrums are commoner in small children and the other conditions usually occur after puberty or during adolescence. The anamnesis is the most important factor in the correct diagnosis of psychogenic paroxystic disorders. Complementary studies are done in doubtful cases, to rule out different pathological processes which might be causing the paroxystic disorder. Amongst these investigations, we emphasize the importance of the video-EEG for differential diagnosis of paroxystic disorders in children.

3-D shape analysis of palatal surface in patients with unilateral complete cleft lip and palate.

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Rusková, Hana; Bejdová, Sárka; Peterka, Miroslav; Krajíček, Václav; Velemínská, Jana

2014-07-01

Facial development of patients with unilateral complete cleft lip and palate (UCLP) is associated with many problems including deformity of the palate. The aim of this study was to evaluate palatal morphology and variability in patients with UCLP compared with Czech norms using methods of geometric morphometrics. The study was based on virtual dental cast analysis of 29 UCLP patients and 29 control individuals at the age of 15 years. The variability of palatal shape in UCLP patients was greater than that in nonclefted palates. Only 24% of clefted palates fell within the variability of controls. The palatal form of UCLP patients (range from 11.8 to 17.2 years) was not correlated with age. Compared with control palates, palates of UCLP patients were narrower, more anteriorly than posteriorly. Apart from the praemaxilla region, they were also shallower, and the difference increased posteriorly. The UCLP palate was characterised by the asymmetry of its vault. The maximum height of the palatal vault was anterior on the clefted side, whereas it was posterior on the nonclefted side. The slope of the UCLP palate was more inclined compared with the control group. The praemaxilla was therefore situated more inferiorly. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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.

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.

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

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

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

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.

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.

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

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.

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.

Estimulação cerebral contínua (DBS talâmica para controle do tremor Deep brain stimulation of VIM thalamic nucleus for tremor control

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José Augusto Nasser

2002-06-01

Full Text Available OBJETIVO: Apresentamos resultados da estimulação contínua do núcleo ventral intermédio (VIM talâmico para o controle do tremor. MÉTODO: Quatro pacientes foram selecionados no período de outubro de 1999 a janeiro de 2001 com tremor incapacitante refratário à farmacoterapia. Dois pacientes apresentavam tremor essencial (TE bilateral e 2 pacientes tremor de repouso por doença de Parkinson (DP, um à direita e outro à esquerda. Após avaliação sistemática, foram submetidos ao implante de eletrodo talâmico, modelo DBS 3387(Medtronic, para estimulação cerebral profunda (ECP com alta frequência, sendo este bilateral nos casos de TE e unilateral nos casos com tremor por DP. RESULTADOS: Os pacientes tiveram seu seguimente clínico até o presente, com média de 12 meses, sendo observada a eficácia da estimulação do núcleo VIM no controle dos disparos das células do tremor. As complicações temporárias do tipo parestesias, disartrias e discreto aumento do tônus foram revertidas após o ajuste dos parâmetros de estimulação. CONCLUSÃO: Os resultados confirmam os achados da literatura, de que a estimulação talâmica é excelente opção terapêutica no tratamento do tremor, havendo possibilidade de estimulação talâmica bilateral simultânea com segurança.PURPOSE: We present our results in 4 patients with tremor, in whom electrodes (uni and bilateral for Deep Brain Stimulation (DBS were implanted in the ventral intermediate nucleus (VIM of the thalamus. METHOD: Four patients with disabling tremor, with drug-resistant spite of optimum therapeutic trials with poor response were referred to do surgery. Two patients had bilateral essential tremor. These patients were implanted with electrodes for DBS 3387 (Medtronic. Two patients had unilateral parkinsonian tremor and they received unilateral implantation of model 3387 DBS. RESULTS: All four patients showed relieve of the tremor symptoms with significant tremor control seen at

Correlation of Palatal Rugoscopy with Gender, Palatal Vault Height ...

African Journals Online (AJOL)

Background: Palatal rugae (PR) are asymmetrical irregular elevations, recorded during maxillary cast fabrication , that can be used for identification purpose if previous comparative sources are available. Aim: This study investigated uniqueness of PR patterns in relation to gender, palatal vault forms, and ABO blood groups ...

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 ...

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

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.

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

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.

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.

Mass Psychogenic Illness: Demography and Symptom Profile of an Episode

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Binoy Krishna Tarafder

2016-01-01

Full Text Available Background. Mass psychogenic illness has been a recurrent phenomenon in Bangladesh over recent times. Objectives. This study was aimed at investigating the demographic characteristics and symptom profile of an outbreak of mass psychogenic illness occurring in a girls’ high school. Methods and Materials. In 14 April 2013, a total of 93 students of a girls’ high school suddenly developed various symptoms following intake of tiffin cake which resulted in panic and hospital admission. A descriptive, cross-sectional observational survey was done to define various characteristics of the outbreak. Results. No organic explanation for the reported illnesses was found. 93 female students were included who were hospitalized during the incident. Trigger factor was found in 98% of students. Most of the students were 13 years old. Average interval between exposure to the trigger and onset of symptoms was 151.5 minutes. Commonest symptoms were abdominal pain (83%, headache (73%, chest pain (69%, body ache (63%, nausea (69%, and generalized weakness and fatigue (61%. Hospital stay following the incident was about 12 hours on average. Conclusion. To avoid unnecessary panic in the community a prompt, coordinated response is important in resolving widespread community anxiety surrounding these episodes.

Mass Psychogenic Illness: Demography and Symptom Profile of an Episode

Science.gov (United States)

Tarafder, Binoy Krishna; Khan, Mohammad Ashik Imran; Islam, Md. Tanvir; Mahmud, Sheikh Abdullah Al; Sarker, Md. Humayun Kabir; Faruq, Imtiaz; Miah, Md. Titu; Arafat, S. M. Yasir

2016-01-01

Background. Mass psychogenic illness has been a recurrent phenomenon in Bangladesh over recent times. Objectives. This study was aimed at investigating the demographic characteristics and symptom profile of an outbreak of mass psychogenic illness occurring in a girls' high school. Methods and Materials. In 14 April 2013, a total of 93 students of a girls' high school suddenly developed various symptoms following intake of tiffin cake which resulted in panic and hospital admission. A descriptive, cross-sectional observational survey was done to define various characteristics of the outbreak. Results. No organic explanation for the reported illnesses was found. 93 female students were included who were hospitalized during the incident. Trigger factor was found in 98% of students. Most of the students were 13 years old. Average interval between exposure to the trigger and onset of symptoms was 151.5 minutes. Commonest symptoms were abdominal pain (83%), headache (73%), chest pain (69%), body ache (63%), nausea (69%), and generalized weakness and fatigue (61%). Hospital stay following the incident was about 12 hours on average. Conclusion. To avoid unnecessary panic in the community a prompt, coordinated response is important in resolving widespread community anxiety surrounding these episodes. PMID:27294104

Psychogenic Explanations of Physical Illness: Time to Examine the Evidence.

Science.gov (United States)

Wilshire, Carolyn E; Ward, Tony

2016-09-01

In some patients with chronic physical complaints, detailed examination fails to reveal a well-recognized underlying disease process. In this situation, the physician may suspect a psychological cause. In this review, we critically evaluated the evidence for this causal claim, focusing on complaints presenting as neurological disorders. There were four main conclusions. First, patients with these complaints frequently exhibit psychopathology but not consistently more often than patients with a comparable "organic" diagnosis, so a causal role cannot be inferred. Second, these patients report a high incidence of adverse life experiences, but again, there is insufficient evidence to indicate a causal role for any particular type of experience. Third, although psychogenic illnesses are believed to be more responsive to psychological interventions than comparable "organic" illnesses, there is currently no evidence to support this claim. Finally, recent evidence suggests that biological and physical factors play a much greater causal role in these illnesses than previously believed. We conclude that there is currently little evidential support for psychogenic theories of illness in the neurological domain. In future research, researchers need to take a wider view concerning the etiology of these illnesses. © The Author(s) 2016.

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...

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

Evidence-Based Medicine: Cleft Palate.

Science.gov (United States)

Woo, Albert S

2017-01-01

After studying this article, the participant should be able to: 1. Describe the incidence of cleft palate and risk factors associated with development of an orofacial cleft. 2. Understand differences among several techniques to repair clefts of both the hard and soft palates. 3. Discuss risk factors for development of postoperative fistulas, velopharyngeal insufficiency, and facial growth problems. 4. Establish a treatment plan for individualized care of a cleft palate patient. Orofacial clefts are the most common congenital malformations of the head and neck region, and approximately three-quarters of these patients have some form of cleft palate deformity. Cleft palate repair is generally performed in children between 6 and 12 months of age. The goals of palate repair are to minimize the occurrence of fistulas, establish a normal velopharyngeal mechanism, and optimize facial growth. This Maintenance of Certification review discusses the incidence and epidemiology associated with cleft palate deformity and specifics associated with patient care, including analgesia, surgical repair techniques, and complications associated with repair of the cleft palate.

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.

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

Vulnerability to psychogenic non-epileptic seizures is linked to low neuropeptide Y levels

DEFF Research Database (Denmark)

Winterdahl, Michael; Miani, Alessandro; Vercoe, Moana

2017-01-01

Psychogenic non-epileptic seizures (PNES) is a conversion disorder that reflects underlying psychological distress. Female patients with PNES often present with a history of prolonged stressors, especially sexual abuse. In the current study, we studied the relationship between neuropeptide Y (NPY...

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.

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.

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.

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...

Cleft Palate Foundation

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... craniofacial journeys. Read the press release here. American Cleft Palate-Craniofacial Association 1504 East Franklin Street, Suite 102 ... order bottles Order ACPA publications © Copyright 2017 American Cleft Palate-Craniofacial Association. Website by Mixer Creative Follow us ...

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.)

Delayed closure of the palatal defect using buccal inversion and palatal rotation flaps after maxillectomy.

Science.gov (United States)

Jung, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Oh, Hee-Kyun

2013-03-01

Maxillectomy leaves oronasal and oroantral defects that result in functional impairment of mastication, deglutition, and speech. Many treatment options are suggested and tried including the palatal flap as local flap. Although palatal flaps have been used to repair various oral cavity defects, they have certain limitations due to the dimensions. The amount and location of the palatal tissues available are important for palatal repair. Secondary intentional healing after maxillectomy will allow the epithelialization of the defect margin adjacent to remained palate, and there will be more mucosa that is available for closure of the defect. We delayed the closure of the palatal defect, while the patient underwent prosthetic treatment for functional recovery in 5 maxillectomy patients. Delayed closure of palatal defect with local flap was done at 10.8 ± 7.9 months after the maxillectomy. While delayed closure in hemimaxillectomy patients left postoperative fistula, it provided separation of the oral cavity and nasal/sinus cavity and adequate surface for prosthesis in partial maxillectomy patients.

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.

Extent of palatal lengthening after cleft palate repair as a contributing factor to the speech outcome.

Science.gov (United States)

Bae, Yong-Chan; Choi, Soo-Jong; Lee, Jae-Woo; Seo, Hyoung-Joon

2015-03-01

Operative techniques in performing cleft palate repair have gradually evolved to achieve better speech ability with its main focus on palatal lengthening and accurate approximation of the velar musculature. The authors doubted whether the extent of palatal lengthening would be directly proportional to the speech outcome. Patients with incomplete cleft palates who went into surgery before 18 months of age were intended for this study. Cases with associated syndromes, mental retardation, hearing loss, or presence of postoperative complications were excluded from the analysis. Palatal length was measured by the authors' devised method before and immediately after the cleft palate repair. Postoperative speech outcome was evaluated around 4 years by a definite pronunciation scoring system. Statistical analysis was carried out between the extent of palatal lengthening and the postoperative pronunciation score by Spearman correlation coefficient method. However, the authors could not find any significant correlation. Although the need for additional research on other variables affecting speech outcome is unequivocal, we carefully conclude that other intraoperative constituents such as accurate reapproximation of the velar musculature should be emphasized more in cleft palate repair rather than palatal lengthening itself.

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

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

Influence of different palate repair protocols on facial growth in unilateral complete cleft lip and palate.

Science.gov (United States)

Xu, Xue; Kwon, Hyuk-Jae; Shi, Bing; Zheng, Qian; Yin, Heng; Li, Chenghao

2015-01-01

To address the question of whether one- or two-stage palatal treatment protocol has fewer detrimental effects on craniofacial growth in patients aged 5 years with unilateral complete cleft lip and palate. Forty patients with non-syndromic unilateral complete cleft lip and palate (UCCLPs) who had received primary cleft lip repair at age 6-12 months and cleft palate repair at age 18-30 months were selected in this study. Eighteen UCCLP patients who received two-stage palate repair were selected as group 1, and 22 UCCLP patients who received one-stage palate repair were selected as group 2. The control group consisted of 20 patients with unilateral incomplete cleft lip (UICL patients) whose age and gender matched with UCCLP patients. A one-sample Kolmogorov-Smirnov test was used to analyze the nature of data distribution. Bonferroni test and Kruskal-Wallis H tests were used for multiple comparisons. Both case groups showed reduced maxillary sagittal length (ANS-PMP, A-PM, p palate repair had a reduced posterior maxillary vertical height (R-PMP, p palate repair. Vomer flap repair inhibited maxilla vertical growth. Delayed hard palate repair showed less detrimental effects on maxillary growth compared to early hard palate repair in UCCLP patients aged 5 years. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Mass psychogenic illness after vaccination.

Science.gov (United States)

Clements, C John

2003-01-01

When vaccines are administered to groups, the physical reactions of the recipients may be similar, causing a form of mass reaction, the mechanism for which is the same as that for mass reactions from other causes. These phenomena have been categorised as mass psychogenic illness (MPI), and have been defined as the collective occurrence of a constellation of symptoms suggestive of organic illness but without an identified cause in a group of people with shared beliefs about the cause of the symptom(s). A review of the literature shows that such outbreaks have been reported in differing cultural and environmental settings including developing and industrialised countries, in the work place, on public transport, in schools, and the military. The perceived threats have been against agents such as food poisoning, fire and toxic gases. Whatever the place or perceived threat, the response seems to be similar. The symptoms generally included headache, dizziness, weakness, and loss of consciousness. Once under way, MPIs are not easy to stop. Incidents reported in the literature show that they can quickly gather momentum and can be amplified by the press who disseminate information rapidly, escalating the events. Management of such mass events can be extremely difficult. Should the public health official in charge continue to try and determine the cause, or should this person call off the entire investigation? It is suggested here that once vaccines are identified as a probable cause of the phenomenon, a dismissive approach may actually be harmful. Unless the spokesperson has already earned a high level of trust, the public are not likely to be convinced easily that nothing was wrong with the vaccine until it has been tested. An increased awareness of MPIs on the part of organisers of future mass vaccination campaigns seems appropriate. Immunisation managers should be aware that mass immunisation campaigns could generate such mass reactions. It is therefore essential that

Conventional bone-anchored palatal distractor using an orthodontic palatal expander for the transverse maxillary distraction osteogenesis: technical note.

Science.gov (United States)

Iida, Seiji; Haraguchi, Seiji; Aikawa, Tomonao; Yashiro, Kohtaro; Okura, Masaya; Kogo, Mikihiko

2008-02-01

Surgical-assisted rapid palatal expansion includes various treatment procedures for solving transverse maxillary deficiencies, especially in cases with a matured palatal suture. Recent introduction of the concept of distraction osteogenesis has contributed to generalize this useful treatment and to develop some bone-borne devices that will not cause the problems found in cases treated by tooth-supported palatal expander. This report shows a conventional bone-borne distractor using commercially available orthodontic palatal expansion screws. The distractor consists of 2 parts: one is a commercially available orthodontic palatal expansion screw (Hyrax type, Fan style) and another is a screw-ring, which is one of the attached parts of the mandibular distraction system. The bone screws are inserted transmucosally to the palatal bone via the screw-rings. The palatal distractor can be applied to varied palatal shapes and can expand the palate without any trouble. This conventional palatal distractor may contribute to generalize the transpalatal maxillary distraction osteogenesis for cases with maxillary teeth problems.

Long-term effects of palate repair on craniofacial morphology in patients with unilateral cleft lip and palate.

Science.gov (United States)

Liao, Yu-Fang; Mars, Michael

2005-11-01

To identify the long-term effects of palate repair on craniofacial growth in patients with unilateral cleft lip and palate (UCLP). Retrospective cross-sectional study. Sri Lankan Cleft Lip and Palate Project. Forty-eight adults with nonsyndromic unilateral cleft lip and palate, 29 men and 19 women, had lip repair only (LRO group). Fifty-eight adults with nonsyndromic unilateral cleft lip and palate, 35 men and 23 women, had lip and palate repairs by the age of 9 (LPR group). Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine craniofacial morphology. In the lip and palate repair group, the depth of the bony pharynx (Ba-PMP), the maxillary length at the alveolar level (PMP-A), the effective length of the maxilla (Ar-IZ, Ar-ANS, Ar-A), the maxillary protrusion (S-N-ANS, SNA), the anteroposterior jaw relation (ANS-N-Pog, ANB), and the overjet were smaller than in the lip repair only group. There were no significant differences in the maxillary length at the basal level (PMP-IZ, PMP-ANS) and the anterior and posterior maxillary heights (N-ANS and R-PMP, respectively) in the two groups. Palate repair inhibits the forward displacement of the basal maxilla and anteroposterior development of the maxillary dentoalveolus in patients with unilateral cleft lip and palate. Palate repair has no detrimental effects on the downward displacement of the basal maxilla or on palatal remodeling in patients with unilateral cleft lip and palate.

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.

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.

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

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

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 ...

[Cleft palate repair with a combined method of mucosal flap pushback of the hard palate].

Science.gov (United States)

Zhao, Z; Li, S; Xu, J

1996-03-01

From January of 1992, we applied a combined method to repair cleft palate in 20 patients and received satisfactory results. The method is characterized by pushing back the mucosal flap of the hard palate, a Z-plasty on the nasal mucosa, repositioning the levator muscle to lengthen the palate, circumferential pharyng oplasty using denervated extensor hallucis brevis muscle, without making relaxing incisions and elevating the mucoperiosteal flap, avoiding interference to the greater and lesser palatine vessels and nerves, without relaxing palatal aponeurosis. The advantages of this method are preserving the normal anatomy and function of the palate and nasopharyngeal cavity, improving the function of velopharyngeal closure and minimizing secondary deformities.

[The influence of cognitive-behavioral therapy on the P300 potential in children with psychogenic nonepileptic seizures and tension headache].

Science.gov (United States)

Stolarska-Weryńska, Urszula; Steczkowska, Małgorzata; Kaciński, Marek

2016-01-01

Explaining associations between neurophysiological and neuropsychological parameteres in children and improving the measurement methods would lead to a better understanding of the pathogenesis and course of psychosomatic disease. Goal: clinical assessment of the efficacy of cognitive-behavioral therapy in the treatment of psychogenic no- nepileptic seizures and tension type headaches in children. Determining the influence of cognitive behavioral therapy on the cognitive P300 potential and whether P300 parameters in children correlate with neuropsychological parameters. 20 children with nonepileptic psychogenic seizures and 30 children with tension type headaches, aged 11.3 - 17.11 years. The final diagnosis was made in the Paediatric Neurology Clinic. The P300 examination was performed before/after therapy, with/without hyperventilation. A fixed structure therapy was implemented (10 sessions, 90 minutes each), during two weeks of hospitalization or in an outpatient clinic (9 children with tension type headache). The psychological assessment comprised of temperament questionnaires, auditory and visual memory trials, executive function and attention trials, and in some cases also intelligence testing. More significant correlations were found in children with psychogenic seizures: attention parameters correlated negatively with reaction time, and this correlation tended to fade in the second examination, after psychotherapy. In children with tension type headache a statistically insignificant tendency was found of a positive correlation between those parameters. Medium P300 parameteres in this group were better. In 17/20 of children with psychogenic seizures a clinical improvement was observed, in 3 children the symptoms persisted in a 6 month follow up, but of a lower frequency. In 11/27 of chil- dren with tension headache the symptoms persisted, also with a lower frequency. cognitive-behavioral therapy is effective in the reduction of symptoms in many cases of

Thermogenic and psychogenic recruitment of human eccrine sweat glands: Variations between glabrous and non-glabrous skin surfaces.

Science.gov (United States)

Machado-Moreira, Christiano A; Taylor, Nigel A S

2017-04-01

Human eccrine sweat-gland recruitment and secretion rates were investigated from the glabrous (volar) and non-glabrous hand surfaces during psychogenic (mental arithmetic) and thermogenic stimuli (mild hyperthermia). It was hypothesised that these treatments would activate glands from both skin surfaces, with the non-thermal stimulus increasing secretion rates primarily by recruiting more sweat glands. Ten healthy men participated in two seated, resting trials in temperate conditions (25-26°C). Trials commenced under normothermic conditions during which the first psychogenic stress was applied. That was followed by passive heating (0.5°C mean body temperature elevation) and thermal clamping, with a second cognitive challenge then applied. Sudomotor activity was evaluated from both hands, with colourimetry used to identify activated sweat glands, skin conductance to determine the onset of precursor sweating and ventilated sweat capsules to measure rates of discharged sweating. From glandular activation and sweat rate data, sweat-gland outputs were derived. These psychogenic and thermogenic stimuli activated sweat glands from both the glabrous and non-glabrous skin surfaces, with the former dominating at the glabrous skin and the latter at the non-glabrous surface. Indeed, those stimuli individually accounted for ~90% of the site-specific maximal number of activated sweat glands observed when both stimuli were simultaneously applied. During the normothermic psychological stimulation, sweating from the glabrous surface was elevated via a 185% increase in the number of activated glands within the first 60s. The hypothetical mechanism for this response may involve the serial activation of additional eccrine sweat glands during the progressive evolution of psychogenic sweating. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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... 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 ...

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.

Brain structural network topological alterations of the left prefrontal and limbic cortex in psychogenic erectile dysfunction.

Science.gov (United States)

Chen, Jianhuai; Chen, Yun; Gao, Qingqiang; Chen, Guotao; Dai, Yutian; Yao, Zhijian; Lu, Qing

2018-05-01

Despite increasing understanding of the cerebral functional changes and structural abnormalities in erectile dysfunction, alterations in the topological organization of brain networks underlying psychogenic erectile dysfunction remain unclear. Here, based on the diffusion tensor image data of 25 patients and 26 healthy controls, we investigated the topological organization of brain structural networks and its correlations with the clinical variables using the graph theoretical analysis. Patients displayed a preserved overall small-world organization and exhibited a less connectivity strength in the left inferior frontal gyrus, amygdale and the right inferior temporal gyrus. Moreover, an abnormal hub pattern was observed in patients, which might disturb the information interactions of the remaining brain network. Additionally, the clustering coefficient of the left hippocampus was positively correlated with the duration of patients and the normalized betweenness centrality of the right anterior cingulate gyrus and the left calcarine fissure were negatively correlated with the sum scores of the 17-item Hamilton Depression Rating Scale. These findings suggested that the damaged white matter and the abnormal hub distribution of the left prefrontal and limbic cortex might contribute to the pathogenesis of psychogenic erectile dysfunction and provided new insights into the understanding of the pathophysiological mechanisms of psychogenic erectile dysfunction.

[P300 potential in chldren with psychogenic nonepileptic events and tension headache].

Science.gov (United States)

Steczkowska, Małgorzata; Stolarska-Weryńska, Urszula; Fiederer, Krystyna; Kaciński, Marek

2016-01-01

Psychotherapy is being used as the primary treatment in nonepileptic psychogenic seizures and tension headaches in children. Children's intelectual functioning is related to certain endogenous neurophysiological parameters. The goal of this study was to establish whether the endogenous potential P300 is different in children with nonepileptic psychogenic events and with tension headaches, and whether it changes under the influence of the cognitive-behavioral psychotherapy. The study included a group of 47 children: 20 with nonepileptic psychogenic seizures (18 girls and 2 boys), aged 11.09-17.11 years, and 27 children with tension headache (25 girls and 2 boys), aged 10.11-17.11 years. The P300 potential was induced using an auditory stimulus. The reaction time, the amount of mistakes and the percentage of attention focus was measured in all children. All children attended 8-10 psychotherapy sessions. The P300 potential was registered before and after the course of therapy, and additionally in both cycles also after a 3 minutes hyperventilation. Medium P300 parameters were closer to normal in the group of children with tension headaches rather than in the group with nonepileptic seizures. The shorter was the reaction time in the first measurement, the higher the attention score and the shorter the reaction time in the second measurement - this was visible in the results of children with nonepileptic seizures, in contrast to children with tension headaches. The use of hyperventilation caused a noticeable extension of the reaction time in the P300 measurement, with other components unchanged (mistake count and percentage of attention focus). The endogenous potential P300 does vary, although on a statistically insignificant level, in groups of children with tension headaches and nonepileptic seizures.

A lining vomer flap for palate pushback in unilateral cleft palate repair.

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Clavin, H D; Owsley, J Q

1978-01-01

A combinaation vomer mucoperiosteal flap and nasal floor mucoperiosteal flap is described which is used to achieve nasal coverage in unilateral cleft palate patients requiring pushbacks. A posteriorly based readily accessible vomer flap is raised on the cleft side and used as nasal lining for the palatal mucoperiosteal flap on the non-cleft side. On the cleft side, a symmetrically sized nasal floor flap is easily elevated under direct vision and used to cover the nasal aspect of the corresponding mucoperiosteal palatal flap.

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

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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.

Diagnosing subtle palatal anomalies: Validation of video-analysis and assessment protocol for diagnosing occult submucous cleft palate.

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Rourke, Ryan; Weinberg, Seth M; Marazita, Mary L; Jabbour, Noel

2017-09-01

Submucous cleft palate (SMCP) classically involves bifid uvula, zona pellucida, and notched hard palate. However, patients may present with more subtle anatomic abnormalities. The ability to detect these abnormalities is important for surgeons managing velopharyngeal dysfunction (VPD) or considering adenoidectomy. Validate an assessment protocol for diagnosis of occult submucous cleft palate (OSMCP) and identify physical examination features present in patients with OSMCP in the relaxed and activated palate positions. Study participants included patients referred to a pediatric VPD clinic with concern for hypernasality or SMCP. Using an appropriately encrypted iPod touch, transoral video was obtained for each patient with the palate in the relaxed and activated positions. The videos were reviewed by two otolaryngologists in normal speed and slow-motion, as needed, and a questionnaire was completed by each reviewer pertaining to the anatomy and function of the palate. 47 patients, with an average age of 4.6 years, were included in the study over a one-year period. Four videos were unusable due to incomplete view of the palate. The most common palatal abnormality noted was OSMCP, diagnosed by each reviewer in 26/43 and 30/43 patients respectively. Using the assessment protocol, agreement on palatal diagnosis was 83.7% (kappa = 0.68), indicating substantial agreement, with the most prevalent anatomic features being vaulted palate elevation (96%) and visible notching of hard palate (75%). The diagnosis of subtle palatal anomalies is difficult and can be subjective. Using the proposed video-analysis method and assessment protocol may improve reliability of diagnosis of OSMCP. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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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.

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

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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.

The Dentato-Rubro-Olivary Tract: Clinical Dimension of This Anatomical Pathway

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Fadil Khoyratty

2013-01-01

Full Text Available Symptomatic palatal tremor is potentially the result of a lesion in the triangle of Guillain-Mollaret (1931 and is associated with hypertrophic olivary degeneration (HOD which has characteristic MR findings. The triangle is defined by dentate efferents ascending through the superior cerebellar peduncle and crossing in the decussation of the brachium conjunctivum inferior to the red nucleus, to finaliy reach the inferior olivary nucleus (ION via the central tegmental tract. The triangle is completed by ION decussating efferents terminating on the original dentate nucleus via the inferior cerebellar peduncle. We can demonstrate the anatomy of this anatomical triangle using a clinical case of palatal tremor presenting with bilateral subjective pulsatile tinnitus along with the pathognomonic MR findings previously described. The hyperintense T2 signal in these patients may be permanent, but the hypertrophied olive normally regresses after 4 years. The temporal relationship between the evolution of the histopathology and the development of the palatal tremor remains unknown as does the natural history of the tremor. Botox injection at the level of tensor and levator veli palatini insertion have been used to treat patients with disabling tremor synchronous tinnitus. A lesion involving the triangle can have a quite varied clinical expression.

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

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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.

Teleseismically-induced tremor near Parkfield, CA - a cacophony or a symphony?

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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.

What many years of tremor reveals about the Mexican Sweet Spot

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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.

Frictional-faulting model for harmonic tremor before Redoubt Volcano eruptions

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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.

Pallidal Dysfunction Drives a Cerebellothalamic Circuit into Parkinson Tremor

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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

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

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

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

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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

Propranolol as an adjunct therapy for hyperthyroid tremor.

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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.

Dementia in Fragile X-associated Tremor/Ataxia Syndrome

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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.

Cleft Palate; A Multidiscipline Approach.

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Stark, Richard B., Ed.

Nineteen articles present a multidisciplinary approach to the management of facial clefts. The following subjects are discussed: the history of cleft lip and cleft palate surgery; cogenital defects; classification; the operation of a cleft palate clinic; physical examination of newborns with cleft lip and/or palate; nursing care; anesthesia;…

Modified Nance palatal button

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Nitin Arora

2015-01-01

Full Text Available This paper describes modified Nance palatal button by which problems encountered in the palatal region around the acrylic button during space closure and molar distalization can be minimized.

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

Early Motor Unit Disease Masquerading as Psychogenic Breathy Dysphonia: A Clinical Case Presentation

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Aronson, Arnold E.

1971-01-01

Presented is a study of a 20-year-old girl with mild, breathy dysphonia, previously diagnosed as psychogenic. In actuality, her voice change was a sign of early myasthenia gravis. It is pointed out that voice changes can be a first and only sign of early neurologic disease. (Author/KW)

Linking Essential Tremor to the Cerebellum: Clinical Evidence.

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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.

Cleft palate caused by congenital teratoma.

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Veyssière, Alexis; Streit, Libor; Traoré, Hamady; Bénateau, Hervé

2017-02-01

A cleft palate results from incomplete fusion of the lateral palatine processes, the median nasal septum and the median palatine process. This case report describes a rare case of congenital teratoma originating from the nasal septum that may have interfered with the fusion of the palatal shelves during embryonic development, resulting in a cleft palate. An infant girl was born at 40 weeks of gestation weighing 3020 g with a complete cleft palate associated with a large central nasopharyngeal tumour. Computed tomography (CT) of the head showed a well defined mass of mixed density. The tumour was attached to the nasal septum in direct contact with the cleft palate. A biopsy confirmed the teratoma. Tumour resection was performed at 5 months, soft palate reconstruction at 7 months and hard palate closure at 14 months. There was no sign of local recurrence 1 year later. Most teratomas are benign and the prognosis is usually good. However, recurrence is not rare if germ cell carcinomatous foci are present within the teratoma. For these reasons, we advocate the use of a two-stage procedure in which closure of the cleft palate is postponed until histological examination confirms complete excision of the teratoma.

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

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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.

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

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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.

Three-dimensional modeling of physiological tremor for hand-held surgical robotic instruments.

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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.

Soft Palate Reconstruction Using Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Resection of Squamous Cell Carcinoma

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Jun Sik Kim

2012-11-01

Full Text Available Squamous cell carcinoma infrequently occurs at the soft palate. Although various methodscan be used for reconstruction of soft palate defects that occur after resecting squamous cellcarcinoma, it is difficult to obtain satisfactory results from the perspective of the functionalrestoration of the soft palate. A combination of bilateral palatal mucomuscular flap for theoral side and superiorly based posterior pharyngeal flap for the nasal side were performed ontwo patients who were diagnosed with squamous cell carcinoma of the soft palate in orderto reconstruct the soft palate defects after surgical resection. After surgery, the patients werefollowed-up for a mean period of 11 months. The flaps were well maintained in both patients.The donor site defects were epithelialized and completely recovered. Additionally, no recurrenceof the primary sites was shown. Slight hyponasality was observed in the voice assessmentsthat were conducted 6 months after surgery. No food regurgitation or aspiration was observedin the swallowing tests. We used a combination of bilateral palatal mucomuscular flap andsuperiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurredafter resecting the squamous cell carcinomas. We reduced the donor site complications andachieved functionally satisfactory outcomes.

Prevalence, cause, and location of palatal fistula in operated complete unilateral cleft lip and palate: retrospective study.

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de Agostino Biella Passos, Vivian; de Carvalho Carrara, Cleide Felício; da Silva Dalben, Gisele; Costa, Beatriz; Gomide, Marcia Ribeiro

2014-03-01

To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors. Retrospective analysis of patient records and evaluation of preoperative initial photographs. Tertiary craniofacial center. Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007. The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate. Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated. Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002). The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.

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

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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.

Holmes' tremor as a delayed complication of thalamic stroke.

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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.

Phenomenology of tremor-like signals observed over hydrocarbon reservoirs

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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

Tectonic tremor

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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.

Successful Treatment of Rubral Tremor by High-Dose Trihexyphenidyl: A Case Report

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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.

Episodic tremor and slip explained by fluid-enhanced microfracturing and sealing

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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.

Methodology for estimating human perception to tremors in high-rise buildings

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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.

Cleft Lip and Palate

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Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They happen early during ... A baby can have a cleft lip, a cleft palate, or both. A cleft lip happens if the ...

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)

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

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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.

CT and MR imaging findings of palatal tumors

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Kato, Hiroki; Kanematsu, Masayuki; Makita, Hiroki; Kato, Keizo; Hatakeyama, Daijiro; Shibata, Toshiyuki; Mizuta, Keisuke; Aoki, Mitsuhiro

2014-01-01

Palatal tumors commonly arise from the minor salivary glands, and benign tumors account for approximately half of all minor salivary gland tumors. Minor salivary gland tumors have an affinity for the posterior hard palate and soft palate and virtually never arise in the midline, probably because of the distribution of palatal salivary glands. The majority of benign salivary gland tumors of the palate are pleomorphic adenomas, while the most common malignant salivary gland tumor is adenoid cystic carcinoma, followed by mucoepidermoid carcinoma, adenocarcinoma, and polymorphous low-grade adenocarcinoma. Epithelial tumors frequently arise from the soft palate. The majority of benign epithelial tumors of the palate are papillomas, while most malignant epithelial tumors are squamous cell carcinomas. Various types of mesenchymal tumors, including fibromas, lipomas, schwannomas, neurofibromas, hemangiomas, and lymphangiomas, also involve the palate. This article describes the CT and MR findings of benign and malignant palatal tumors

CT and MR imaging findings of palatal tumors

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Kato, Hiroki, E-mail: hkato@gifu-u.ac.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Kanematsu, Masayuki, E-mail: masa_gif@yahoo.co.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); High-level Imaging Diagnosis Center, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Makita, Hiroki, E-mail: makitah@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Kato, Keizo, E-mail: keizo@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Hatakeyama, Daijiro, E-mail: hatakeya@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Shibata, Toshiyuki, E-mail: shibat@gifu-u.ac.jp [Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu (Japan); Mizuta, Keisuke, E-mail: kmizuta@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan); Aoki, Mitsuhiro, E-mail: aoki@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan)

2014-03-15

Palatal tumors commonly arise from the minor salivary glands, and benign tumors account for approximately half of all minor salivary gland tumors. Minor salivary gland tumors have an affinity for the posterior hard palate and soft palate and virtually never arise in the midline, probably because of the distribution of palatal salivary glands. The majority of benign salivary gland tumors of the palate are pleomorphic adenomas, while the most common malignant salivary gland tumor is adenoid cystic carcinoma, followed by mucoepidermoid carcinoma, adenocarcinoma, and polymorphous low-grade adenocarcinoma. Epithelial tumors frequently arise from the soft palate. The majority of benign epithelial tumors of the palate are papillomas, while most malignant epithelial tumors are squamous cell carcinomas. Various types of mesenchymal tumors, including fibromas, lipomas, schwannomas, neurofibromas, hemangiomas, and lymphangiomas, also involve the palate. This article describes the CT and MR findings of benign and malignant palatal tumors.

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

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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

Cognitive-behavioral therapy for psychogenic nonepileptic seizures

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Goldstein, L.H.; Chalder, T.; Chigwedere, C.; Khondoker, M.R.; Moriarty, J.; Toone, B.K.; Mellers, J.D.C.

2010-01-01

Objective: To compare cognitive-behavioral therapy (CBT) and standard medical care (SMC) as treatments for psychogenic nonepileptic seizures (PNES). Methods: Our randomized controlled trial (RCT) compared CBT with SMC in an outpatient neuropsychiatric setting. Sixty-six PNES patients were randomized to either CBT (plus SMC) or SMC alone, scheduled to occur over 4 months. PNES diagnosis was established by video-EEG telemetry for most patients. Exclusion criteria included comorbid history of epilepsy, <2 PNES/month, and IQ <70. The primary outcome was seizure frequency at end of treatment and at 6-month follow-up. Secondary outcomes included 3 months of seizure freedom at 6-month follow-up, measures of psychosocial functioning, health service use, and employment. Results: In an intention-to-treat analysis, seizure reduction following CBT was superior at treatment end (group × time interaction p < 0.0001; large to medium effect sizes). At follow-up, the CBT group tended to be more likely to have experienced 3 months of seizure freedom (odds ratio 3.125, p = 0.086). Both groups improved in some health service use measures and on the Work and Social Adjustment Scale. Mood and employment status showed no change. Conclusions: Our findings suggest that cognitive-behavioral therapy is more effective than standard medical care alone in reducing seizure frequency in PNES patients. Classification of evidence: This study provides Class III evidence that CBT in addition to SMC, as compared to SMC alone, significantly reduces seizure frequency in patients with PNES (change in median monthly seizure frequency: baseline to 6 months follow-up, CBT group, 12 to 1.5; SMC alone group, 8 to 5). GLOSSARY AED = antiepileptic drug; CBT = cognitive-behavioral therapy; CI = confidence interval; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; HADS = Hospital Anxiety and Depression Scale; IQR = interquartile range; ITT = intention-to-treat; OR = odds ratio; PNES

Wrist sensor-based tremor severity quantification in Parkinson's disease using convolutional neural network.

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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.

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

Application of palatal RB obturator in babies with isolated palatal cleft

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Radojičić Julija

2009-01-01

Full Text Available Background. Isolated cleft of secondary palate has a specific clinical picture due to a wide communication between the mouth and nose cavity. As a consequence of that, babies born with this malformation are often subject to infections of the upper bronchial tubes, middle ear, speech disorders, and certainly the most difficult existential problem they face at the very beginning of their lives, the impossibility of suckling (breast feeding. Such babies have to be fed with gastric probe. The difficulties in their nutrition have often been described in literature, yet a singular attitude toward early orthodontic therapy has not been adopted still. The aim of the paper was to describe a design and application of obturator immediately after the birth of a baby with isolated palatal cleft, and the role in feeding. Case report. We presented a female neonate, born on 27th December 2007, with a wide fissure in the shape of the letter U over the entire secondary palate. The baby was referred to the Stomatology Clinic due to nutrition impossibility. To avoid feeding with gastric probe, the formation of RB obturator was performed (artificial palate. Hereby, the procedure of obturator making with an explanation of its function is presented. Conclusion. The application of RB obturator and the necessary education of parents have a major role in shortening the time of breast feeding and increasing the amount of food intake and, thus, for the normal growth and development of newborn infants with isolated palate cleft.

Rare association of central pontine myelinolysis with infantile tremor syndrome

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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.

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.

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

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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.

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

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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.

Parkinsonism in fragile X-associated tremor/ataxia syndrome (FXTAS): revisited.

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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.

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

The Fetal Cleft palate: V. Elucidation of the Mechanism of Palatal Clefting in the Congenital Caprine Model

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Maternal ingestion of Nicotiana glauca from gestation days 32 through 41 results in a high incidence of cleft palate in Spanish goats. This caprine cleft palate model was used to evaluate the temporal sequence of palatal shelf fusion throughout the period of cleft induction with the poisonous plant...

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.

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

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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.

Migrating tremors illuminate complex deformation beneath the seismogenic San Andreas fault.

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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.

Psychogenic stuttering and other acquired nonorganic speech and language abnormalities.

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Binder, Laurence M; Spector, Jack; Youngjohn, James R

2012-08-01

Three cases are presented of peculiar speech and language abnormalities that were evaluated in the context of personal injury lawsuit or workers compensation claims of brain dysfunction after mild traumatic brain injuries. Neuropsychological measures of effort and motivation showed evidence of suboptimal motivation or outright malingering. The speech and language abnormalities of these cases probably were not consistent with neurogenic features of dysfluent speech including stuttering or aphasia. We propose that severe dysfluency or language abnormalities persisting after a single, uncomplicated, mild traumatic brain injury are unusual and should elicit suspicion of a psychogenic origin.

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

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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.

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

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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.

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.

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

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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.

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.

TCDD disrupts posterior palatogenesis and causes cleft palate.

Science.gov (United States)

Yamada, Tomohiro; Hirata, Azumi; Sasabe, Eri; Yoshimura, Tomohide; Ohno, Seiji; Kitamura, Naoya; Yamamoto, Tetsuya

2014-01-01

Dioxins (e.g. 2,3,7,8-tetrachlorodibenzo-p-dioxin; TCDD) cause cleft palate at a high rate. A post-fusional split may contribute to the pathogenesis, and tissue fragility may be a concern. The objective of this study was to investigate the effects of TCDD on the palatal epithelium, bone and muscle, which contribute to tissue integrity. ICR mice (10-12 weeks old) were used. TCDD was administered on E12.5 at 40 mg/kg. Immunohistochemical staining for AhR, ER-α, laminin, collagen IV, osteopontin, Runx2, MyoD, and desmin were performed. Furthermore, western blot analysis for osteopontin, Runx2, MyoD, and desmin were performed to evaluate protein expression in the palatal tissue. Immunohistologically, there was little difference in the collagen IV and laminin localization in the palatal epithelium between control versus TCDD-treated mice. Runx2 and osteopontin immunoreactivity decreased in the TCDD-treated palatal bone, and MyoD and desmin decreased in the TCDD-treated palatal muscle. AhR and ER-α immunoreactivity were localized to the normal palatal bone, but ER-α was diminished in the TCDD-treated palate. On western blot analysis, Runx2, MyoD, and desmin were all downregulated in the TCDD-treated palate. TCDD may suppress palatal osteogenesis and myogenesis via AhR, and cause cleft palates via a post-fusional split mechanism, in addition to a failure of palatal fusion. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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.

Biomechanical Loading as an Alternative Treatment for Tremor: A Review of Two Approaches

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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

Interarytenoid muscle botox injection for treatment of adductor spasmodic dysphonia with vocal tremor.

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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.

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.

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.

Hearing outcomes in patients with cleft lip/palate.

Science.gov (United States)

Skuladottir, Hildur; Sivertsen, Ase; Assmus, Jorg; Remme, Asa Rommetveit; Dahlen, Marianne; Vindenes, Hallvard

2015-03-01

Objective : Children with cleft lip and palate or cleft palate only have a high incidence of conductive hearing loss from otitis media with effusion. Studies demonstrating longitudinal results are lacking. This study was undertaken to investigate long-term longitudinal hearing outcomes of children with cleft lip and/or cleft palate and cleft palate only. Design : Retrospective chart review. Setting : Clinical charts of patients born with cleft lip and palate or cleft palate only in 1985 to 1994 who were referred to the cleft team in Bergen, Norway. Study findings include 15 years of follow-up. Participants : The study population consisted of 317 children of whom 159 had nonsyndromic cleft lip and palate and 158 had nonsyndromic cleft palate. Main Outcome Measures : Pure tone average calculated from pure tone audiometry at ages 4, 6, and 15 years. Results : The median pure tone average significantly improved with increasing age. For the cleft lip and palate group, the median pure tone average at ages 4, 6, and 15 years was 16 dB hearing level (HL), 13 dB HL, and 9 dB HL, respectively (P ≤ .001). In the cleft palate group the median pure tone average at ages 4, 6, and 15 years was 15 dB HL, 12 dB HL, and 9 dB HL, respectively (P ≤ .001). There was no significant difference in the hearing levels between the two groups. Patients who had surgical closure of the palate at age 18 months had a significantly better pure tone average outcome at age 15 compared with patients who had surgery at 12 months. Conclusions : Hearing improves significantly from childhood to adolescence in patients with cleft lip and palate and cleft palate only.

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

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...

Aspiration pneumonia in patients with cleft palate

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Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il [Hanyang University College of Medicine, Seoul (Korea, Republic of)

2003-03-01

To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group.

Aspiration pneumonia in patients with cleft palate

International Nuclear Information System (INIS)

Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il

2003-01-01

To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group

Speech intelligibility after gingivectomy of excess palatal tissue

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Aruna Balasundaram

2014-01-01

Full Text Available To appreciate any enhancement in speech following gingivectomy of enlarged anterior palatal gingiva. Periodontal literature has documented various conditions, pathophysiology, and treatment modalities of gingival enlargement. Relationship between gingival maladies and speech alteration has received scant attention. This case report describes on altered speech pattern enhancement secondary to the gingivectomy procedure. A systemically healthy 24-year- female patient reported with bilateral anterior gingival enlargement who was provisionally diagnosed as "gingival abscess with inflammatory enlargement" in relation to palatal aspect of the right maxillary canine to left maxillary canine. Bilateral gingivectomy procedure was performed by external bevel incision in relation to anterior palatal gingiva and a large wedge of epithelium and connective tissue was removed. Patient and her close acquaintances noticed a great improvement in her pronunciation and enunciation of sounds like "t", "d", "n", "l", "th", following removal of excess gingival palatal tissue and was also appreciated with visual analog scale score. Exploration of linguistic research documented the significance of tongue-palate contact during speech. Any excess gingival tissue in palatal region brings about disruption in speech by altering tongue-palate contact. Periodontal surgery like gingivectomy may improve disrupted phonetics. Excess gingival palatal tissue impedes on tongue-palate contact and interferes speech. Pronunciation of consonants like "t", "d", "n", "l", "th", are altered with anterior enlarged palatal gingiva. Excision of the enlarged palatal tissue results in improvement of speech.

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.

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. 

Facts about Cleft Lip and Cleft Palate

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... Information For… Media Policy Makers Facts about Cleft Lip and Cleft Palate Language: English (US) Español (Spanish) Recommend on Facebook ... can make referrals to cleft/craniofacial treatment teams. Cleft Lip & Palate Foundation of Smiles Cleft Lip & Palate Foundation of ...

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

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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.

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

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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.

[Suture simulator - Cleft palate surgery].

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Devinck, F; Riot, S; Qassemyar, A; Belkhou, A; Wolber, A; Martinot Duquennoy, V; Guerreschi, P

2017-04-01

Cleft palate requires surgery in the first years of life, furthermore repairing anatomically the soft and hard palate is complex on a surgical level because of the fine tissues and the local intraoral configuration. It is valuable to train first on simulators before going to the operating room. However, there is no material dedicated to learning how to perform intraoral sutures in cleft palate surgery. We made one, in an artisanal manner, in order to practice before the real surgical gesture. The simulator was designed based on precise anatomical data. A steel pipe, fixed on a rigid base represented the oral cavity. An adapted split spoon represented the palate. All pieces could be removed in order to apply a hydrocellular dressing before training for sutures. Our simulator was tested by 3 senior surgeons in our department in close to real-life conditions in order to evaluate its anatomical accuracy. It is valuable to have a simulator to train on cleft palate sutures within teaching university hospitals that manage this pathology. Our simulator has a very low cost, it is easy to make and is anatomically accurate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Detailed Tremor Migration Styles in Guerrero, Mexico Imaged with Cross-station Cross-correlations

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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

Quantification of a Secondary Task-Specific Tremor in a Violinist after a Temporal Lobectomy

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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.

Electrophysiologic Assessments of Involuntary Movements: Tremor and Myoclonus

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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.

Treatment of essential and parkinsonian tremor with nipradilol.

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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.

Cleft Lip and Palate Surgery

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... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery is ... the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients. The goal is to help restore the ...

"The Barking Girl": A Case Report of Psychogenic Cough in a Child with a Review of Literature.

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Jakati, Praveen Kumar; Naskar, Subrata; Khanna, Anisha

2017-01-01

A 9-year-old girl presented with 2-month history of continuous coughing; despite detailed evaluation, no organic cause was found. Considering the provisional diagnosis of a psychogenic cough, she was advised for psychiatry consultation. After a psychological assessment, she was found to have comorbid anxiety (Screen for Child Anxiety Related Disorders score- 25) along with punitive parenting and sibling rivalry issues. She was initially treated with parental psychoeducation, play therapy, and behavior therapy. Since she did not show expected progress with the treatment, low-dose escitalopram was started along with the ongoing therapy, considering her anxiety. There was a significant improvement in her symptoms in 1-month follow-up. She maintained improvement during further follow-ups. This case illustrates the need to identify and treat comorbid psychiatric issues in the management of a psychogenic cough.

Using Tectonic Tremor to Constrain Seismic-wave Attenuation in Cascadia

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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

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...

Cleft lip and palate repair

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... this page: //medlineplus.gov/ency/article/002979.htm Cleft lip and palate repair To use the sharing features on this ... Cheiloplasty; Cleft rhinoplasty; Palatoplasty; Tip rhinoplasty Patient Instructions Cleft lip and palate repair - discharge Images Cleft lip repair - series References ...

Maxillary Arch Dimensions and Spectral Characteristics of Children with Cleft Lip and Palate Who Produce Middorsum Palatal Stops

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Zajac, David J.; Cevidanes, Lucia; Shah, Sonam; Haley, Katarina L.

2012-01-01

Purpose: The purpose of this study was twofold: (a) to determine maxillary arch dimensions of children with repaired cleft lip and palate (CLP) who produced middorsum palatal stops and (b) to describe some spectral characteristics of middorsum palatal stops. Method: Maxillary arch width, length, and height dimensions and first spectral moments of…

Palate dimensions in six-year-old children with unilateral cleft lip and palate: a six-center study on dental casts.

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Koželj, Vesna; Vegnuti, Miljana; Drevenšek, Martina; Hortis-Dzierzbicka, Maria; Gonzalez-Landa, Gonzalo; Hanstein, Siiri; Klimova, Irena; Kobus, Kazimierz; Kobus-Zaleśna, Katarzyna; Semb, Gunvor; Shaw, Bill

2012-11-01

To compare palatal dimensions in 6-year-old children with unilateral cleft lip and palate (UCLP) treated by different protocols with those of noncleft children. Retrospective intercenter outcome study. Patients : Upper dental casts from 129 children with repaired UCLP and 30 controls were analyzed by the trigonometric method. Six European cleft centers. Main outcome measures : Sagittal, transverse, and vertical dimensions of the palate were observed. Palate variables were analyzed with descriptive methods and nonparametric tests. Regarding several various characteristics measured on a relatively small number of subjects, hierarchical, k-means clustering, and principal component analyses were used. Mean values of the observed dimensions for five cleft groups differed significantly from the control (p cleft differed significantly from all other cleft groups in most variables (p palate. A similar number of treated children were classified into each cluster, while all children without clefts were classified in the same cluster. The percentage of treated children from a particular group that fit this cluster ranged from 0% to 70% and increased with age at palatal closure and number of primary surgical procedures. At 6 years of age, children with stepwise repair and hard palate closure after the age of two more frequently result in palatal dimensions of noncleft control than children with earlier palatal closure and one-stage cleft repair.

Validation of a telephone screening tool for spasmodic dysphonia and vocal fold tremor.

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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.

Large Contrast Between the Moment Magnitude of Tremor and the Moment Magnitude of Slip in ETS Events

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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.

Nonvolcanic tremors deep beneath the San Andreas Fault.

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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.

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.

Seismic Tremors and Three-Dimensional Magma Wagging

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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

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

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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

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.

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.

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.

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

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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.)

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.)

Palatal bone thickness measured by palatal index method using cone-beam computed tomography in nonorthodontic patients for placement of mini-implants

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W S Manjula

2015-01-01

Full Text Available Introduction: The purpose of this study was to compare the bone thickness of the palatal areas in different palatal index (PI groups. Materials and Methods: Cone-beam computed tomography scans of 10 subjects were selected with a mean age group of 18 years. The measurements of palatal bone thickness were made at 36 sites using CareStream 3D Imaging software. The PI was measured using Korkhaus ratio (palatal height/palatal width. One-way analysis of variance was used to analyze intergroup differences, as well as the PI difference. Results: Bone thickness was higher in the anterior region than in the middle and posterior regions P<0.001. Furthermore, significant differences were found among the midline, medial, and lateral areas of the palate. Conclusions: These findings might be helpful for clinicians to enhance the successful use of temporary anchorage devices in the palate.

Acupuncture therapy: mechanism of action, efficacy, and safety: a potential intervention for psychogenic disorders?

Science.gov (United States)

2014-01-01

Scientific bases for the mechanism of action of acupuncture in the treatment of pain and the pathogenic mechanism of acupuncture points are briefly summarized. The efficacy and safety of acupuncture therapy is discussed based on the results of German clinical trials. A conclusion on the role for acupuncture in the treatment of psychogenic disorders could not be reached. PMID:24444292

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

Illicit stimulant use in humans is associated with a long-term increase in tremor.

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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.

CLEFT PALATE. FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

Science.gov (United States)

RUTHERFORD, DAVID; WESTLAKE, HAROLD

DESIGNED TO PROVIDE AN ESSENTIAL CORE OF INFORMATION, THIS BOOK TREATS NORMAL AND ABNORMAL DEVELOPMENT, STRUCTURE, AND FUNCTION OF THE LIPS AND PALATE AND THEIR RELATIONSHIPS TO CLEFT LIP AND CLEFT PALATE SPEECH. PROBLEMS OF PERSONAL AND SOCIAL ADJUSTMENT, HEARING, AND SPEECH IN CLEFT LIP OR CLEFT PALATE INDIVIDUALS ARE DISCUSSED. NASAL RESONANCE…

Evidence-based medicine: cleft palate.

Science.gov (United States)

Chepla, Kyle J; Gosain, Arun K

2013-12-01

After reading this article, the participant should be able to: 1. Describe recent changes in treatment of cleft palate. 2. Compare the efficacy of different surgical treatments. 3. Assess their own knowledge of cleft palate repair. 4. Determine where further individual in-depth study and development are warranted. The Maintenance of Certification in Plastic Surgery series is designed to ensure professional development and measure continued competency within a specialty or subspecialty. The present article provides an evaluation of the interval studies regarding the management of cleft palate with a specific focus on craniofacial growth, speech outcomes, and obstructive sleep apnea since the last Maintenance of Certification in Plastic Surgery article on the subject published in 2010. This purpose of this article is to update plastic and craniomaxillofacial surgeons on recent changes in treatment of cleft palate, provide a means for accurate self-assessment, and guide further individual in-depth study and development.

[Surgical correction of cleft palate].

Science.gov (United States)

Kimura, F T; Pavia Noble, A; Soriano Padilla, F; Soto Miranda, A; Medellín Rodríguez, A

1990-04-01

This study presents a statistical review of corrective surgery for cleft palate, based on cases treated at the maxillo-facial surgery units of the Pediatrics Hospital of the Centro Médico Nacional and at Centro Médico La Raza of the National Institute of Social Security of Mexico, over a five-year period. Interdisciplinary management as performed at the Cleft-Palate Clinic, in an integrated approach involving specialists in maxillo-facial surgery, maxillar orthopedics, genetics, social work and mental hygiene, pursuing to reestablish the stomatological and psychological functions of children afflicted by cleft palate, is amply described. The frequency and classification of the various techniques practiced in that service are described, as well as surgical statistics for 188 patients, which include a total of 256 palate surgeries performed from March 1984 to March 1989, applying three different techniques and proposing a combination of them in a single surgical time, in order to avoid complementary surgery.

How to tackle tremor – systematic review of the literature and diagnostic work-up

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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.

Changes of Physiological Tremor Following Maximum Intensity Exercise in Male and Female Young Swimmers

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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.

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

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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.

Electrocorticography reveals beta desynchronization in the basal ganglia-cortical loop during rest tremor in Parkinson's disease.

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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.

Forecast for Artificial Muscle Tremor Behavior Based on Dynamic Additional Grey Catastrophe Prediction

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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.

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

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

Effect of stretching and proprioceptive loading in hand function among patients with cerebellar tremor

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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.

Influence of timing of hard palate repair in a two-stage procedure on early language development in Danish children with cleft palate

DEFF Research Database (Denmark)

Willadsen, Elisabeth

2012-01-01

Objective: to investigate the influence of timing of hard palate closure on early language development from 18 months to 3 years of age. Design: a prospective, randomized clinical trial. Participants: thirty-four children with UCLP with velum closure at 4 months of age, and hard palate closure...... language development in cleft palate children. Key words: cleft palate, phonological development, lexical development, surgical timing....... at 12 months (EarlyHPR (Early hard palate repair)) or 36 months (LateHPU (Late hard palate Unrepaired)) by random assignment. Thirty-five control children matched for gender and age. Methods: all children were video recorded during a play interaction with a parent at 18 months of age. These recordings...

“The Barking Girl”: A Case Report of Psychogenic Cough in a Child with a Review of Literature

Science.gov (United States)

Jakati, Praveen Kumar; Naskar, Subrata; Khanna, Anisha

2017-01-01

A 9-year-old girl presented with 2-month history of continuous coughing; despite detailed evaluation, no organic cause was found. Considering the provisional diagnosis of a psychogenic cough, she was advised for psychiatry consultation. After a psychological assessment, she was found to have comorbid anxiety (Screen for Child Anxiety Related Disorders score- 25) along with punitive parenting and sibling rivalry issues. She was initially treated with parental psychoeducation, play therapy, and behavior therapy. Since she did not show expected progress with the treatment, low-dose escitalopram was started along with the ongoing therapy, considering her anxiety. There was a significant improvement in her symptoms in 1-month follow-up. She maintained improvement during further follow-ups. This case illustrates the need to identify and treat comorbid psychiatric issues in the management of a psychogenic cough. PMID:28852260

Which patients with epilepsy are at risk for psychogenic nonepileptic seizures (PNES)? A multicenter case-control study

NARCIS (Netherlands)

Wissel, Benjamin D.; Dwivedi, Alok K.; Gaston, Tyler E.; Rodriguez-Porcel, Federico J.; Aljaafari, Danah; Hopp, Jennifer L.; Krumholz, Allan; van der Salm, Sandra M. A.; Andrade, Danielle M.; Borlot, Felippe; Moseley, Brian D.; Cavitt, Jennifer L.; Williams, Stevie; Stone, Jon; LaFrance, W. Curt; Szaflarski, Jerzy P.; Espay, Alberto J.

2016-01-01

We sought to examine the clinical and electrographic differences between patients with combined epileptic (ES) and psychogenic nonepileptic seizures (PNES) and age- and gender-matched patients with ES-only and PNES-only. Data from 138 patients (105 women [77%]), including 46 with PNES/ES

Correction of incomplete cleft palate by u-shaped flap palatoplasty ...

African Journals Online (AJOL)

After complete dissection of the nasal and palatal mucosa, palatal muscles were carefully dissected from the posterior edge of the bones of the hard palate, wherein the well-mobilised flap receded backward spontaneously and elongated the soft palate. After suturing the nasal mucosa in the midline, the dissected palatal ...

Is there a Premotor Phase of Essential Tremor?

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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.

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

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.

Suction Cup Induced Palatal Fistula: Surgical Closure by Palatal ...

African Journals Online (AJOL)

1Department of Pediatrics, Pragna Children's Hospital, Hyderabad, ... Eluru, 4Department of Conservative Dentistry and Endodontics, KIMS Dental College and ... The surgical closure of palatal fistula planned under general anesthesia.

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

Expression analyses of human cleft palate tissue suggest a role for osteopontin and immune related factors in palatal development

DEFF Research Database (Denmark)

Jakobsen, L.P.; Borup, R.; Vestergaard, J.

2009-01-01

. Moreover, selected differentially expressed genes were analyzed by quantitative RT-PCR, and by immunohistochemical staining of craniofacial tissue from human embryos. Osteopontin (SPP1) and other immune related genes were significantly higher expressed in palate tissue from patients with CLP compared to CP...... and palate (CLP). In order to understand the biological basis in these cleft lip and palate subgroups better we studied the expression profiles in human tissue from patients with CL/P. In each of the CL/P subgroups, samples were obtained from three patients and gene expression analysis was performed...... and immunostaining in palatal shelves against SPP1, chemokine receptor 4 (CXCR4) and serglycin (PRG1) in human embryonic craniofacial tissue were positive, supporting a role for these genes in palatal development. However, gene expression profiles are subject to variations during growth and therefore we recommend...

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.

Emotional stimuli-provoked seizures potentially misdiagnosed as psychogenic non-epileptic attacks: A case of temporal lobe epilepsy with amygdala enlargement

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Hidetaka Tamune

Full Text Available The association between emotional stimuli and temporal lobe epilepsy (TLE is largely unknown. Here, we report the case of a depressed, 50-year-old female complaining of episodes of a “spaced out” experience precipitated by emotional stimuli. Psychogenic non-epileptic attacks were suspected. However, video-EEG coupled with emotional stimuli-provoked procedures and MRI findings of amygdala enlargement, led to the diagnosis of left TLE. Accurate diagnosis and explanation improved her subjective depression and seizure frequency. This case demonstrated that emotional stimuli can provoke seizures in TLE and suggested the involvement of the enlarged amygdala and the modulation of emotion-related neural circuits. Keywords: Video-EEG, Psychogenic non-epileptic attacks, Temporal lobe epilepsy, Amygdala enlargement, Reflex seizure, Provoked seizure

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.

Atypical Porcine Pestivirus: A Possible Cause of Congenital Tremor Type A‐II in Newborn Piglets

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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.

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

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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.

Subglacial discharge at tidewater glaciers revealed by seismic tremor

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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.

Dynamic Variability of Isometric Action Tremor in Precision Pinching

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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.

MSX-1 gene expression and regulation in embryonic palatal tissue.

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Nugent, P; Greene, R M

1998-01-01

The palatal cleft seen in Msx-1 knock-out mice suggests a role for this gene in normal palate development. The cleft is presumed secondary to tooth and jaw malformations, since in situ hybridization suggests that Msx-1 mRNA is not highly expressed in developing palatal tissue. In this study we demonstrate, by Northern blot analysis, the expression of Msx-1, but not Msx-2, in the developing palate and in primary cultures of murine embryonic palate mesenchymal cells. Furthermore, we propose a role for Msx-1 in retinoic acid-induced cleft palate, since retinoic acid inhibits Msx-1 mRNA expression in palate mesenchymal cells. We also demonstrate that transforming growth factor beta inhibits Msx-1 mRNA expression in palate mesenchymal cells, with retinoic acid and transforming growth factor beta acting synergistically when added simultaneously to these cells. These data suggest a mechanistic interaction between retinoic acid, transforming growth factor beta, and Msx-1 in the etiology of retinoic acid-induced cleft palate.

3-D shape analysis of palatal surface in patients with unilateral complete cleft lip and palate

Czech Academy of Sciences Publication Activity Database

Rusková, H.; Bejdová, Š.; Peterka, Miroslav; Krajíček, V.; Velemínská, J.

2014-01-01

Roč. 42, č. 5 (2014), e140-e147 ISSN 1010-5182 Grant - others:GA UK(CZ) 309611 Institutional support: RVO:68378041 Keywords : unilateral cleft of lip and palate * palate shape * surface scanning Subject RIV: FF - HEENT, Dentistry Impact factor: 2.933, year: 2014

Use of early hard palate closure using a vomer flap in cleft lip and palate patients.

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Smarius, Bram J A; Breugem, Corstiaan C

2016-08-01

The aim of the present study was to determine the influence of the vomer flap during cleft palate closure. A retrospective review was performed of all consecutive unilateral/bilateral complete cleft lip and palate (Veau III en IV) children who were treated by a simultaneous lip and hard palate closure using a vomer flap. Data were collected for sex, date of birth, syndrome, adoption, cleft palate type, type of repair, date of cleft repair, cleft width, lateral incisions, fistula and location of fistula. Ninety-one children (M = 62, F 29) were operated. Mean age at time of lip closure and vomer flap was 5.8 months (range 2.9 months to 49.2 months, SD 7.1) and the mean age at palate closure was 13.6 months (range 6.3 months to 79.9 months, SD 10.8). The mean cleft width at first assessment was 13.0 mm (range 7-22 mm) compared to 8.8 mm (range 4-15 mm) at second assessment (mean difference 4.6 mm, 95% CI 3.93-5.35, p cleft width, subsequently leading to a low fistula incidence (1.1%). Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Complex Non-volcanic Tremor in Guerrero Mexico Triggered by the 2010 Mw 8.8 Chilean Earthquake

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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.

Development of a system for measurement and analysis of tremor using a three-axis accelerometer.

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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.

Histopathologic and immunohistochemical features of soft palate muscles and nerves in dogs with an elongated soft palate.

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Arai, Kiyotaka; Kobayashi, Masanori; Harada, Yasuji; Hara, Yasushi; Michishita, Masaki; Ohkusu-Tsukada, Kozo; Takahashi, Kimimasa

2016-01-01

To histologically evaluate and compare features of myofibers within the elongated soft palate (ESP) of brachycephalic and mesocephalic dogs with those in the soft palate of healthy dogs and to assess whether denervation or muscular dystrophy is associated with soft palate elongation. Soft palate specimens from 24 dogs with ESPs (obtained during surgical intervention) and from 14 healthy Beagles (control group). All the soft palate specimens underwent histologic examination to assess myofiber atrophy, hypertrophy, hyalinization, and regeneration. The degrees of atrophy and hypertrophy were quantified on the basis of the coefficient of variation and the number of myofibers with hyalinization and regeneration. The specimens also underwent immunohistochemical analysis with anti-neurofilament or anti-dystrophin antibody to confirm the distribution of peripheral nerve branches innervating the palatine myofibers and myofiber dystrophin expression, respectively. Myofiber atrophy, hypertrophy, hyalinization, and regeneration were identified in almost all the ESP specimens. Degrees of atrophy and hypertrophy were significantly greater in the ESP specimens, compared with the control specimens. There were fewer palatine peripheral nerve branches in the ESP specimens than in the control specimens. Almost all the myofibers in the ESP and control specimens were dystrophin positive. These results suggested that palatine myopathy in dogs may be caused, at least in part, by denervation of the palatine muscles and not by Duchenne- or Becker-type muscular dystrophy. These soft palate changes may contribute to upper airway collapse and the progression of brachycephalic airway obstructive syndrome.

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

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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.

Differential diagnosis between Parkinson's disease and essential tremor using the smartphone's accelerometer.

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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.

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

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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

Alarm systems detect volcanic tremor and earthquake swarms during Redoubt eruption, 2009

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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

Radial forearm free flap for soft palate reconstruction.

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Lacombe, V; Blackwell, K E

1999-01-01

Defects of the soft palate resulting from head and neck oncologic surgery traditionally have been rehabilitated using a prosthetic obturator. In general, the results of soft palate obturation have been satisfactory, with most patients achieving velopharyngeal competence during speech and swallowing. However, soft palate obturators have several disadvantages. Device stability and retention are impaired in patients who are edentulous. In addition, prosthetic obturators cover large areas of sensate mucosa in the hard palate, maxillary alveolus, and oropharynx, contributing significantly to the loss of sensory feedback from the oral cavity and oropharynx. Considerable evidence suggests that sensory impairment within the oral cavity and pharynx results in impaired mastication, deglutition, and articulation. A minority of patients find palatal obturators to be unsatisfactory, secondary to either inconvenience or device discomfort.

Pleomorphic adenoma of minor salivary gland: hard palate

International Nuclear Information System (INIS)

Garcia Canas, Wilmer; Benitez Narvaez, N.

2006-01-01

The pleomorphic adenoma or mixed tumor occurs in 4 to 14% of the accessory glands salivary. Different localizations exist: AEC, nasal block, lips, maxillary sinus, nasopharynx or in any other localization where salivate tissue exists, but the palate constitutes the most frequent localization, because it gathers more than 50% of minor salivary glands. In the palate, it can be developed a wide variety of tumors coming from the connective and epithelial tissue, 44% arise in the minor salivary glands. In 49 to 65% of them are benign tumors, principally pleomorphic adenomas, located preferably in the hard palate, nearby or in the union with the soft palate as in our case. We present a 42 year old patient with at pleomorphic adenoma of hard palate. (The author)

Patterning of palatal rugae through sequential addition reveals an anterior/posterior boundary in palatal development

Czech Academy of Sciences Publication Activity Database

Pantalacci, S.; Procházka, Jan; Martin, A.; Rothová, Michaela; Lambert, A.; Bernard, L.; Charles, C.; Viriot, L.; Peterková, Renata; Laudet, V.

2008-01-01

Roč. 116, č. 8 (2008), s. 116-133 ISSN 1471-213X R&D Projects: GA ČR GA304/07/0223; GA MŠk OC B23.002 Institutional research plan: CEZ:AV0Z50390512 Keywords : secondary palate * cleft - palate * expression analysis Subject RIV: EA - Cell Biology Impact factor: 3.079, year: 2008

Adaptation to an electropalatograph palate: acoustic, impressionistic, and perceptual data.

Science.gov (United States)

McLeod, Sharynne; Searl, Jeff

2006-05-01

The purpose of this study was to evaluate adaptation to the electropalatograph (EPG) from the perspective of consonant acoustics, listener perceptions, and speaker ratings. Seven adults with typical speech wore an EPG and pseudo-EPG palate over 2 days and produced syllables, read a passage, counted, and rated their adaptation to the palate. Consonant acoustics, listener ratings, and speaker ratings were analyzed. The spectral mean for the burst (/t/) and frication (/s/) was reduced for the first 60-120 min of wearing the pseudo-EPG palate. Temporal features (stop gap, frication, and syllable duration) were unaffected by wearing the pseudo-EPG palate. The EPG palate had a similar effect on consonant acoustics as the pseudo-EPG palate. Expert listener ratings indicated minimal to no change in speech naturalness or distortion from the pseudo-EPG or EPG palate. The sounds [see text] were most likely to be affected. Speaker self-ratings related to oral comfort, speech, tongue movement, appearance, and oral sensation were negatively affected by the presence of the palatal devices. Speakers detected a substantial difference when wearing a palatal device, but the effects on speech were minimal based on listener ratings. Spectral features of consonants were initially affected, although adaptation occurred. Wearing an EPG or pseudo-EPG palate for approximately 2 hr results in relatively normal-sounding speech with acoustic features similar to a no-palate condition.