The effect of inertial loading on wrist postural tremor in essential tremor.

PubMed

Héroux, M E; Pari, G; Norman, K E

2009-05-01

Determine the effect of inertial loading on the strength of motor unit entrainment and the synergistic/competitive interaction between central and mechanical reflex tremor components in subjects with essential tremor (ET). Twenty-three subjects with ET and 22 controls held their hand in an outstretched position while supporting sub-maximal loads (no-load, 5%, 15% and 25% 1-repetition maximum). Hand postural tremor and wrist extensor neuromuscular activity were recorded. Inertial loading resulted in a reduction in postural tremor in all ET subjects. The largest reduction in tremor amplitude occurred between 5% and 15% loads, which was associated with spectral separation of the mechanical reflex and central tremor components in a large number of ET subjects. Despite an increase in overall neuromuscular activity with inertial loading, EMG tremor spectral power did not increase with loading. The effect of inertial loading on postural tremor amplitude appears to be mediated in large part by its effect on the interaction between mechanical reflex and central tremor components. Also, ET is associated with a constant absolute level of motor unit entrainment. The amplitude of postural tremor is dependent on both central and peripheral factors, with proportionally greater motor unit entrainment occurring at low contraction intensities.

Kinetic Tremor

PubMed Central

Louis, Elan D.

2007-01-01

Tremor is among the acute effects of nicotine exposure. Published studies have focused on smoking-related postural (static) hand tremor rather than kinetic tremor (tremor during hand use), and gender differences in smoking-related tremor have not been examined. In a group of adults who were sampled from a population (mean ± SD = 65.7 ± 11.5 years, range = 18 - 92 years), the investigator assessed whether the severity of postural and kinetic tremors differed in smokers versus non-smokers, and whether this difference was influenced by gender. Twenty-seven (9.9%) of 273 subjects were current smokers. Greater tremor was observed in smokers than non-smokers during a variety of activities (drawing a spiral, using a spoon, finger-nose-finger maneuver, all p < 0.05) and smokers had a higher total tremor score than non-smokers (5.15 ± 3.06 vs. 3.41 ± 2.88, p < 0.01), even after adjusting for age, caffeine intake and other potential confounding factors. The difference between smokers and non-smokers in terms of hand tremor was more apparent in women than in men. In women, the number of cigarettes smoked on the day of testing was weakly correlated with the total tremor score (r = 0.17, p = 0.03). In summary, smokers had more kinetic hand tremor than non-smokers. This difference between smokers and non-smokers was more apparent in women than in men. These results suggest that smoking habits should be considered carefully in order to avoid over- or underestimating the effects of occupational and non-occupational exposures to other tremor-producing neurotoxins. PMID:17267044

Pathological ponto-cerebello-thalamo-cortical activations in primary orthostatic tremor during lying and stance.

PubMed

Schöberl, Florian; Feil, Katharina; Xiong, Guoming; Bartenstein, Peter; la Fougére, Christian; Jahn, Klaus; Brandt, Thomas; Strupp, Michael; Dieterich, Marianne; Zwergal, Andreas

2017-01-01

Primary orthostatic tremor is a rare neurological disease characterized mainly by a high frequency tremor of the legs while standing. The aim of this study was to identify the common core structures of the oscillatory circuit in orthostatic tremor and how it is modulated by changes of body position. Ten patients with orthostatic tremor and 10 healthy age-matched control subjects underwent a standardized neurological and neuro-ophthalmological examination including electromyographic and posturographic recordings. Task-dependent changes of cerebral glucose metabolism during lying and standing were measured in all subjects by sequential 18 F-fluorodeoxyglucose-positron emission tomography on separate days. Results were compared between groups and conditions. All the orthostatic tremor patients, but no control subject, showed the characteristic 13-18 Hz tremor in coherent muscles during standing, which ceased in the supine position. While lying, patients had a significantly increased regional cerebral glucose metabolism in the pontine tegmentum, the posterior cerebellum (including the dentate nuclei), the ventral intermediate and ventral posterolateral nucleus of the thalamus, and the primary motor cortex bilaterally compared to controls. Similar glucose metabolism changes occurred with clinical manifestation of the tremor during standing. The glucose metabolism was relatively decreased in mesiofrontal cortical areas (i.e. the medial prefrontal cortex, supplementary motor area and anterior cingulate cortex) and the bilateral anterior insula in orthostatic tremor patients while lying and standing. The mesiofrontal hypometabolism correlated with increased body sway in posturography. This study confirms and further elucidates ponto-cerebello-thalamo-primary motor cortical activations underlying primary orthostatic tremor, which presented consistently in a group of patients. Compared to other tremor disorders one characteristic feature in orthostatic tremor seems to be the

Primary writing tremor.

PubMed

Bain, P G; Findley, L J; Britton, T C; Rothwell, J C; Gresty, M A; Thompson, P D; Marsden, C D

1995-12-01

Primary writing tremor (PWT) is considered to be a type of task-specific tremor in which tremor predominantly occurs and interferes with handwriting. We describe the clinical and neurophysiological features of 21 patients (20 male and one female) with PWT. Mean age at tremor onset was 50.1 years. A family history of PWT was obtained from seven patients. Ten patients obtained benefit from drug treatment (mainly propranalol or primidone) and seven responded to alcohol. The writing speeds of the patients (mean +/- SEM: 73.1 +/- 6.6 letters per minute) when using their preferred hand were significantly reduced (Student's t test: P < 0.001) compared with those of healthy control subjects (mean +/- SEM: 127.7 +/- 6.4). Surface polymyography performed during writing showed 4.1-7.3 Hz rhythmic activity predominantly in the intrinsic hand and forearm muscles. Alternating, extensor activation alone, skipping from alternating to extensor activation, and co-contracting EMG patterns were recorded from the flexor and extensor muscles of the forearm. There was no evidence for excessive 'overflow' of this rhythmic EMG activity, as similar activity was detected in comparable muscle groups of healthy control subjects. Accelerometry confirmed that the frequency of PWT ranged from 4.1-7.3 Hz (median 5.5 Hz) and that normal subjects wrote with a 4.0-7.7 Hz oscillation (median 4.6 Hz). Forearm reciprocal inhibition was normal in PWT (n = 13), and thus patients with PWT can be distinguished from those with writer's cramp in whom decreased presynaptic inhibition has been found. Patients were sub-classified as having either type A (n = 11) or B (n = 10) PWT depending on whether tremor appeared during writing (type A: task induced tremor) or whilst writing and adopting the hand position used in writing (type B: positionally sensitive tremor). However, the only differences between these two groups were that a co-contracting EMG pattern and tremor induced by tendon taps to the volar aspect of

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

PubMed Central

Handforth, Adrian

2012-01-01

Background Harmaline and harmine are tremorigenic β-carbolines that, on administration to experimental animals, induce an acute postural and kinetic tremor of axial and truncal musculature. This drug-induced action tremor has been proposed as a model of essential tremor. Here we review what is known about harmaline tremor. Methods Using the terms harmaline and harmine on PubMed, we searched for papers describing the effects of these β-carbolines on mammalian tissue, animals, or humans. Results Investigations over four decades have shown that harmaline induces rhythmic burst-firing activity in the medial and dorsal accessory inferior olivary nuclei that is transmitted via climbing fibers to Purkinje cells and to the deep cerebellar nuclei, then to brainstem and spinal cord motoneurons. The critical structures required for tremor expression are the inferior olive, climbing fibers, and the deep cerebellar nuclei; Purkinje cells are not required. Enhanced synaptic norepinephrine or blockade of ionic glutamate receptors suppresses tremor, whereas enhanced synaptic serotonin exacerbates tremor. Benzodiazepines and muscimol suppress tremor. Alcohol suppresses harmaline tremor but exacerbates harmaline-associated neural damage. Recent investigations on the mechanism of harmaline tremor have focused on the T-type calcium channel. Discussion Like essential tremor, harmaline tremor involves the cerebellum, and classic medications for essential tremor have been found to suppress harmaline tremor, leading to utilization of the harmaline model for preclinical testing of antitremor drugs. Limitations are that the model is acute, unlike essential tremor, and only approximately half of the drugs reported to suppress harmaline tremor are subsequently found to suppress tremor in clinical trials. PMID:23440018

Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia.

PubMed

Cury, Rubens Gisbert; Fraix, Valerie; Castrioto, Anna; Pérez Fernández, Maricely Ambar; Krack, Paul; Chabardes, Stephan; Seigneuret, Eric; Alho, Eduardo Joaquim Lopes; Benabid, Alim-Louis; Moro, Elena

2017-09-26

To report on the long-term outcomes of deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM) in Parkinson disease (PD), essential tremor (ET), and dystonic tremor. One hundred fifty-nine patients with PD, ET, and dystonia underwent VIM DBS due to refractory tremor at the Grenoble University Hospital. The primary outcome was a change in the tremor scores at 1 year after surgery and at the latest follow-up (21 years). Secondary outcomes included the relationship between tremor score reduction over time and the active contact position. Tremor scores (Unified Parkinson's Disease Rating Scale-III, items 20 and 21; Fahn, Tolosa, Marin Tremor Rating Scale) and the coordinates of the active contacts were recorded. Ninety-eight patients were included. Patients with PD and ET had sustained improvement in tremor with VIM stimulation (mean improvement, 70% and 66% at 1 year; 63% and 48% beyond 10 years, respectively; p < 0.05). There was no significant loss of stimulation benefit over time ( p > 0.05). Patients with dystonia exhibited a moderate response at 1-year follow-up (41% tremor improvement, p = 0.027), which was not sustained after 5 years (30% improvement, p = 0.109). The more dorsal active contacts' coordinates in the right lead were related to a better outcome 1 year after surgery ( p = 0.029). During the whole follow-up, forty-eight patients (49%) experienced minor side effects, whereas 2 (2.0%) had serious events (brain hemorrhage and infection). VIM DBS is an effective long-term (beyond 10 years) treatment for tremor in PD and ET. Effects on dystonic tremor were modest and transient. This provides Class IV evidence. It is an observational study. © 2017 American Academy of Neurology.

Tremor - self-care

MedlinePlus

... may help you stop drinking. Managing Your Tremor Day-to-day Tremors can worsen over time. They may begin ... do your daily activities. To help in your day-to-day: Buy clothes with Velcro fasteners instead ...

Estimating small amplitude tremor sources

NASA Astrophysics Data System (ADS)

Katakami, S.; Ito, Y.; Ohta, K.

2017-12-01

Various types of slow earthquakes have been recently observed at both the updip and downdip edges of the coseismic slip areas [Obara and Kato, 2016]. Frequent occurrence of slow earthquakes may help us to reveal the physics underlying megathrust events as useful analogs. Maeda and Obara [2009] estimated spatiotemporal distribution of seismic energy radiation from low-frequency tremors. They applied their method to only the tremors, whose hypocenters had been decided with multiple station method. However, recently Katakami et al. (2016) identified a lot of continuous tremors with small amplitude that were not recorded multiple stations. These small events should be important to reveal the whole slow earthquake activity and to understand strain condition around a plate boundary in subduction zones. First, we apply the modified frequency scanning method (mFSM) at a single station to NIED Hi-net data in the southwestern Japan to understand whole tremor activity which were included weak signal tremors. Second, we developed a method to identify the tremor source area by using the difference of apparent tremor energy at each station by mFSM. We estimated the apparent source tremor energy after correcting both site amplification factor and geometrical spreading. Finally we calculate a tremor source area if the difference of apparent tremor energy between each pair of sites is the smallest. We checked a validity of this analysis by using only tremors which were already detected by envelope correlation method [Idehara et al., 2014]. We calculated the average amplitude as apparent tremor energy in 5 minutes window after occurring tremor at each station. Our results almost consistent to hypocenters which were determined the envelope correlation method. We successfully determined apparent tremor source areas of weak continuous tremors after estimating possible tremor occurrence time windows by using mFSM.

Promoting Physical Activity through Hand-Held Computer Technology

PubMed Central

King, Abby C.; Ahn, David K.; Oliveira, Brian M.; Atienza, Audie A.; Castro, Cynthia M.; Gardner, Christopher D.

2009-01-01

Background Efforts to achieve population-wide increases in walking and similar moderate-intensity physical activities potentially can be enhanced through relevant applications of state-of-the-art interactive communication technologies. Yet few systematic efforts to evaluate the efficacy of hand-held computers and similar devices for enhancing physical activity levels have occurred. The purpose of this first-generation study was to evaluate the efficacy of a hand-held computer (i.e., personal digital assistant [PDA]) for increasing moderate intensity or more vigorous (MOD+) physical activity levels over 8 weeks in mid-life and older adults relative to a standard information control arm. Design Randomized, controlled 8-week experiment. Data were collected in 2005 and analyzed in 2006-2007. Setting/Participants Community-based study of 37 healthy, initially underactive adults aged 50 years and older who were randomized and completed the 8-week study (intervention=19, control=18). Intervention Participants received an instructional session and a PDA programmed to monitor their physical activity levels twice per day and provide daily and weekly individualized feedback, goal setting, and support. Controls received standard, age-appropriate written physical activity educational materials. Main Outcome Measure Physical activity was assessed via the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire at baseline and 8 weeks. Results Relative to controls, intervention participants reported significantly greater 8-week mean estimated caloric expenditure levels and minutes per week in MOD+ activity (p<0.04). Satisfaction with the PDA was reasonably high in this largely PDA-naive sample. Conclusions Results from this first-generation study indicate that hand-held computers may be effective tools for increasing initial physical activity levels among underactive adults. PMID:18201644

Dystonia and Tremor: The Clinical Syndromes with Isolated Tremor

PubMed Central

Albanese, Alberto; Sorbo, Francesca Del

2016-01-01

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

Tremor

MedlinePlus

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

Effect of nipradilol, a beta-adrenergic blocker with vasodilating activity, on oxotremorine-induced tremor in mice.

PubMed

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.

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

PubMed

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

2017-03-01

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

Energy Cost of Active and Sedentary Music Video Games: Drum and Handheld Gaming vs. Walking and Sitting

PubMed Central

MIRANDA, EDWIN; OVERSTREET, BRITTANY S.; FOUNTAIN, WILLIAM A.; GUTIERREZ, VINCENT; KOLANKOWSKI, MICHAEL; OVERSTREET, MATTHEW L.; SAPP, RYAN M.; WOLFF, CHRISTOPHER A.; MAZZETTI, SCOTT A.

2017-01-01

To compare energy expenditure during and after active and handheld video game drumming compared to walking and sitting. Ten experienced, college-aged men performed four protocols (one per week): no-exercise seated control (CTRL), virtual drumming on a handheld gaming device (HANDHELD), active drumming on drum pads (DRUM), and walking on a treadmill at ~30% of VO2max (WALK). Protocols were performed after an overnight fast, and expired air was collected continuously during (30min) and after (30min) exercise. DRUM and HANDHELD song lists, day of the week, and time of day were identical for each participant. Significant differences (p < 0.05) among the average rates of energy expenditure (kcal·min−1) during activity included WALK > DRUM > HANDHELD. No significant differences in the rates of energy expenditure among groups during recovery were observed. Total energy expenditure was significantly greater (p < 0.05) during WALK (149.5 ± 30.6 kcal) compared to DRUM (118.7 ± 18.8 kcal) and HANDHELD (44.9±11.6 kcal), and greater during DRUM compared to HANDHELD. Total energy expenditure was not significantly different between HANDHELD (44.9 ± 11.6 kcal) and CTRL (38.2 ± 6.0 kcal). Active video game drumming at expert-level significantly increased energy expenditure compared to handheld, but it hardly met moderate-intensity activity standards, and energy expenditure was greatest during walking. Energy expenditure with handheld video game drumming was not different from no-exercise control. Thus, traditional aerobic exercise remains at the forefront for achieving the minimum amount and intensity of physical activity for health, individuals desiring to use video games for achieving weekly physical activity recommendations should choose games that require significant involvement of lower-body musculature, and time spent playing sedentary games should be a limited part of an active lifestyle. PMID:29170705

Energy Cost of Active and Sedentary Music Video Games: Drum and Handheld Gaming vs. Walking and Sitting.

PubMed

Miranda, Edwin; Overstreet, Brittany S; Fountain, William A; Gutierrez, Vincent; Kolankowski, Michael; Overstreet, Matthew L; Sapp, Ryan M; Wolff, Christopher A; Mazzetti, Scott A

2017-01-01

To compare energy expenditure during and after active and handheld video game drumming compared to walking and sitting. Ten experienced, college-aged men performed four protocols (one per week): no-exercise seated control (CTRL), virtual drumming on a handheld gaming device (HANDHELD), active drumming on drum pads (DRUM), and walking on a treadmill at ~30% of VO 2max (WALK). Protocols were performed after an overnight fast, and expired air was collected continuously during (30min) and after (30min) exercise. DRUM and HANDHELD song lists, day of the week, and time of day were identical for each participant. Significant differences (p < 0.05) among the average rates of energy expenditure (kcal·min -1 ) during activity included WALK > DRUM > HANDHELD. No significant differences in the rates of energy expenditure among groups during recovery were observed. Total energy expenditure was significantly greater (p < 0.05) during WALK (149.5 ± 30.6 kcal) compared to DRUM (118.7 ± 18.8 kcal) and HANDHELD (44.9±11.6 kcal), and greater during DRUM compared to HANDHELD. Total energy expenditure was not significantly different between HANDHELD (44.9 ± 11.6 kcal) and CTRL (38.2 ± 6.0 kcal). Active video game drumming at expert-level significantly increased energy expenditure compared to handheld, but it hardly met moderate-intensity activity standards, and energy expenditure was greatest during walking. Energy expenditure with handheld video game drumming was not different from no-exercise control. Thus, traditional aerobic exercise remains at the forefront for achieving the minimum amount and intensity of physical activity for health, individuals desiring to use video games for achieving weekly physical activity recommendations should choose games that require significant involvement of lower-body musculature, and time spent playing sedentary games should be a limited part of an active lifestyle.

Electrophysiological characteristics of task-specific tremor in 22 instrumentalists.

PubMed

Lee, André; Tominaga, Kenta; Furuya, Shinichi; Miyazaki, Fumio; Altenmüller, Eckart

2015-03-01

Our aim was to address three characteristics of task-specific tremor in musicians (TSTM): First, we quantified muscular activity of flexor and extensor muscles, of coactivation as well as tremor acceleration. Second, we compared muscular activity between task-dependent and position-dependent tremor. Third, we investigated, whether there is an overflow of muscular activity to muscles adjacent to the affected muscles in TSTM. Tremor acceleration and muscular activity were measured in the affected muscles and the muscles adjacent to the affected muscles in 22 patients aged 51.5 ± 11.4 years with a task-specific tremor. We assessed power of muscular oscillatory activity and calculated the coherence between EMG activity of affected muscles and tremor acceleration as well as between adjacent muscles and tremor acceleration. This was done for task-dependent and position-dependent tremor. We found the highest power and coherence of muscular oscillatory activity in the frequency range of 3-8 Hz for affected and adjacent muscles. No difference was found between task-dependent and position-dependent tremor in neither power nor coherence measures. Our results generalize previous results of a relation between coactivation and tremor among a variety of musicians. Furthermore, we found coherence of adjacent muscles and TSTM. This indicates that overflow exists in TSTM and suggests an association of TST with dystonia.

Rhythmic finger tapping reveals cerebellar dysfunction in essential tremor.

PubMed

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

2015-04-01

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

Diagnosis and Management of Essential Tremor and Dystonic Tremor

PubMed Central

Gironell, Alexandre

2009-01-01

Essential tremor (ET) is the most common adult movement disorder. Traditionally considered as a benign disease, it can cause an important physical and psychosocial disability. Drug treatment for ET remains poor and often unsatisfactory. Current therapeutic strategies for ET are reviewed according to the level of discomfort caused by tremor. For mild tremor, nonpharmacological strategies consist of alcohol and acute pharmacological therapy; for moderate tremor, pharmacological therapies (propranolol, gabapentin, primidone, topiramate, alprazolam and other drugs); and for severe tremor, the role of functional surgery is emphasised (thalamic deep brain stimulation, thalamotomy). The more specific treatment of head tremor with the use of botulinum toxin is also discussed. Several points are discussed to guide the immediate research into this disease in the near future. Dystonic tremor is a common symptom in dystonia. Diagnostic criteria for dystonic tremor and differential diagnosis with psychogenic tremor and ET are described. Treatment of dystonic tremor matches the treatment of dystonia. In cases of symptomatic dystonic tremor similar to ET, therapeutic strategies would be the same as for ET. PMID:21179530

Cataloging tremor at Kilauea Volcano, Hawaii

NASA Astrophysics Data System (ADS)

Thelen, W. A.; Wech, A.

2013-12-01

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

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

PubMed Central

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

2015-01-01

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

Differential diagnosis of common tremor syndromes

PubMed Central

Bhidayasiri, R

2005-01-01

Tremor is one of the most common involuntary movement disorders seen in clinical practice. In addition to the detailed history, the differential diagnosis is mainly clinical based on the distinction at rest, postural and intention, activation condition, frequency, and topographical distribution. The causes of tremor are heterogeneous and it can present alone (for example, essential tremor) or as a part of a neurological syndrome (for example, multiple sclerosis). Essential tremor and the tremor of Parkinson's disease are the most common tremors encountered in clinical practice. This article focuses on a practical approach to these different forms of tremor and how to distinguish them clinically. Evidence supporting various strategies used in the differentiation is then presented, followed by a review of formal guidelines or recommendations when they exist. PMID:16344298

Backprojection of volcanic tremor

USGS Publications Warehouse

Haney, Matthew M.

2014-01-01

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

The many roads to tremor.

PubMed

Brittain, John-Stuart; Brown, Peter

2013-12-01

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

Distinguishing the central drive to tremor in Parkinson's disease and essential tremor.

PubMed

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

2015-01-14

Parkinson's disease (PD) and essential tremor (ET) are the two most common movement disorders. Both have been associated with similar patterns of network activation leading to the suggestion that they may result from similar network dysfunction, specifically involving the cerebellum. Here, we demonstrate that parkinsonian tremors and ETs result from distinct patterns of interactions between neural oscillators. These patterns are reflected in the tremors' derived frequency tolerance, a novel measure readily attainable from bedside accelerometry. Frequency tolerance characterizes the temporal evolution of tremor by quantifying the range of frequencies over which the tremor may be considered stable. We found that patients with PD (N = 24) and ET (N = 21) were separable based on their frequency tolerance, with PD associated with a broad range of stable frequencies whereas ET displayed characteristics consistent with a more finely tuned oscillatory drive. Furthermore, tremor was selectively entrained by transcranial alternating current stimulation applied over cerebellum. Narrow frequency tolerances predicted stronger entrainment of tremor by stimulation, providing good evidence that the cerebellum plays an important role in pacing those tremors. The different patterns of frequency tolerance could be captured with a simple model based on a broadly coupled set of neural oscillators for PD, but a more finely tuned set of oscillators in ET. Together, these results reveal a potential organizational principle of the human motor system, whose disruption in PD and ET dictates how patients respond to empirical, and potentially therapeutic, interventions that interact with their underlying pathophysiology. Copyright © 2015 Brittain et al.

Cross-spectral analysis of physiological tremor and muscle activity. I. Theory and application to unsynchronized electromyogram.

PubMed

Timmer, J; Lauk, M; Pfleger, W; Deuschl, G

1998-05-01

We investigate the relationship between the extensor electromyogram (EMG) and tremor times series in physiological hand tremor by cross-spectral analysis. Special attention is directed to the phase spectrum and the effects of observational noise. We calculate the theoretical phase spectrum for a second-order linear stochastic process and compare the results to measured tremor data recorded from subjects who did not show a synchronized EMG activity in the corresponding extensor muscle. The results show that physiological tremor is well described by the proposed model and that the measured EMG represents a Newtonian force by which the muscle acts on the hand.

Tremor in dystonia.

PubMed

Pandey, Sanjay; Sarma, Neelav

2016-08-01

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

Comparison of mibefradil and derivative NNC 55-0396 effects on behavior, cytochrome P450 activity, and tremor in mouse models of essential tremor

PubMed Central

Quesada, Arnulfo; Bui, Peter H.; Homanics, Gregg E.; Hankinson, Oliver; Handforth, Adrian

2014-01-01

NNC 55-0396 [(1S,2S)-2-(2-(N-[(3-benzimidazol-2-yl)propyl]-N-methylamino)ethyl)-6-fluoro-1,2, 3,4-tetrahydro-1-isopropyl-2-naphtyl cyclopropanecarboxylate dihydrochloride], is a mibefradil derivative that retains potent in vitro T-type calcium channel antagonist efficacy. We compared the two compounds for behavioral toxicity, effects on cytochrome P450 activity, and efficacy against tremor in the γ-aminobutyric acid type A (GABAA) receptor subunit α1-null mouse, and the harmaline tremor model of essential tremor in wild-type mice. NNC 55-0396 was better tolerated than mibefradil in the horizontal wire test of sedation/motor function, with 3/6 failing at 300 and 30 mg/kg respectively. To assess for a potential interaction with harmaline, mice were given the drugs, followed by harmaline or vehicle, and tested 30 min later in the inverted wire grid test. Mibefradil exacerbated, whereas NNC 55-0396 ameliorated harmaline-induced test deficits. In mouse liver microsomes, NNC 55-0396 was a less potent inhibitor of harmaline O-demethylation than mibefradil (Ki: 0.95 and 0.29 µM respectively), and also less potent at inhibiting testosterone 6-β-hydroxylation (Ki: 0.71 and 0.12 µM respectively). In the GABAA α1-null model, NNC 55-0396 but not mibefradil, (each at 20 mg/kg), suppressed tremor while NNC 55-0396 at 12.5 mg/kg suppressed harmaline-induced tremor by half by 20–100 min, whereas mibefradil at the same dose did not significantly affect tremor. In contrast to mibefradil, NNC 55-0396 is well tolerated and suppresses tremor, and exerts less cytochrome P450 inhibition. These results suggest potential clinical utility for NNC 55-0396 or similar derivatives as a T-type calcium antagonist. PMID:21256842

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

NASA Astrophysics Data System (ADS)

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

2009-02-01

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

Somatosensory temporal discrimination in essential tremor and isolated head and voice tremors.

PubMed

Conte, Antonella; Ferrazzano, Gina; Manzo, Nicoletta; Leodori, Giorgio; Fabbrini, Giovanni; Fasano, Alfonso; Tinazzi, Michele; Berardelli, Alfredo

2015-05-01

The aim of this study was to investigate the somatosensory temporal discrimination threshold in patients with essential tremor (sporadic and familial) and to evaluate whether somatosensory temporal discrimination threshold values differ depending on the body parts involved by tremor. We also investigated the somatosensory temporal discrimination in patients with isolated voice tremor. We enrolled 61 patients with tremor: 48 patients with essential tremor (31 patients with upper limb tremor alone, nine patients with head tremor alone, and eight patients with upper limb plus head tremor; 22 patients with familial vs. 26 sporadic essential tremor), 13 patients with isolated voice tremor, and 45 healthy subjects. Somatosensory temporal discrimination threshold values were normal in patients with familial essential tremor, whereas they were higher in patients with sporadic essential tremor. When we classified patients according to tremor distribution, somatosensory temporal discrimination threshold values were normal in patients with upper limb tremor and abnormal only in patients with isolated head tremor. Temporal discrimination threshold values were also abnormal in patients with isolated voice tremor. Somatosensory temporal discrimination processing is normal in patients with familial as well as in patients with sporadic essential tremor involving the upper limbs. By contrast, somatosensory temporal discrimination is altered in patients with isolated head tremor and voice tremor. This study with somatosensory temporal discrimination suggests that isolated head and voice tremors might possibly be considered as separate clinical entities from essential tremor. © 2015 International Parkinson and Movement Disorder Society.

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

PubMed

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

2002-04-01

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

Temporal variation of tectonic tremor activity in southern Taiwan around the 2010 ML6.4 Jiashian earthquake

NASA Astrophysics Data System (ADS)

Chao, Kevin; Peng, Zhigang; Hsu, Ya-Ju; Obara, Kazushige; Wu, Chunquan; Ching, Kuo-En; van der Lee, Suzan; Pu, Hsin-Chieh; Leu, Peih-Lin; Wech, Aaron

2017-07-01

Deep tectonic tremor, which is extremely sensitive to small stress variations, could be used to monitor fault zone processes during large earthquake cycles and aseismic processes before large earthquakes. In this study, we develop an algorithm for the automatic detection and location of tectonic tremor beneath the southern Central Range of Taiwan and examine the spatiotemporal relationship between tremor and the 4 March 2010 ML6.4 Jiashian earthquake, located about 20 km from active tremor sources. We find that tremor in this region has a relatively short duration, short recurrence time, and no consistent correlation with surface GPS data. We find a short-term increase in the tremor rate 19 days before the Jiashian main shock, and around the time when the tremor rate began to rise one GPS station recorded a flip in its direction of motion. We hypothesize that tremor is driven by a slow-slip event that preceded the occurrence of the shallower Jiashian main shock, even though the inferred slip is too small to be observed by all GPS stations. Our study shows that tectonic tremor may reflect stress variation during the prenucleation process of a nearby earthquake.

[Genetics of tremor].

PubMed

Kuhlenbäumer, G; Hopfner, F

2018-04-01

Tremor is a symptom of many diseases and can constitute a disease of its own: essential tremor. The genetics of essential tremor and differential diagnosis of monogenic diseases with the symptom tremor. Literature search and search of clinical genetics databases, e.g. OMIM, GeneReviews, MDSGene and the German Neurological Society (DGN) guidelines. The genetics of essential tremor remain unresolved in spite of large, adequately powered studies. Tremor is a symptom of differential diagnostic value in many movement disorders. A slight tremor might have been missed or not reported in many descriptions of movement disorders. Progress in the genetics of essential tremor probably requires a more detailed phenotyping allowing stratification into phenotypically defined subgroups. Tremor should always be included in the examination and description of movement disorders even if tremor is not a cardinal symptom. Tremor might be helpful in the differential diagnosis of hereditary dystonia, hereditary ataxia, spastic paraplegia and other movement disorders.

Essential tremor

MedlinePlus

... Tremor - familial; Benign essential tremor; Shaking - essential tremor Images Central nervous system and peripheral nervous system References Jankovic J. Parkinson disease and other movement disorders. In: Daroff ...

Correlates Between Force and Postural Tremor in Older Individuals with Essential Tremor.

PubMed

Kavanagh, Justin J; Keogh, Justin W L

2016-12-01

Essential tremor (ET) is commonly associated with kinetic tremor. However, other forms of tremor, such as force and postural tremor, may occur in ET with less severity. This study objectively assessed force and postural tremor characteristics in ET with the purpose of identifying the relationships between these tremors. Ten individuals with ET (age 71 ± 5 years) and ten healthy controls (age 70 ± 5 years) participated in the study. Force tremor was quantified as fluctuations in index finger abduction force during isometric contractions at 10 % maximum voluntary contraction (MVC) and 60 % MVC. Postural tremor was quantified as index finger acceleration when the subjects held their entire arm unsupported, and when their arm was supported so that only the index finger could move. Time- and frequency-domain parameters were extracted from tremor data, and then correlations within, and between, tremor subtypes were examined. ET force tremor was dependent on contraction intensity whereas postural tremor was unaffected by the level of limb support. Significant correlations existed between frequency components of postural tremor and force tremor amplitude. Force tremor amplitude normalised to the level of contraction intensity correlated to the proportion of power for postural tremor. These correlations were observed for both contraction intensities and both levels of postural support. The proportion of power represents the output of central oscillators in ET patients and therefore correlated well to force tremor. Given that significant relationships existed between spectral features of postural tremor and the overall force tremor amplitude, it is clear that these tremor modalities are not completely independent in older adults with ET.

Phase dependent modulation of tremor amplitude in essential tremor through thalamic stimulation

PubMed Central

Cagnan, Hayriye; Brittain, John-Stuart; Little, Simon; Foltynie, Thomas; Limousin, Patricia; Zrinzo, Ludvic; Hariz, Marwan; Joint, Carole; Fitzgerald, James; Green, Alexander L.; Aziz, Tipu

2013-01-01

High frequency deep brain stimulation of the thalamus can help ameliorate severe essential tremor. Here we explore how the efficacy, efficiency and selectivity of thalamic deep brain stimulation might be improved in this condition. We started from the hypothesis that the effects of electrical stimulation on essential tremor may be phase dependent, and that, in particular, there are tremor phases at which stimuli preferentially lead to a reduction in the amplitude of tremor. The latter could be exploited to improve deep brain stimulation, particularly if tremor suppression could be reinforced by cumulative effects. Accordingly, we stimulated 10 patients with essential tremor and thalamic electrodes, while recording tremor amplitude and phase. Stimulation near the postural tremor frequency entrained tremor. Tremor amplitude was also modulated depending on the phase at which stimulation pulses were delivered in the tremor cycle. Stimuli in one half of the tremor cycle reduced median tremor amplitude by ∼10%, while those in the opposite half of the tremor cycle increased tremor amplitude by a similar amount. At optimal phase alignment tremor suppression reached 27%. Moreover, tremor amplitude showed a non-linear increase in the degree of suppression with successive stimuli; tremor suppression was increased threefold if a stimulus was preceded by four stimuli with a similar phase relationship with respect to the tremor, suggesting cumulative, possibly plastic, effects. The present results pave the way for a stimulation system that tracks tremor phase to control when deep brain stimulation pulses are delivered to treat essential tremor. This would allow treatment effects to be maximized by focussing stimulation on the optimal phase for suppression and by ensuring that this is repeated over many cycles so as to harness cumulative effects. Such a system might potentially achieve tremor control with far less power demand and greater specificity than current high frequency

Scaling analysis of bilateral hand tremor movements in essential tremor patients.

PubMed

Blesic, S; Maric, J; Dragasevic, N; Milanovic, S; Kostic, V; Ljubisavljevic, Milos

2011-08-01

Recent evidence suggests that the dynamic-scaling behavior of the time-series of signals extracted from separate peaks of tremor spectra may reveal existence of multiple independent sources of tremor. Here, we have studied dynamic characteristics of the time-series of hand tremor movements in essential tremor (ET) patients using the detrended fluctuation analysis method. Hand accelerometry was recorded with (500 g) and without weight loading under postural conditions in 25 ET patients and 20 normal subjects. The time-series comprising peak-to-peak (PtP) intervals were extracted from regions around the first three main frequency components of power spectra (PwS) of the recorded tremors. The data were compared between the load and no-load condition on dominant (related to tremor severity) and non-dominant tremor side and with the normal (physiological) oscillations in healthy subjects. Our analysis shows that, in ET, the dynamic characteristics of the main frequency component of recorded tremors exhibit scaling behavior. Furthermore, they show that the two main components of ET tremor frequency spectra, otherwise indistinguishable without load, become significantly different after inertial loading and that they differ between the tremor sides (related to tremor severity). These results show that scaling, a time-domain analysis, helps revealing tremor features previously not revealed by frequency-domain analysis and suggest that distinct oscillatory central circuits may generate the tremor in ET patients.

Nicotine evokes kinetic tremor by activating the inferior olive via α7 nicotinic acetylcholine receptors.

PubMed

Kunisawa, Naofumi; Iha, Higor A; Shimizu, Saki; Tokudome, Kentaro; Mukai, Takahiro; Kinboshi, Masato; Serikawa, Tadao; Ohno, Yukihiro

2016-11-01

Nicotinic acetylcholine (nACh) receptors are implicated in the pathogenesis of movement disorders (e.g., tremor) and epilepsy. Here, we performed behavioral and immunohistochemical studies using mice and rats to elucidate the mechanisms underlying nicotine-induced tremor. Treatments of animals with nicotine (0.5-2mg/kg, i.p.) elicited kinetic tremor, which was completely suppressed by the nACh receptor antagonist mecamylamine (MEC). The specific α7 nACh receptor antagonist methyllycaconitine (MLA) also inhibited nicotine-induced tremor, whereas the α4β2 nACh antagonist dihydro-β-erythroidine (DHβE) or the peripheral α3β4 nACh antagonist hexamethonium showed no effects. Mapping analysis of Fos protein expression, a biological marker of neural excitation, revealed that a tremorgenic dose (1mg/kg) of nicotine region-specifically elevated Fos expression in the piriform cortex (PirC), medial habenula, solitary nucleus and inferior olive (IO) among 44 brain regions examined. In addition, similarly to the tremor responses, nicotine-induced Fos expression in the PirC and IO was selectively antagonized by MLA, but not by DHβE. Furthermore, an electrical lesioning of the IO, but not the PirC, significantly suppressed the induction of nicotine tremor. The present results suggest that nicotine elicits kinetic tremor in rodents by activating the IO neurons via α7 nACh receptors. Copyright © 2016 Elsevier B.V. All rights reserved.

Functional tremor.

PubMed

Schwingenschuh, P; Deuschl, G

2016-01-01

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

Ambient tremors in a collisional orogenic belt

USGS Publications Warehouse

Chuang, Lindsay Yuling; Chen, Kate Huihsuan; Wech, Aaron G.; Byrne, Timothy; Peng, Wei

2014-01-01

Deep-seated tectonic tremors have been regarded as an observation tied to interconnected fluids at depth, which have been well documented in worldwide subduction zones and transform faults but not in a collisional mountain belt. In this study we explore the general features of collisional tremors in Taiwan and discuss the possible generation mechanism. In the 4 year data, we find 231 ambient tremor episodes with durations ranging from 5 to 30 min. In addition to a coseismic slip-induced stress change from nearby major earthquake, increased tremor rate is also highly correlated with the active, normal faulting earthquake swarms at the shallower depth. Both the tremor and earthquake swarm activities are confined in a small, area where the high attenuation, high thermal anomaly, the boundary between high and low resistivity, and localized veins on the surfaces distributed, suggesting the involvement of fluids from metamorphic dehydration within the orogen.

Transducer-based evaluation of tremor

PubMed Central

Haubenberger, Dietrich; Abbruzzese, Giovanni; Bain, Peter G; Bajaj, Nin; Benito-León, Julián; Bhatia, Kailash P; Deuschl, Günther; Forjaz, Maria João; Hallett, Mark; Louis, Elan D; Lyons, Kelly E; Mestre, Tiago A; Raethjen, Jan; Stamelou, Maria; Tan, Eng-King; Testa, Claudia M; Elble, Rodger J

2016-01-01

The Movement Disorder Society (MDS) established a task force on tremor that reviewed the use of transducer-based measures in the quantification and characterization of tremor. Studies of accelerometry, electromyography, activity monitoring, gyroscopy, digitizing tablet-based measures, vocal acoustic analysis, and several other transducer-based methods were identified by searching PubMed.gov. The availability, use, acceptability, reliability, validity, and responsiveness were reviewed for each measure using the following criteria: 1) used in the assessment of tremor, 2) used in published studies by people other than the developers, and 3) adequate clinimetric testing. Accelerometry, gyroscopy, electromyography, and digitizing tablet-based measures fulfilled all three criteria. Compared to rating scales, transducers are far more sensitive to changes in tremor amplitude and frequency, but they do not appear to be more capable of detecting a change that exceeds random variability in tremor amplitude (minimum detectable change). The use of transducer-based measures requires careful attention to their limitations and validity in a particular clinical or research setting. PMID:27273470

Tremor in the Elderly: Essential and Aging-Related Tremor

PubMed Central

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

2016-01-01

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

Tremor

MedlinePlus

... recommend the use of weights, splints, other adaptive equipment, and special plates and utensils for eating. Speech- ... on tremor also is available from the following organizations: International Essential Tremor Foundation P.O. Box 14005 ...

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

PubMed

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

2016-09-01

Distinguishing between different tremor disorders can be challenging. Some tremor disorders are thought to have typical tremor characteristics: the current study aims to provide sensitivity and specificity for five 'typical' tremor phenomena. Retrospectively, we examined 210 tremor patients referred for electrophysiological recordings between January 2008 and January 2014. The final clinical diagnosis was used as the gold standard. The first step was to determine whether patients met neurophysiological criteria for their type of tremor. Once established, we focused on 'typical' characteristics: tremor frequency decrease upon loading (enhanced physiological tremor (EPT)), amplitude increase upon loading, distractibility and entrainment (functional tremor (FT)), and intention tremor (essential tremor (ET)). The prevalence of these phenomena in the 'typical' group was compared to the whole group. Most patients (87%) concurred with all core clinical neurophysiological criteria for their tremor type. We found a frequency decrease upon loading to be a specific (95%), but not a sensitive (42%) test for EPT. Distractibility and entrainment both scored high on sensitivity (92%, 91%) and specificity (94%, 91%) in FT, whereas a tremor amplitude increase was specific (92%), but not sensitive (22%). Intention tremor was a specific finding in ET (85%), but not a sensitive test (45%). Combination of characteristics improved sensitivity. In this study, we retrospectively determined sensitivity and specificity for five 'typical' tremor characteristics. Characteristics proved specific, but few were sensitive. These data on tremor phenomenology will help practicing neurologists to improve distinction between different tremor disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Temporal discrimination in patients with dystonia and tremor and patients with essential tremor.

PubMed

Tinazzi, Michele; Fasano, Alfonso; Di Matteo, Alessandro; Conte, Antonella; Bove, Francesco; Bovi, Tommaso; Peretti, Alessia; Defazio, Giovanni; Fiorio, Mirta; Berardelli, Alfredo

2013-01-01

To investigate whether psychophysical techniques assessing temporal discrimination could help in differentiating patients who have tremor associated with dystonia or essential tremor. We tested somatosensory temporal discrimination thresholds (TDT) and temporal discrimination movement thresholds (TDMT) in 39 patients who had tremor associated with dystonia or essential tremor presenting with upper-limb tremor of comparable severity and compared their findings with those from a group of 25 sex- and age-matched healthy control subjects. TDT was higher in patients who had tremor associated with dystonia than in those with essential tremor and healthy controls (110.6 ± 31.3 vs 63.1 ± 15.2 vs 62.4 ± 9.2; p < 0.001). Conversely, TDMT was higher in patients with essential tremor than in those with tremor associated with dystonia and healthy controls (113.7 ± 14.7 vs 103.4 ± 11.3 vs 100.4 ± 4.2; p < 0.001). Combining the 2 tests in a pattern for essential tremor (abnormal TDMT/normal TDT) and tremor associated with dystonia (normal TDMT/abnormal TDT) yielded a positive predictive value (PPV) of 86.7% and a negative predictive value (NPV) of 70.8% for diagnosing essential tremor and a PPV of 100.0% and NPV of 74.1% for diagnosing tremor associated with dystonia. TDT and TDMT testing should prove a useful tool for differentiating tremor associated with dystonia and essential tremor. Our findings imply that the pathophysiologic mechanisms underlying tremor associated with dystonia differ from those for essential tremor.

Diagnosis and Management of Tremor.

PubMed

Louis, Elan D

2016-08-01

Tremor, which is a rhythmic oscillation of a body part, is among the most common involuntary movements. Rhythmic oscillations may manifest in a variety of ways; as a result, a rich clinical phenomenology surrounds tremor. For this reason, diagnosing tremor disorders can be particularly challenging. The aim of this article is to provide the reader with a straightforward approach to the diagnosis and management of patients with tremor. Scientific understanding of the pathophysiologic basis of tremor disorders has grown considerably in recent years with the use of a broad range of neuroimaging approaches and rigorous, controlled postmortem studies. The basal ganglia and cerebellum are structures that seem to play a prominent role. The diagnosis of tremor disorders is challenging. The approach to tremor involves a history and a neurologic examination that is focused on the nuances of tremor phenomenology, of which there are many. The evaluation should begin with a tremor history and a focused neurologic examination. The examination should attend to the many subtleties of tremor phenomenology. Among other things, the history and examination are used to establish whether the main type of tremor is an action tremor (ie, postural, kinetic, or intention tremor) or a resting tremor. The clinician should then formulate two sets of differential diagnoses: disorders in which action tremor is the predominant tremor versus those in which resting tremor is the main tremor. Among the most common of the former type are essential tremor, enhanced physiologic tremor, drug-induced tremor, dystonic tremor, orthostatic tremor, and cerebellar tremor. Parkinson disease is the most common form of resting tremor, along with drug-induced resting tremor. This article details the clinical features of each of these as well as other tremor disorders.

Cognitive Stress Reduces the Effect of Levodopa on Parkinson's Resting Tremor.

PubMed

Zach, Heidemarie; Dirkx, Michiel F; Pasman, Jaco W; Bloem, Bastiaan R; Helmich, Rick C

2017-03-01

Resting tremor in Parkinson's disease (PD) increases markedly during cognitive stress. Dopamine depletion in the basal ganglia is involved in the pathophysiology of resting tremor, but it is unclear whether this contribution is altered under cognitive stress. We test the hypothesis that cognitive stress modulates the levodopa effect on resting tremor. Tremulous PD patients (n = 69) were measured in two treatment conditions (OFF vs. ON levodopa) and in two behavioral contexts (rest vs. cognitive co-activation). Using accelerometry, we tested the effect of both interventions on tremor intensity and tremor variability. Levodopa significantly reduced tremor intensity (across behavioral contexts), while cognitive co-activation increased it (across treatment conditions). Crucially, the levodopa effect was significantly smaller during cognitive co-activation than during rest. Resting tremor variability increased after levodopa and decreased during cognitive co-activation. Cognitive stress reduces the levodopa effect on Parkinson's tremor. This effect may be explained by a stress-related depletion of dopamine in the basal ganglia motor circuit, by stress-related involvement of nondopaminergic mechanisms in tremor (e.g., noradrenaline), or both. Targeting these mechanisms may open new windows for treatment. Clinical tremor assessments under evoked cognitive stress (e.g., counting tasks) may avoid overestimation of treatment effects in real life. © 2017 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd.

The phenomenology of parkinsonian tremor.

PubMed

Deuschl, Günther; Papengut, Frank; Hellriegel, Helge

2012-01-01

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

Morphometric and functional MRI changes in essential tremor with and without resting tremor.

PubMed

Nicoletti, Valentina; Cecchi, Paolo; Frosini, Daniela; Pesaresi, Ilaria; Fabbri, Serena; Diciotti, Stefano; Bonuccelli, Ubaldo; Cosottini, Mirco; Ceravolo, Roberto

2015-03-01

The etiopathogenesis of essential tremor (ET) is still debated, since the predominant role of circuit dysfunction or brain degenerative changes has not been clearly established. The relationship with Parkinson's Disease (PD) is also controversial and resting tremor occurs in up to 20 % of ET. We investigated the morphological and functional changes associated with ET and we assessed potential differences related to the presence (ET+R) or absence (ET-R) of resting tremor. 32 ET patients (18 ET+R; 14 ET-R) and 12 healthy controls (HC) underwent 3T-MRI protocol including Spoiled Gradient T1-weighted sequence for Voxel-Based Morphometry (VBM) analysis and functional MRI during continuous writing of "8" with right dominant hand. VBM analysis revealed no gray and white matter atrophy comparing ET patients to HC and ET+R to ET-R patients. HC showed a higher BOLD response with respect to ET patients in cerebellum and other brain areas pertaining to cerebello-thalamo-cortical circuit. Between-group activation maps showed higher activation in precentral gyrus bilaterally, right superior and inferior frontal gyri, left postcentral gyrus, superior and inferior parietal gyri, mid temporal and supramarginal gyri, cerebellum and internal globus pallidus in ET-R compared to ET+R patients. Our findings support that the dysfunction of cerebello-thalamo-cortical network is associated with ET in absence of any morphometric changes. The dysfunction of GPi in ET+R patients, consistently with data reported in PD resting tremor, might suggest a potential role of this structure in this type of tremor.

Transducer-based evaluation of tremor.

PubMed

Haubenberger, Dietrich; Abbruzzese, Giovanni; Bain, Peter G; Bajaj, Nin; Benito-León, Julián; Bhatia, Kailash P; Deuschl, Günther; Forjaz, Maria João; Hallett, Mark; Louis, Elan D; Lyons, Kelly E; Mestre, Tiago A; Raethjen, Jan; Stamelou, Maria; Tan, Eng-King; Testa, Claudia M; Elble, Rodger J

2016-09-01

The International Parkinson and Movement Disorder Society established a task force on tremor that reviewed the use of transducer-based measures in the quantification and characterization of tremor. Studies of accelerometry, electromyography, activity monitoring, gyroscopy, digitizing tablet-based measures, vocal acoustic analysis, and several other transducer-based methods were identified by searching PubMed.gov. The availability, use, acceptability, reliability, validity, and responsiveness were reviewed for each measure using the following criteria: (1) used in the assessment of tremor; (2) used in published studies by people other than the developers; and (3) adequate clinimetric testing. Accelerometry, gyroscopy, electromyography, and digitizing tablet-based measures fulfilled all three criteria. Compared to rating scales, transducers are far more sensitive to changes in tremor amplitude and frequency, but they do not appear to be more capable of detecting a change that exceeds random variability in tremor amplitude (minimum detectable change). The use of transducer-based measures requires careful attention to their limitations and validity in a particular clinical or research setting. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

A role for locus coeruleus in Parkinson tremor

PubMed Central

Isaias, Ioannis U.; Marzegan, Alberto; Pezzoli, Gianni; Marotta, Giorgio; Canesi, Margherita; Biella, Gabriele E. M.; Volkmann, Jens; Cavallari, Paolo

2012-01-01

We analyzed rest tremor, one of the etiologically most elusive hallmarks of Parkinson disease (PD), in 12 consecutive PD patients during a specific task activating the locus coeruleus (LC) to investigate a putative role of noradrenaline (NA) in tremor generation and suppression. Clinical diagnosis was confirmed in all subjects by reduced dopamine reuptake transporter (DAT) binding values investigated by single photon computed tomography imaging (SPECT) with [123I] N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) tropane (FP-CIT). The intensity of tremor (i.e., the power of Electromyography [EMG] signals), but not its frequency, significantly increased during the task. In six subjects, tremor appeared selectively during the task. In a second part of the study, we retrospectively reviewed SPECT with FP-CIT data and confirmed the lack of correlation between dopaminergic loss and tremor by comparing DAT binding values of 82 PD subjects with bilateral tremor (n = 27), unilateral tremor (n = 22), and no tremor (n = 33). This study suggests a role of the LC in Parkinson tremor. PMID:22287946

Tremor in multiple sclerosis: The intriguing role of the cerebellum.

PubMed

Ayache, Samar S; Chalah, Moussa A; Al-Ani, Tarik; Farhat, Wassim H; Zouari, Hela G; Créange, Alain; Lefaucheur, Jean-Pascal

2015-11-15

Tremor is frequently encountered in multiple sclerosis (MS) patients. However, its underlying pathophysiological mechanisms remain poorly understood. Our aim was to assess the potential role of the cerebellum and brain stem structures in the generation of MS tremor.We performed accelerometric (ACC) and electromyographic(EMG) assessment of tremor in 32MS patients with manual clumsiness. In addition to clinical examination, patients underwent a neurophysiological exploration of the brainstem and cerebellar functions,which consisted of blink and masseter inhibitory reflexes, cerebello-thalamo-cortical inhibition (CTCi), and somatosensory evoked potentials. Tremor was clinically visible in 18 patients and absent in 14. Patients with visible tremor had more severe score of ataxia and clinical signs of cerebellar dysfunction, as well as a more reduced CTCi on neurophysiological investigation. However, ACC and EMG recordings confirmed the presence of a real rhythmic activity in only one patient. In most MS patients, the clinically visible tremor corresponded to a pseudorhythmic activity without coupling between ACC and EMG recordings. Cerebellar dysfunction may contribute to the occurrence of this pseudorhythmic activity mimicking tremor during posture and movement execution.

Is Slow Slip a Cause or a Result of Tremor?

NASA Astrophysics Data System (ADS)

Luo, Y.; Ampuero, J. P.

2017-12-01

of tremor activity. We also find that, despite important interactions between asperities, tremor activity rates are proportional to the underlying aseismic slip rate, supporting an approach to estimate SSE properties with high spatial-temporal resolutions via tremor activity.

The Distribution and Severity of Tremor in Speech Structures of Persons with Vocal Tremor.

PubMed

Hemmerich, Abby L; Finnegan, Eileen M; Hoffman, Henry T

2017-05-01

Vocal tremor may be associated with cyclic oscillations in the pulmonary, laryngeal, velopharyngeal, or oral regions. This study aimed to correlate the overall severity of vocal tremor with the distribution and severity of tremor in structures involved. Endoscopic and clinical examinations were completed on 20 adults with vocal tremor and two age-matched controls during sustained phonation. Two judges rated the severity of vocal tremor and the severity of tremor affecting each of 13 structures. Participants with mild vocal tremor typically presented with tremor in three laryngeal structures, moderate vocal tremor in five structures (laryngeal and another region), and severe vocal tremor in eight structures affecting all regions. The severity of tremor was lowest (mean = 1.2 out of 3) in persons with mild vocal tremor and greater in persons with moderate (mean = 1.5) and severe vocal tremor (mean = 1.4). Laryngeal structures were most frequently (95%) and severely (1.7 out of 3) affected, followed by velopharynx (40% occurrence, 1.3 severity), pulmonary (40% occurrence, 1.1 severity), and oral (40% occurrence, 1.0 severity) regions. Regression analyses indicated tremor severity of the supraglottic structures, and vertical laryngeal movement contributed most to vocal tremor severity during sustained phonation (r = 0.77, F = 16.17, P < 0.0001). A strong positive correlation (r = 0.72) was found between the Tremor Index and the severity of the vocal tremor during sustained phonation. It is useful to obtain a wide endoscopic view of the larynx to visualize tremor, which is rarely isolated to the true vocal folds alone. Published by Elsevier Inc.

Semiology of Tremors.

PubMed

Molina-Negro, P; Hardy, J

1975-02-01

Since the description by Galen in the 2nd Century, A.D., clinical neurology has acknowledged the existence of two types of tremor: that which occurs at rest and that occuring during the execution of movement. With the help of refined methods of analysis, E.M.G. and cinephotography, the authors have carried out a detailed clinical assessment in more than 400 patients. The basic criterion used to define a tremor was the classical definition of Dejerine: "An involuntary, rhythmical and symmetrical movement about an axis of equilibrium." As a result of this study, the conclusion has been reached that there are two types of tremor: postural tremor and tremor of attitude. Both are present while the limb remains immobile, whether by wilful design or when at rest in a position of posture and subject only to the action of gravity. During voluntary movement, tremor is not present. Irregular, asymmetrical and non-rhythmic oscillations may appear however - as in so-called intention tremor, of cerebellar origin - but this abnormal movement can hardly be called a real tremor. It is merely a manifestation of ataxia. As a consequence of this study, it is suggested that further understanding of the basic mechanism of tremor can be reached by the investigation of the central neural structures which are involved in the physiology of posture and attitude.

Tidal modulation of nonvolcanic tremor.

PubMed

Rubinstein, Justin L; La Rocca, Mario; Vidale, John E; Creager, Kenneth C; Wech, Aaron G

2008-01-11

Episodes of nonvolcanic tremor and accompanying slow slip recently have been observed in the subduction zones of Japan and Cascadia. In Cascadia, such episodes typically last a few weeks and differ from "normal" earthquakes in their source location and moment-duration scaling. The three most recent episodes in the Puget Sound/southern Vancouver Island portion of the Cascadia subduction zone were exceptionally well recorded. In each episode, we saw clear pulsing of tremor activity with periods of 12.4 and 24 to 25 hours, the same as the principal lunar and lunisolar tides. This indicates that the small stresses associated with the solid-earth and ocean tides influence the genesis of tremor much more effectively than they do the genesis of normal earthquakes. Because the lithostatic stresses are 10(5) times larger than those associated with the tides, we argue that tremor occurs on very weak faults.

Approach to a tremor patient

PubMed Central

Sharma, Soumya; Pandey, Sanjay

2016-01-01

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

Essential tremor.

PubMed Central

Murray, T. J.

1981-01-01

Essential tremor, including the juvenile and senile variations, may be a result of a disorder of the servomechanism that controls physiologic tremor. Hands and arms are affected most commonly, and the tremor can vary in amplitude as well as frequency. Long-term treatment with propranolol has been helpful for some patients, although older patients are less likely to benefit. Other drugs and behaviour modification therapy have been less successful. Surgical treatment is effective but should probably be reserved for severe cases. An effective instrument for measuring the subjective and objective aspects of the tremor is still needed, as is an effective long-term method of treatment. PMID:7018658

Lessons from (triggered) tremor

USGS Publications Warehouse

Gomberg, Joan

2010-01-01

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

Is postural tremor size controlled by interstitial potassium concentration in muscle?

PubMed Central

Lakie, M; Hayes, N; Combes, N; Langford, N

2004-01-01

Objectives: To determine whether factors associated with postural tremor operate by altering muscle interstitial K+. Methods: An experimental approach was used to investigate the effects of procedures designed to increase or decrease interstitial K+. Postural physiological tremor was measured by conventional means. Brief periods of ischaemic muscle activity were used to increase muscle interstitial K+. Infusion of the ß2 agonist terbutaline was used to decrease plasma (and interstitial) K+. Blood samples were taken for the determination of plasma K+. Results: Ischaemia rapidly reduced tremor size, but only when the muscle was active. The ß2 agonist produced a slow and progressive rise in tremor size that was almost exactly mirrored by a slow and progressive decrease in plasma K+. Conclusions: Ischaemic reduction of postural tremor has been attributed to effects on muscle spindles or an unexplained effect on muscle. This study showed that ischaemia did not reduce tremor size unless there was accompanying muscular activity. An accumulation of K+ in the interstitium of the ischaemic active muscle may blunt the response of the muscle and reduce its fusion frequency, so that the force output becomes less pulsatile and tremor size decreases. When a ß2 agonist is infused, the rise in tremor mirrors the resultant decrease in plasma K+. Decreased plasma K+ reduces interstitial K+ concentration and may produce greater muscular force fluctuation (more tremor). Many other factors that affect postural tremor size may exert their effect by altering plasma K+ concentration, thereby changing the concentration of K+ in the interstitial fluid. PMID:15201362

San Andreas tremor cascades define deep fault zone complexity

USGS Publications Warehouse

Shelly, David R.

2015-01-01

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

Tremor in progressive supranuclear palsy.

PubMed

Fujioka, Shinsuke; Algom, Avi A; Murray, Melissa E; Sanchez-Contreras, Monica Y; Tacik, Pawel; Tsuboi, Yoshio; Van Gerpen, Jay A; Uitti, Ryan J; Rademakers, Rosa; Ross, Owen A; Wszolek, Zbigniew K; Dickson, Dennis W

2016-06-01

Tremor is thought to be a rare feature of progressive supranuclear palsy (PSP). We retrospectively reviewed the database of the CurePSP brain bank at Mayo Clinic Florida to retrieve all available clinical information for PSP patients. All patients underwent a standard neuropathological assessment and an immunohistochemical evaluation for tau and α-synuclein. DNA was genotyped for the MAPT H1/H2 haplotype. Of the 375 PSP patients identified, 344 had a documented presence or absence of tremor, which included 146 (42%) with tremor, including 29 (20%) with postural/action tremors, 16 (11%) with resting tremor, 7 (5%) with intention tremor, 20 (14%) with a combination of different types of tremor, and 74 (51%) patients who had tremor at some point during their illness, but details were unavailable. The tremor severity of 96% of the patients (54/55) who had this data was minimal to mild. The probability of observing a tremor during a neurological examination during the patient's illness was estimated to be ∼22%. PSP patients with postural/action tremors and PSP patients with resting tremor responded to carbidopa-levodopa therapy more frequently than PSP patients without tremor, although the therapy response was always transient. There were no significant differences in pathological findings between the tremor groups. Tremor is an inconspicuous feature of PSP; however, 42% (146/344) of the PSP patients in our study presented some form of tremor. Because there is no curative therapy for PSP, carbidopa/levodopa therapy should be tried for patients with postural, action, and resting tremor. Copyright © 2016 Elsevier Ltd. All rights reserved.

Linking Essential Tremor to the Cerebellum-Animal Model Evidence.

PubMed

Handforth, Adrian

2016-06-01

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

Case Studies in Tremor.

PubMed

Shanker, Vicki L

2016-08-01

Tremor is a frequent patient complaint in the neurologist's office. Nevertheless, despite the routine nature of this office presentation, misdiagnosis of common tremors is not an infrequent practice. In addition, there are less common causes of tremor that can be missed if the clinician is not aware of key features. An organized and methodical history and neurologic examination are essential in developing the differential diagnosis in tremor patients and ultimately in achieving the correct diagnosis. Awareness of key historical features associated with tremor and knowledge of the movement disorders examination will improve tremor assessment. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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.

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

PubMed

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

2016-04-01

DAT-SPECT, is a well-established procedure for distinguishing drug-induced parkinsonism from Parkinson's disease (PD). We investigated the usefulness of blink reflex recovery cycle (BRrc) and of electromyographic parameters of resting tremor for the differentiation of patients with drug-induced parkinsonism with resting tremor (rDIP) from those with resting tremor due to PD. This was a cross-sectional study. In 16 patients with rDIP and 18 patients with PD we analysed electrophysiological parameters (amplitude, duration, burst and pattern) of resting tremor. BRrc at interstimulus intervals (ISI) of 100, 150, 200, 300, 400, 500 and 750 msec was also analysed in patients with rDIP, patients with PD and healthy controls. All patients and controls underwent DAT-SPECT. Rest tremor amplitude was higher in PD patients than in rDIP patients (p < 0.001), while frequency and burst duration were higher in rDIP than in PD (p < 0.001, p < 0.003, respectively). Resting tremor showed a synchronous pattern in all patients with rDIP, whereas it had an alternating pattern in all PD patients (p < 0.001). DAT-SPECT was normal in rDIP patients while it was markedly abnormal in patients with PD. In the absence of DAT-SPECT, the pattern of resting tremor can be considered a useful investigation for differentiating rDIP from PD. Copyright © 2016. Published by Elsevier Ltd.

Pharmacological and Physiological Characterization of the Tremulous Jaw Movement Model of Parkinsonian Tremor: Potential Insights into the Pathophysiology of Tremor

PubMed Central

Collins-Praino, Lyndsey E.; Paul, Nicholas E.; Rychalsky, Kristen L.; Hinman, James R.; Chrobak, James J.; Senatus, Patrick B.; Salamone, John D.

2011-01-01

Tremor is a cardinal symptom of parkinsonism, occurring early on in the disease course and affecting more than 70% of patients. Parkinsonian resting tremor occurs in a frequency range of 3–7 Hz and can be resistant to available pharmacotherapy. Despite its prevalence, and the significant decrease in quality of life associated with it, the pathophysiology of parkinsonian tremor is poorly understood. The tremulous jaw movement (TJM) model is an extensively validated rodent model of tremor. TJMs are induced by conditions that also lead to parkinsonism in humans (i.e., striatal DA depletion, DA antagonism, and cholinomimetic activity) and reversed by several antiparkinsonian drugs (i.e., DA precursors, DA agonists, anticholinergics, and adenosine A2A antagonists). TJMs occur in the same 3–7 Hz frequency range seen in parkinsonian resting tremor, a range distinct from that of dyskinesia (1–2 Hz), and postural tremor (8–14 Hz). Overall, these drug-induced TJMs share many characteristics with human parkinsonian tremor, but do not closely resemble tardive dyskinesia. The current review discusses recent advances in the validation of the TJM model, and illustrates how this model is being used to develop novel therapeutic strategies, both surgical and pharmacological, for the treatment of parkinsonian resting tremor. PMID:21772815

Jaw tremor as a physiological biomarker of bruxism.

PubMed

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 <35% maximum voluntary force). Bite force control was quantified in terms of the power spectra of force fluctuations, masseter EMG activity, and force-to-EMG coherence. Patients had greater jaw force tremor at ∼8 Hz relative to controls, along with increased masseter EMG activity and force-to-EMG coherence in the same frequency range. Patients also showed lower force-to-EMG coherence at low frequencies (<3 Hz), but greater coherence at high frequencies (20-40 Hz). Finally, patients had greater 6-10 Hz force tremor during periods of descending vs. ascending force, while controls showed no difference in tremor with respect to force dynamics. Patients with 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.

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

PubMed

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.

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

PubMed Central

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

Voice Tremor in Parkinson's Disease: An Acoustic Study.

PubMed

Gillivan-Murphy, Patricia; Miller, Nick; Carding, Paul

2018-01-30

Voice tremor associated with Parkinson disease (PD) has not been characterized. Its relationship with voice disability and disease variables is unknown. This study aimed to evaluate voice tremor in people with PD (pwPD) and a matched control group using acoustic analysis, and to examine correlations with voice disability and disease variables. Acoustic voice tremor analysis was completed on 30 pwPD and 28 age-gender matched controls. Voice disability (Voice Handicap Index), and disease variables of disease duration, Activities of Daily Living (Unified Parkinson's Disease Rating Scale [UPDRS II]), and motor symptoms related to PD (UPDRS III) were examined for relationship with voice tremor measures. Voice tremor was detected acoustically in pwPD and controls with similar frequency. PwPD had a statistically significantly higher rate of amplitude tremor (Hz) than controls (P = 0.001). Rate of amplitude tremor was negatively and significantly correlated with UPDRS III total score (rho -0.509). For pwPD, the magnitude and periodicity of acoustic tremor was higher than for controls without statistical significance. The magnitude of frequency tremor (Mftr%) was positively and significantly correlated with disease duration (rho 0.463). PwPD had higher Voice Handicap Index total, functional, emotional, and physical subscale scores than matched controls (P < 0.001). Voice disability did not correlate significantly with acoustic voice tremor measures. Acoustic analysis enhances understanding of PD voice tremor characteristics, its pathophysiology, and its relationship with voice disability and disease symptomatology. Copyright © 2018 The Voice Foundation. All rights reserved.

Automated detection and characterization of harmonic tremor in continuous seismic data

NASA Astrophysics Data System (ADS)

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.

Mapping Yakutat Subduction with Tectonic Tremor

NASA Astrophysics Data System (ADS)

Wech, A.

2015-12-01

Subduction of the Yakutat microplate (YAK) in south-central Alaska may be responsible for regional high topography, large slip during the 1964 earthquake, and the anomalous gap in arc volcanism, but the exact geodynamics and its relationship with the underlying Pacific Plate (PP) are not fully understood. Refraction data support distinct subducting layers, and both GPS and body wave tomography suggest the YAK extends from the Cook Inlet volcanoes in the west to the Wrangell volcanic field in the east. Earthquakes, however, are limited to normal faulting within the PP with an abrupt eastern boundary 80 km west of the inferred YAK edge, and more recent active source seismic data suggest subduction of one homogenous thickened oceanic plateau. Here, I perform a search for tectonic tremor to investigate the role of tremor and slow slip in the system. I scan continuous waveforms from 2007-2015 using all available data from permanent and campaign seismic stations in south-central Alaska. Using envelope cross-correlation, I detect and locate ~9,000 tectonic tremor epicenters, providing a map of the transition zone downdip of the 1964 earthquake. Tremor epicenters occur downdip of discrete slow slip events, and tremor rates do not correlate temporally with slow slip behavior. Depth resolution is poor, but horizontal locations are well constrained and spatially correlate with the velocity images of the YAK. Likewise, tremor extends 80 km further east than intraslab seismicity. Tremor swarms occur intermittently and manifest as ambient tremor. I interpret tremor to mark slow, semi-continuous slip occurring at the boundary between the YAK and North American plates, whose interface continues beyond the eastern edge of the PP. In this model, the YAK is welded to the underlying PP in the west, but extends past the eastern terminus of the PP. This geometry explains the correlation between tremor and the YAK, the discrepancy between deep seismicity and tremor, and the paucity of

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

PubMed Central

Sternberg, Eliezer J.; Alcalay, Roy N.; Levy, Oren A.; Louis, Elan D.

2013-01-01

Background: An estimated 30–50% of essential tremor (ET) diagnoses are incorrect, and the true diagnosis in those patients is often Parkinson’s disease (PD) or other tremor disorders. There are general statements about the tremor in these ET and PD, but published data on the more subtle characteristics of tremor are surprisingly limited. Postural tremor may occur in both disorders, adding to the difficulty. There are several anecdotal impressions regarding specific features of postural tremor in ET vs. PD, including joint distribution (e.g., phalanges, metacarpal-phalangeal joints, wrist), tremor directionality (e.g., flexion-extension vs. pronation-supination), and presence of intention tremor. However, there is little data to support these impressions. Methods: In this cross-sectional study, 100 patients (ET, 50 PD) underwent detailed videotaped neurological examinations. Arm tremor was rated by a movement disorder neurologist who assessed severity and directionality across multiple joints. Results: During sustained arm extension, ET patients exhibited more wrist than metacarpal-phalangeal and phalangeal joint tremor than did PD patients (p < 0.001), and more wrist flexion-extension tremor than wrist pronation-supination tremor (p < 0.001). During the finger-nose-finger maneuver, intention tremor was present in approximately one in four (28%) ET patients vs. virtually none (4%) of the Parkinson’s patients (p < 0.001). Conclusions: We evaluated the location, severity, and directionality of postural tremor in ET and PD, and the presence of intention tremor, observing several clinical differences. We hope that detailed phenomenological data on tremor in ET and PD will help practicing physicians delineate the two diseases. PMID:23717300

Hand-held monitor of sympathetic nervous system using salivary amylase activity and its validation by driver fatigue assessment.

PubMed

Yamaguchi, Masaki; Deguchi, Mitsuo; Wakasugi, Junichi; Ono, Shin; Takai, Noriyasu; Higashi, Tomoyuki; Mizuno, Yasufumi

2006-01-15

In order to realize a hand-held monitor of the sympathetic nervous system, we fabricated a completely automated analytical system for salivary amylase activity using a dry-chemistry system. This was made possible by the fabrication of a disposable test-strip equipped with built-in collecting and reagent papers and an automatic saliva transfer device. In order to cancel out the effects of variations in environmental temperature and pH of saliva, temperature- and pH-adjusted equations were experimentally determined, and each theoretical value was input into the memory of the hand-held monitor. Within a range of salivary amylase activity between 10 and 140 kU/l, the calibration curve for the hand-held monitor showed a coefficient with R(2)=0.97. Accordingly, it was demonstrated that the hand-held monitor enabled a user to automatically measure the salivary amylase activity with high accuracy with only 30 microl sample of saliva within a minute from collection to completion of the measurement. In order to make individual variations of salivary amylase activity negligible during driver fatigue assessment, a normalized equation was proposed. The normalized salivary amylase activity correlated with the mental and physical fatigue states. Thus, this study demonstrated that an excellent hand-held monitor with an algorithm for normalization of individuals' differences in salivary amylase activity, which could be easily and quickly used for evaluating the activity of the sympathetic nervous system at any time. Furthermore, it is suggested that the salivary amylase activity might be used as a better index for psychological research.

Effects of peripheral cooling on intention tremor in multiple sclerosis

PubMed Central

Feys, P; Helsen, W; Liu, X; Mooren, D; Albrecht, H; Nuttin, B; Ketelaer, P

2005-01-01

Objective: To investigate the effect of peripheral sustained cooling on intention tremor in patients with multiple sclerosis (MS). MS induced upper limb intention tremor affects many functional activities and is extremely difficult to treat. Materials/Methods: Deep (18°C) and moderate (25°C) cooling interventions were applied for 15 minutes to 23 and 11 tremor arms of patients with MS, respectively. Deep and moderate cooling reduced skin temperature at the elbow by 13.5°C and 7°C, respectively. Evaluations of physiological variables, the finger tapping test, and a wrist step tracking task were performed before and up to 30 minutes after cooling. Results: The heart rate and the central body temperature remained unchanged throughout. Both cooling interventions reduced overall tremor amplitude and frequency proportional to cooling intensity. Tremor reduction persisted during the 30 minute post cooling evaluation period. Nerve conduction velocity was decreased after deep cooling, but this does not fully explain the reduction in tremor amplitude or the effects of moderate cooling. Cooling did not substantially hamper voluntary movement control required for accurate performance of the step tracking task. However, changes in the mechanical properties of muscles may have contributed to the tremor amplitude reduction. Conclusions: Cooling induced tremor reduction is probably caused by a combination of decreased nerve conduction velocity, changed muscle properties, and reduced muscle spindle activity. Tremor reduction is thought to relate to decreased long loop stretch reflexes, because muscle spindle discharge is temperature dependent. These findings are clinically important because applying peripheral cooling might enable patients to perform functional activities more efficiently. PMID:15716530

Orthostatic tremor: a cerebellar pathology?

PubMed Central

Popa, Traian; García-Lorenzo, Daniel; Valabregue, Romain; Legrand, André-Pierre; Apartis, Emmanuelle; Marais, Lea; Degos, Bertrand; Hubsch, Cecile; Fernández-Vidal, Sara; Bardinet, Eric; Roze, Emmanuel; Lehéricy, Stéphane; Meunier, Sabine; Vidailhet, Marie

2016-01-01

Abstract See Muthuraman et al. (doi:10.1093/aww164) for a scientific commentary on this article. Primary orthostatic tremor is characterized by high frequency tremor affecting the legs and trunk during the standing position. Cerebellar defects were suggested in orthostatic tremor without direct evidence. We aimed to characterize the anatomo-functional defects of the cerebellar motor pathways in orthostatic tremor. We used multimodal neuroimaging to compare 17 patients with orthostatic tremor and 17 age- and gender-matched healthy volunteers. Nine of the patients with orthostatic tremor underwent repetitive transcranial stimulation applied over the cerebellum during five consecutive days. We quantified the duration of standing position and tremor severity through electromyographic recordings. Compared to healthy volunteers, grey matter volume in patients with orthostatic tremor was (i) increased in the cerebellar vermis and correlated positively with the duration of the standing position; and (ii) increased in the supplementary motor area and decreased in the lateral cerebellum, which both correlated with the disease duration. Functional connectivity between the lateral cerebellum and the supplementary motor area was abnormally increased in patients with orthostatic tremor, and correlated positively with tremor severity. After repetitive transcranial stimulation, tremor severity and functional connectivity between the lateral cerebellum and the supplementary motor area were reduced. We provide an explanation for orthostatic tremor pathophysiology, and demonstrate the functional relevance of cerebello-thalamo-cortical connections in tremor related to cerebellar defects. PMID:27329770

Long-term detection of Parkinsonian tremor activity from subthalamic nucleus local field potentials.

PubMed

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.

Motor network disruption in essential tremor: a functional and effective connectivity study.

PubMed

Buijink, Arthur W G; van der Stouwe, A M Madelein; Broersma, Marja; Sharifi, Sarvi; Groot, Paul F C; Speelman, Johannes D; Maurits, Natasha M; van Rootselaar, Anne-Fleur

2015-10-01

Although involvement of the cerebello-thalamo-cortical network has often been suggested in essential tremor, the source of oscillatory activity remains largely unknown. To elucidate mechanisms of tremor generation, it is of crucial importance to study the dynamics within the cerebello-thalamo-cortical network. Using a combination of electromyography and functional magnetic resonance imaging, it is possible to record the peripheral manifestation of tremor simultaneously with brain activity related to tremor generation. Our first aim was to study the intrinsic activity of regions within the cerebello-thalamo-cortical network using dynamic causal modelling to estimate effective connectivity driven by the concurrently recorded tremor signal. Our second aim was to objectify how the functional integrity of the cerebello-thalamo-cortical network is affected in essential tremor. We investigated the functional connectivity between cerebellar and cortical motor regions showing activations during a motor task. Twenty-two essential tremor patients and 22 healthy controls were analysed. For the effective connectivity analysis, a network of tremor-signal related regions was constructed, consisting of the left primary motor cortex, premotor cortex, supplementary motor area, left thalamus, and right cerebellar motor regions lobule V and lobule VIII. A measure of variation in tremor severity over time, derived from the electromyogram, was included as modulatory input on intrinsic connections and on the extrinsic cerebello-thalamic connections, giving a total of 128 models. Bayesian model selection and random effects Bayesian model averaging were used. Separate seed-based functional connectivity analyses for the left primary motor cortex, left supplementary motor area and right cerebellar lobules IV, V, VI and VIII were performed. We report two novel findings that support an important role for the cerebellar system in the pathophysiology of essential tremor. First, in the effective

Global search of triggered non-volcanic tremor

NASA Astrophysics Data System (ADS)

Chao, Tzu-Kai Kevin

chapter focuses on a systematic comparison of triggered tremor around the Calaveras Fault (CF) in northern California (NC), the Parkfield-Cholame section of the San Andreas Fault (SAF) in central California (CC), and the San Jacinto Fault (SJF) in southern California (SC). Out of 42 large (Mw ≥7.5) earthquakes between 2001 and 2010, only the 2002 Mw 7.9 Denali fault earthquake triggered clear tremor in NC and SC. In comparison, abundant triggered and ambient tremor has been observed in CC. Further analysis reveal that the lack of triggered tremor observations in SC and NC is not simply a consequence of their different background noise levels as compared to CC, but rather reflects different background tremor rates in these regions. In the final chapter, I systematically search for triggered tremor following the 2011 Mw9.0 Tohoku-Oki earthquake in the regions where ambient or triggered tremor has been found before. The main purpose is to check whether triggered tremor is observed in regions when certain conditions (e.g., surface wave amplitudes) are met. Triggered tremor is observed in southwest Japan, Taiwan, the Aleutian Arc, south-central Alaska, northern Vancouver Island, the Parkfield-Cholame section of the SAF in CC and the SJF in SC, and the North Island of New Zealand. Such a widespread triggering of tremor is not too surprising because of the large amplitude surface waves (minimum peak value of ˜0.1 cm/s) and the associated dynamic stresses (at least ˜7-8 kPa), which is one of the most important factors in controlling the triggering threshold. The triggered tremor in different region is located close to or nearby the ambient tremor active area. In addition, the amplitudes of triggered tremor have positive correlations with the amplitudes of teleseismic surface waves among many regions. Moreover, both Love and Rayleigh waves participate in triggering tremor in different regions, and their triggering potential is somewhat controlled by the incident angles. In

Nonvolcanic Deep Tremors in the Transform Plate Bounding San Andreas Fault Zone

NASA Astrophysics Data System (ADS)

Nadeau, R. M.; Dolenc, D.

2004-12-01

Recently, deep ( ˜ 20 to 40 km) nonvolcanic tremor activity has been observed on convergent plate boundaries in Japan and in the Cascadia region of North America (Obara, 2002; Rodgers and Dragert, 2003; Szeliga et al., 2004). Because of the abundance of available fluids from subduction processes in these convergent zones, fluids are believed to play an important role in the generation of the tremor activity. The transient rates of tremor activity in these regions are also observed to correlate either with the occurrence of larger earthquakes (Obara, 2002) or with geodetically determined transient creep events that release large amounts of strain energy deep beneath the locked Cascadia megathrust (M.M. Miller et al., 2002; Rodgers and Dragert, 2003; Szeliga et al., 2004). These associations suggest that nonvolcanic tremor activity may participate in a fundamental mode of deep moment release and in the triggering of large subduction zone events (Rodgers and Dragert, 2003). We report the discovery of deep ( ˜ 20 to 45 km) nonvolcanic tremor activity on the transform plate bounding San Andreas Fault (SAF) in central California where, in contrast to subduction zones, long-term deformation directions are horizontal and fluid availability from subduction zone processes is absent. The source region of the SAF tremors lies beneath the epicentral region of the great 1857 magnitude (M) ˜ 8, Fort Tejon earthquake whose rupture zone is currently locked (Sieh, 1978). Activity rate transients of the tremors occurring since early 2001 also correlate with seismicity rate variations above the tremor source region.

Orthostatic tremor: a cerebellar pathology?

PubMed

Gallea, Cécile; Popa, Traian; García-Lorenzo, Daniel; Valabregue, Romain; Legrand, André-Pierre; Apartis, Emmanuelle; Marais, Lea; Degos, Bertrand; Hubsch, Cecile; Fernández-Vidal, Sara; Bardinet, Eric; Roze, Emmanuel; Lehéricy, Stéphane; Meunier, Sabine; Vidailhet, Marie

2016-08-01

SEE MUTHURAMAN ET AL DOI101093/AWW164 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Primary orthostatic tremor is characterized by high frequency tremor affecting the legs and trunk during the standing position. Cerebellar defects were suggested in orthostatic tremor without direct evidence. We aimed to characterize the anatomo-functional defects of the cerebellar motor pathways in orthostatic tremor. We used multimodal neuroimaging to compare 17 patients with orthostatic tremor and 17 age- and gender-matched healthy volunteers. Nine of the patients with orthostatic tremor underwent repetitive transcranial stimulation applied over the cerebellum during five consecutive days. We quantified the duration of standing position and tremor severity through electromyographic recordings. Compared to healthy volunteers, grey matter volume in patients with orthostatic tremor was (i) increased in the cerebellar vermis and correlated positively with the duration of the standing position; and (ii) increased in the supplementary motor area and decreased in the lateral cerebellum, which both correlated with the disease duration. Functional connectivity between the lateral cerebellum and the supplementary motor area was abnormally increased in patients with orthostatic tremor, and correlated positively with tremor severity. After repetitive transcranial stimulation, tremor severity and functional connectivity between the lateral cerebellum and the supplementary motor area were reduced. We provide an explanation for orthostatic tremor pathophysiology, and demonstrate the functional relevance of cerebello-thalamo-cortical connections in tremor related to cerebellar defects. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The cerebral basis of Parkinsonian tremor: A network perspective.

PubMed

Helmich, Rick C

2018-02-01

Tremor in Parkinson's disease is a poorly understood sign. Although it is one of the clinical hallmarks of the disease, its pathophysiology remains unclear. It is clear that tremor involves different neural mechanisms than bradykinesia and rigidity, the other core motor signs of Parkinson's disease. In particular, the role of dopamine in tremor has been heavily debated given clinical observations that tremor has a variable response to dopaminergic medication. From a neuroscience perspective, tremor is also a special sign; unlike other motor signs, it has a clear electrophysiological signature (frequency, phase, and power). These unique features of tremor, and newly available neuroimaging methods, have sparked investigations into the pathophysiology of tremor. In this review, evidence will be discussed for the idea that parkinsonian tremor results from increased interactions between the basal ganglia and the cerebello-thalamo-cortical circuit, driven by altered dopaminergic projections to nodes within both circuits, and modulated by context-dependent factors, such as psychological stress. Models that incorporate all of these features may help our understanding of the pathophysiology of tremor and interindividual differences between patients. One example that will be discussed in this article is the "dimmer-switch" model. According to this model, cerebral activity related to parkinsonian tremor first arises in the basal ganglia and is then propagated to the cerebello-thalamo-cortical circuit, where the tremor rhythm is maintained and amplified. In the future, detailed knowledge about the architecture of the tremor circuitry in individual patients ("tremor fingerprints") may provide new, mechanism-based treatments for this debilitating motor sign. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Medical Treatment of Essential Tremor

PubMed Central

Rajput, Ali H; Rajput, Alex

2014-01-01

Essential tremor (ET) is the most common pathological tremor characterized by upper limb action—postural tremor (PT)/kinetic tremor (KT). There are no specific neuropathological or biochemical abnormalities in ET. The disability is consequent to amplitude of KT, which may remain mild without handicap or may become disabling. The most effective drugs for sustained tremor control are propranolol and primidone. Symptomatic drug treatment must be individualized depending on the circumstances that provoke the tremor-related disability. Broad guidelines for treatment are discussed in this review. Patients may be treated intermittently only on stressful occasions with propranolol, clonazepam, or primidone monotherapy, or an alcoholic drink. Those with persistently disabling tremor need continued treatment. PMID:24812533

Tremor entities and their classification: an update.

PubMed

Gövert, Felix; Deuschl, Günther

2015-08-01

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

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

PubMed

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.

Treatment of Essential Tremor

MedlinePlus

... successfully treats limb tremor is weakened by the research methods involved. DBS and thalamotomy each pose some risk. They are used only when tremor is very disabling and drugs do not ... is best? Research on treatments for essential tremor is limited. No ...

Tremor associated with focal and segmental dystonia.

PubMed

Rudzińska, M; Krawczyk, M; Wójcik-Pędziwiatr, M; Szczudlik, A; Wasielewska, A

2013-01-01

Tremor occurs in 10-85% of patients with focal dystonia as so-called dystonic tremor or tremor associated with dystonia. The aim of this study was to assess the incidence and to characterize parameters of tremor accompanying focal and segmental dystonia. One hundred and twenty-three patients with diagnosis of focal and segmental dystonia together with 51 healthy controls were included in the study. For each participant, clinical examination and objective assessment (accelerometer, electromyography, graphic tablet) of hand tremor was performed. Frequency and severity of tremor were assessed in three positions: at rest (rest tremor); with hands extended (postural tremor); during 'finger-to-nose' test and during Archimedes spiral drawing (kinetic tremor). Based on the mass load test, type of tremor was determined as essential tremor type or enhanced physiological type. The incidence of tremor was significantly higher in dystonic patients as compared to controls (p = 0.0001). In clinical examination, tremor was found in 50% of dystonic patients, and in instrumental assessment in an additional 10-20%. The most frequent type of tremor was postural and kinetic tremor with 7 Hz frequency and featured essential tremor type. In the control group, tremor was detected in about 10% of subjects as 9-Hz postural tremor of enhanced physiological tremor type. No differences were found between patients with different types of dystonia with respect to the tremor incidence, type and parameters (frequency and severity). No correlations between tremor severity and dystonia severity were found either.

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

NASA Astrophysics Data System (ADS)

Swiecki, Z.; Schwartz, S. Y.

2010-12-01

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

Tremor-related activity of neurons in the 'motor' thalamus: changes in firing rate and pattern in the MPTP vervet model of parkinsonism.

PubMed

Guehl, D; Pessiglione, M; François, C; Yelnik, J; Hirsch, E C; Féger, J; Tremblay, L

2003-06-01

The pathophysiology of parkinsonian tremor remains a matter of debate with two opposing hypotheses proposing a peripheral and a central origin, respectively. A central origin of tremor could arise either from a rhythmic activity of the internal segment of the globus pallidus (GPi) or from a structure such as the thalamus, outside the basal ganglia. In this study, single-unit recordings were performed in three 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated monkeys within the GPi and within three territories of the motor thalamus (delimited by their afferent inputs from the GPi, the substantia nigra and the cerebellum, respectively). For each recorded neuron, we compared the variations in firing rate and pattern in tremor and no tremor periods. Tremor either occurred spontaneously or was induced by external stimulation. When the animals entered into a tremor period we observed: (i) an increase in the mean firing rate in about half of the recorded neurons of the motor thalamus; and (ii), a change from an irregular to a rhythmic discharge within the range of tremor frequency (5-7 Hz) in about 10% of the recorded neurons of the motor thalamus (pallidal and cerebellar territories) and the GPi. Most of the thalamic neurons that exhibited a rhythmic discharge during tremor were found to be sensitive to external stimulation. Because the changes in firing rate occurred predominantly in the motor thalamus and not in the GPi, and because a fast rhythmic discharge of 10-15 Hz was frequently observed in the GPi and not in the motor thalamus, we conclude that thalamic activity is not a simple reproduction of basal ganglia output. Moreover, we suggest that thalamic processing of basal ganglia outputs could participate in the genesis of tremor, and that this thalamic processing could be influenced by sensory inputs and/or changes in attentional level elicited by external stimulation.

Is tremor related to celiac disease?

PubMed

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

2017-06-14

Neurological features in celiac disease (CD) are not rare (5%-36%), but tremor is scarcely described. Subjects with CD and healthy controls completed an online survey using WHIGET tremor rating scale. One thousand five hundred and twelve subjects completed the survey, finally 674 CD patients and 290 healthy subjects were included. A higher prevalence of tremor in CD patients was observed in comparison to controls (28% vs 14%, P < 0.001). Frequency of family history of tremor in CD patients with and without tremor was 25% and 20% ( P = 0.2), while in the control group it was 41% and 10% ( P < 0.001). Controls with tremor showed a higher frequency of family history of tremor when compared to CD patients with tremor (41.5% vs 24.6%, P = 0.03). The results suggested that tremor in CD might be more frequent and possibly related to the disease itself and not due to associated essential tremor.

Rest tremor in idiopathic adult-onset dystonia.

PubMed

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

2016-05-01

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

Primary bowing tremor: a task-specific movement disorder of string instrumentalists.

PubMed

Lederman, Richard J

2012-12-01

Fear of a tremulous or unsteady bow is widespread among string instrumentalists. Faulty technique and performance anxiety have generally been blamed. The cases of 4 high-level violinists and 1 violist, 3 women and 2 men, with uncontrollable bow tremor are presented. Age at onset was from 16 to 75 years, and symptom duration 8 months to 20 years at the time of neurological evaluation. The degree of tremor varied with type of bow stroke and even the portion of the bow contacting the string. Only 1 patient had a slight postural tremor of the opposite limb. In 3 of 5 the tremor was task-specific; the other 2 had mild and nontroubling tremor with other activities. The tremor appeared to worsen over time but then seemed to stabilize. The characteristics of this tremor appear to be distinguishable from the features of both essential tremor and focal dystonia; comparison is made with representative string players afflicted by these other disorders. Analogy of this tremor is made with primary writing tremor, a well-defined task-specific movement disorder also sharing at least some features with both essential tremor and writers' cramp, a focal dystonia. Hence, it was decided to call this primary bowing tremor. Clinical features, family history, diagnostic studies, and responsiveness to treatment of primary writing tremor are discussed to emphasize the similarity to primary bowing tremor. This appears to represent a previously unreported form of task-specific movement disorder of string instrumentalists.

Essential tremor: electrophysiological and pharmacological evidence for a subdivision.

PubMed Central

Deuschl, G; Lücking, C H; Schenck, E

1987-01-01

Forty five patients with essential tremor have been investigated by means of clinical examination, polygraphic EMG records and testing of long-latency reflexes. Clinically there were no differences between the patients, whereas the electrophysiological investigations suggested two subtypes. One group of patients may be characterised by normal long-latency reflexes and synchronous tremor bursts in antagonists or activity of the antigravity muscle alone. The second group had abnormal long-latency reflexes and reciprocal EMG activity in antagonists. It is suggested that these two groups represent distinct subgroups of essential tremor. Patients of the first group responded well to propranolol, whereas those of the second group did not. PMID:3694203

A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor

PubMed Central

Zhang, Bin; Huang, Feifei; Liu, Jun; Zhang, Dingguo

2018-01-01

Due to a lack of reliable non-invasive bio-markers, misdiagnosis between Parkinson's disease and essential tremor is common. Although some assistive engineering approaches have been proposed, little acceptance has been obtained for these methods lack well-studied mechanisms and involve operator-dependent procedures. Aiming at a better differentiation between the two tremor causes, we present a novel posture, termed arm-rested posture, to ameliorate the quality of recorded tremor sequences. To investigate its efficacy, the posture was compared with another common posture, called arm-stretching posture, in fundamental aspects of tremor intensity and dominant frequency. A tremor-affected cohort comprising 50 subjects (PD = 26, ET = 24) with inhomogeneous tremor manifestation were recruited. From each subject, acceleration data of 5 min in terms of each posture were recorded. In the overall process, no operator-dependent procedures, such as data screening, was employed. The differentiation performance of the two postures were assessed by the index of discrimination coefficient and a receiver operating characteristic analysis based on binary logistic regression. The results of the differentiation assessment consistently demonstrate a better performance with the arm-rested posture than with the arm-stretching posture. As a by-product, factors of disease stage (incipient, progressed stage), spectrum estimate (PSD, bispectrum) and recording length (5–300s) were investigated. The significant effect of disease stage was only found in PD in terms of tremor intensity [F(1, 516) = 7.781, P < 0.05]. The bispectrum estimate was found to have better performance than the PSD estimate in extracting dominant frequency in terms of the discrimination coefficient. By extending the recording length, we noticed an increase in the performance of dominant frequency. The best result of the arm-rested posture was obtained with the maximum recording length of 300 s (area under the curve: 0

Spatio-temporal distribution of energy radiation from low frequency tremor

NASA Astrophysics Data System (ADS)

Maeda, T.; Obara, K.

2007-12-01

Recent fine-scale hypocenter locations of low frequency tremors (LFTs) estimated by cross-correlation technique (Shelly et al. 2006; Maeda et al. 2006) and new finding of very low frequency earthquake (Ito et al. 2007) suggest that these slow events occur at the plate boundary associated with slow slip events (Obara and Hirose, 2006). However, the number of tremor detected by above technique is limited since continuous tremor waveforms are too complicated. Although an envelope correlation method (ECM) (Obara, 2002) enables us to locate epicenters of LFT without arrival time picks, however, ECM fails to locate LFTs precisely especially on the most active stage of tremor activity because of the low-correlation of envelope amplitude. To reveal total energy release of LFT, here we propose a new method for estimating the location of LFTs together with radiated energy from the tremor source by using envelope amplitude. The tremor amplitude observed at NIED Hi-net stations in western Shikoku simply decays in proportion to the reciprocal of the source-receiver distance after the correction of site- amplification factor even though the phases of the tremor are very complicated. So, we model the observed mean square envelope amplitude by time-dependent energy radiation with geometrical spreading factor. In the model, we do not have origin time of the tremor since we assume that the source of the tremor continuously radiates the energy. Travel-time differences between stations estimated by the ECM technique also incorporated in our locating algorithm together with the amplitude information. Three-component 1-hour Hi-net velocity continuous waveforms with a pass-band of 2-10 Hz are used for the inversion after the correction of site amplification factors at each station estimated by coda normalization method (Takahashi et al. 2005) applied to normal earthquakes in the region. The source location and energy are estimated by applying least square inversion to the 1-min window

Handheld computing in pathology

PubMed Central

Park, Seung; Parwani, Anil; Satyanarayanan, Mahadev; Pantanowitz, Liron

2012-01-01

Handheld computing has had many applications in medicine, but relatively few in pathology. Most reported uses of handhelds in pathology have been limited to experimental endeavors in telemedicine or education. With recent advances in handheld hardware and software, along with concurrent advances in whole-slide imaging (WSI), new opportunities and challenges have presented themselves. This review addresses the current state of handheld hardware and software, provides a history of handheld devices in medicine focusing on pathology, and presents future use cases for such handhelds in pathology. PMID:22616027

Diagnosis and Treatment of Common Forms of Tremor

PubMed Central

Puschmann, Andreas; Wszolek, Zbigniew K.

2014-01-01

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

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

NASA Astrophysics Data System (ADS)

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

Short pauses in thalamic deep brain stimulation promote tremor and neuronal bursting.

PubMed

Swan, Brandon D; Brocker, David T; Hilliard, Justin D; Tatter, Stephen B; Gross, Robert E; Turner, Dennis A; Grill, Warren M

2016-02-01

We conducted intraoperative measurements of tremor during DBS containing short pauses (⩽50 ms) to determine if there is a minimum pause duration that preserves tremor suppression. Nine subjects with ET and thalamic DBS participated during IPG replacement surgery. Patterns of DBS included regular 130 Hz stimulation interrupted by 0, 15, 25 or 50 ms pauses. The same patterns were applied to a model of the thalamic network to quantify effects of pauses on activity of model neurons. All patterns of DBS decreased tremor relative to 'off'. Patterns with pauses generated less tremor reduction than regular high frequency DBS. The model revealed that rhythmic burst-driver inputs to thalamus were masked during DBS, but pauses in stimulation allowed propagation of bursting activity. The mean firing rate of bursting-type model neurons as well as the firing pattern entropy of model neurons were both strongly correlated with tremor power across stimulation conditions. The temporal pattern of stimulation influences the efficacy of thalamic DBS. Pauses in stimulation resulted in decreased tremor suppression indicating that masking of pathological bursting is a mechanism of thalamic DBS for tremor. Pauses in stimulation decreased the efficacy of open-loop DBS for suppression of tremor. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Genetics Home Reference: essential tremor

MedlinePlus

... types of activities, such as eating, drinking, or writing. Essential tremor can also occur when the muscles are opposing gravity, such as when the hands are extended. It is usually not evident at ...

Quantification of sound instability in embouchure tremor based on the time-varying fundamental frequency.

PubMed

Lee, André; Voget, Jakob; Furuya, Shinichi; Morise, Masanori; Altenmüller, Eckart

2016-05-01

Task-specific tremor in musicians is an involuntary oscillating muscular activity mostly of the hand or the embouchure, which predominantly occurs while playing the instrument. In contrast to arm or hand tremors, which have been examined and objectified based on movement kinematics and muscular activity, embouchure tremor has not yet been investigated. To quantify and describe embouchure tremor we analysed sound production and investigated the fluctuation of the time-varying fundamental frequency of sustained notes. A comparison between patients with embouchure tremor and healthy controls showed a significantly higher fluctuation of the fundamental frequency for the patients in the high pitch with a tremor frequency range between 3 and 8 Hz. The present findings firstly provide further information about a scarcely described movement disorder and secondly further evaluate a new quantification method for embouchure tremor, which has recently been established for embouchure dystonia.

Serotonergic modulation of nicotine-induced kinetic tremor in mice.

PubMed

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

2017-06-01

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

Surgery for Dystonia and Tremor.

PubMed

Crowell, Jason L; Shah, Binit B

2016-03-01

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

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

PubMed Central

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

Global Search of Triggered Tectonic Tremor

NASA Astrophysics Data System (ADS)

Peng, Z.; Aiken, C.; Chao, K.; Gonzalez-Huizar, H.; Wang, B.; Ojha, L.; Yang, H.

2013-05-01

Deep tectonic tremor has been observed at major plate-boundary faults around the Pacific Rim. While regular or ambient tremor occurs spontaneously or accompanies slow-slip events, tremor could be also triggered by large distant earthquakes and solid earth tides. Because triggered tremor occurs on the same fault patches as ambient tremor and is relatively easy to identify, a systematic global search of triggered tremor could help to identify the physical mechanisms and necessary conditions for tremor generation. Here we conduct a global search of tremor triggered by large teleseismic earthquakes. We mainly focus on major faults with significant strain accumulations where no tremor has been reported before. These includes subduction zones in Central and South America, strike-slip faults around the Caribbean plate, the Queen Charlotte-Fairweather fault system and the Denali fault in the western Canada and Alaska, the Sumatra-Java subduction zone, the Himalaya frontal thrust faults, as well as major strike-slip faults around Tibet. In each region, we first compute the predicted dynamic stresses σd from global earthquakes with magnitude>=5.0 in the past 20 years, and select events with σd > 1 kPa. Next, we download seismic data recorded by stations from local or global seismic networks, and identify triggered tremor as a high-frequency non-impulsive signal that is in phase with the large-amplitude teleseismic waves. In cases where station distributions are dense enough, we also locate tremor based on the standard envelope cross-correlation techniques. Finally, we calculate the triggering potential for the Love and Rayleigh waves with the local fault orientation and surface-wave incident angles. So far we have found several new places that are capable of generating triggered tremor. We will summarize these observations and discuss their implications on physical mechanisms of tremor and remote triggering.

Re-emergent tremor in Parkinson's disease.

PubMed

Belvisi, Daniele; Conte, Antonella; Bologna, Matteo; Bloise, Maria Carmela; Suppa, Antonio; Formica, Alessandra; Costanzo, Matteo; Cardone, Pierluigi; Fabbrini, Giovanni; Berardelli, Alfredo

2017-03-01

Re-emergent tremor (RET) is a postural tremor that appears after a variable delay in patients with Parkinson's disease (PD). The aim of the present study was to evaluate the occurrence and the clinical characteristics of RET in a population of patients with PD. We consecutively assessed 210 patients with PD. We collected the patients' demographic and clinical data. RET was clinically characterized in terms of latency, severity and body side affected. We also investigated a possible relationship with motor and non-motor symptoms and differences in the clinical features in patients with and without RET. RET was present in 42/210 patients. The mean latency of RET was 9.20 ± 6.8 seconds. Mean severity was 2.4 ± 1.9. RET was unilateral in 21 patients. Patients with RET had less severe speech, posture and gait disorders and upper limb and global bradykinesia than patients without RET. Similar findings were observed when we compared patients with RET with patients with tremor at rest associated with action tremor, patients with isolated action tremor and patients with no tremor. By contrast, patients with RET tremor did not clinically differ from those with isolated tremor at rest. Our results suggest that patients with RET and patients with isolated tremor at rest represent the same clinical subtype, whereas patients with action tremor (whether isolated or associated with tremor at rest) might belong to a distinct subtype that is clinically worse. Patients with RET represents a benign subtype of PD, even within the tremor-dominant phenotype. Copyright © 2016 Elsevier Ltd. All rights reserved.

Treatment of essential tremor with arotinolol.

PubMed

Kuroda, Y; Kakigi, R; Shibasaki, H

1988-04-01

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

Prevalence and Correlates of Rest Tremor in Essential Tremor: Cross-Sectional Survey of 831 Patients Across Four Distinct Cohorts

PubMed Central

Louis, Elan D.; Hernandez, Nora; Michalec, Monika

2015-01-01

Background Essential tremor (ET) is among the most commonly encountered neurological disorders. Its hallmark feature is kinetic tremor. However, other tremors may also occur in ET patients, creating considerable diagnostic confusion among treating physicians. Hence, characterizing the prevalence and clinical accompaniments of these other tremors is of value. Surprisingly, there are few data on the prevalence of rest tremor in ET patients, and even fewer data on the clinical correlates of such tremor. Methods 831 patients in four distinct settings (population, genetics study, study of environmental epidemiology, brain bank) underwent a detailed videotaped neurological examination that was reviewed by a senior movement disorders neurologist. Rest tremor was evaluated in several positions (seated, standing, lying down). Results The prevalence of rest tremor while seated or standing was lowest in the population-based setting (1.9%), highest in the brain bank study (46.4%), and intermediate in the remaining two settings (9.6% and 14.7%, respectively). Rest tremor was restricted to the arms and was not observed in the legs. Rest tremor was associated with older age, longer disease duration (in some studies), greater tremor severity and, to some extent, the presence of cranial tremors. Conclusions Rest tremor can be a common clinical feature of ET. Its prevalence is highly dependent on the setting in which patients are evaluated, ranging from as low as 1% to nearly 50%. Rest tremor seems to emerge as a clinical feature with advancing disease. The anatomical substrates for this type of tremor remain unknown at present. PMID:25786561

Essential pitfalls in "essential” tremor

PubMed Central

Espay, AJ; Lang, AE; Erro, R; Merola, A; Fasano, A; Berardelli, A; Bhatia, KP

2016-01-01

While essential tremor has been considered the most common movement disorder, it has largely remained a diagnosis of exclusion: many tremor and non-tremor features must be absent for the clinical diagnosis to stand. The clinical features of “essential tremor” overlap with or may be part of other tremor disorders and, not surprisingly, this prevalent familial disorder has remained without a gene identified, without a consistent natural history, and without an acceptable pathology or pathophysiologic underpinning. The collective evidence suggests that under the rubric of essential tremor there exists multiple unique diseases, some of which represent cerebellar dysfunction, but for which there is no intrinsic “essence” other than a common oscillatory behavior on posture and action. One approach may be to use the term “essential tremor” only as a transitional node in the deep phenotyping of tremor disorders based on historical, phenomenological, and neurophysiological features, to facilitate its etiologic diagnosis or serve for future gene- and biomarker-discovery efforts. This approach deemphasizes essential tremor as a diagnostic entity and facilitates the understanding of the underlying disorders in order to develop biologically tailored diagnostic and therapeutic strategies. PMID:28116753

Spatial distribution of non volcanic tremors offshore eastern Taiwan

NASA Astrophysics Data System (ADS)

Xie, X. S.; Lin, J. Y.; Hsu, S. K.; Lee, C. H.; Liang, C. W.

2012-04-01

Non-volcanic tremor (NVT), originally identified in the subduction zone of the southwest Japan, have been well studied in the circum-Pacific subduction zones and the transform plate boundary in California. Most studies related NVT to the release of fluids, while some others associated them with slow-slip events, and can be triggered instantaneously by the surface waves of teleseismic events. Taiwan is located at a complex intersection of the Philippines Sea Plate and the Eurasian Plate. East of Taiwan, the Philippine Sea plate subducts northward beneath the Ryukyu arc. The major part of the island results from the strong convergence between the two plates and the convergent boundary is along the Longitudinal Valley. Moreover, an active strike-slip fault along the Taitung Canyon was reported in the offshore eastern Taiwan. In such complicate tectonic environments, NVT behavior could probably bring us more information about the interaction of all the geological components in the area. In this study, we analyze the seismic signals recorded by the Ocean bottom Seismometer (OBS) deployed offshore eastern Taiwan in September 2009. TAMS (Tremor Active Monitor System) software was used to detect the presence of NVT. 200 tremor-like signals were obtained from the 3 weeks recording period. We use the SSA (Source-Scanning Algorithm) to map the possible distribution of the tremor. In total, 180 tremors were located around the eastern offshore Taiwan. The tremors are mainly distributed in two source areas: one is along the Taitung Canyon, and the other is sub-parallel to the Ryukyu Trench, probably along the plate interface. Many tremors are located at depth shallower than 5 km, which suggests a possible existence of a weak basal detachment along the sea bottom. Other tremors with larger depth may be related to the dehydration of the subducting sea plate as suggested by the former studies. Limited by the short recording period of the OBS experiment, we could not obtain any

Global Examination of Triggered Tectonic Tremor following the 2017 Mw8.1 Tehuantepec Earthquake in Mexico

NASA Astrophysics Data System (ADS)

Chao, K.; Gonzalez-Huizar, H.; Tang, V.; Klaeser, R. D.; Mattia, M.; Van der Lee, S.

2017-12-01

Triggered tremor is one type of slow earthquake that activated by teleseismic surfaces waves of large magnitude earthquake. Observations of triggered tremor can help to evaluate the background ambient tremor rate and slow slip events in the surrounding region. The Mw 8.1 Tehuantepec earthquake in Mexico is an ideal tremor-triggering candidate for a global search for triggered tremor. Here, we examine triggered tremor globally following the M8.1 event and model the tremor-triggering potential. We examine 7,000 seismic traces and found a widely spread triggered tremor along the western coast of the North America occur during the surface waves of the Mw 8.1 event. Triggered tremor appeared in the San Jacinto Fault, San Andreas Fault around Parkfield, and Calaveras Fault in California, in Vancouver Island in Cascadia subduction zone, in Queen Charlotte Margin and Eastern Denali Fault in Canada, and in Alaska and Aleutian Arc. In addition, we observe a newly found triggered tremor source in Mt. Etna in Sicily Island, Italy. However, we do not find clear triggered tremor evidences in the tremor active regions in Japan, Taiwan, and in New Zealand. We model tremor-triggering potential at the triggering earthquake source and triggered tremor sources. Our modeling results suggest the source parameters of the M8.1 triggering events and the stress at the triggered fault zone are two critical factors to control tremor-triggering threshold.

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

PubMed

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

2015-12-01

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

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

PubMed

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 < 0.001), but not during the resting state (P = 0.067). Pre-execution tremor amplitude correlated with angular deviation (r = 0.45, P = 0.007). For the first time, we document a task-specific kinetic finger tremor in carrom players. This finger tremor during the immediate pre-execution phase appears to be a significant determinant of stroke accuracy.

Surface-wave potential for triggering tectonic (nonvolcanic) tremor

USGS Publications Warehouse

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.

Cerebello-cortical network fingerprints differ between essential, Parkinson's and mimicked tremors.

PubMed

Muthuraman, Muthuraman; Raethjen, Jan; Koirala, Nabin; Anwar, Abdul Rauf; Mideksa, Kidist G; Elble, Rodger; Groppa, Sergiu; Deuschl, Günter

2018-06-01

Cerebello-thalamo-cortical loops play a major role in the emergence of pathological tremors and voluntary rhythmic movements. It is unclear whether these loops differ anatomically or functionally in different types of tremor. We compared age- and sex-matched groups of patients with Parkinson's disease or essential tremor and healthy controls (n = 34 per group). High-density 256-channel EEG and multi-channel EMG from extensor and flexor muscles of both wrists were recorded simultaneously while extending the hands against gravity with the forearms supported. Tremor was thereby recorded from patients, and voluntarily mimicked tremor was recorded from healthy controls. Tomographic maps of EEG-EMG coherence were constructed using a beamformer algorithm coherent source analysis. The direction and strength of information flow between different coherent sources were estimated using time-resolved partial-directed coherence analyses. Tremor severity and motor performance measures were correlated with connection strengths between coherent sources. The topography of oscillatory coherent sources in the cerebellum differed significantly among the three groups, but the cortical sources in the primary sensorimotor region and premotor cortex were not significantly different. The cerebellar and cortical source combinations matched well with known cerebello-thalamo-cortical connections derived from functional MRI resting state analyses according to the Buckner-atlas. The cerebellar sources for Parkinson's tremor and essential tremor mapped primarily to primary sensorimotor cortex, but the cerebellar source for mimicked tremor mapped primarily to premotor cortex. Time-resolved partial-directed coherence analyses revealed activity flow mainly from cerebellum to sensorimotor cortex in Parkinson's tremor and essential tremor and mainly from cerebral cortex to cerebellum in mimicked tremor. EMG oscillation flowed mainly to the cerebellum in mimicked tremor, but oscillation flowed mainly

Postural tremor and chronic inflammatory demyelinating polyneuropathy.

PubMed

Cao, Yiming; Menon, Parvathi; Ching-Fen Chang, Florence; Mahant, Neil; Geevasinga, Nimeshan; Fung, Victor S C; Vucic, Steve

2017-03-01

Chronic inflammatory demyelinating polyneuropathy (CIDP) typically presents with a combination of sensory and motor impairments. Tremor is recognized as a common and debilitating feature in CIDP, although the underlying mechanisms are unclear. Clinical tremor severity and disability scores were collected prospectively in 25 CIDP patients and compared with 22 neuromuscular controls. Postural and kinetic tremor were significantly more frequent in CIDP patients (80%) than in neuromuscular controls (35%; P < 0.005). Tremor severity and tremor-related disability were also significantly greater in CIDP patients than in controls. Accelerometry data confirmed the presence of a 5.5 Hz postural tremor and a 5 Hz kinetic tremor. Tremor appears to be a common clinical feature of CIDP that results in significant disability. Sensory and motor impairment may be associated with development of tremor in CIDP. Muscle Nerve 55: 338-343, 2017. © 2016 Wiley Periodicals, Inc.

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

PubMed

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.

Tremor in School-Aged Children: A Cross-Sectional Study of Tremor in 819 Boys and Girls in Burgos, Spain

PubMed Central

Louis, Elan D.; Cubo, Esther; Trejo-Gabriel-Galán, José M.; Villaverde, Vanesa Ausín; Benito, Vanesa Delgado; Velasco, Sara Sáez; Vicente, Jesús Macarrón; Guevara, José Cordero; Benito-León, Julián

2011-01-01

Background Mild hand tremor occurs in most normal adults. There are no surveys of the prevalence or clinical correlates of such tremor among children. Methods A cross-sectional study of tics, tremor and other neurological disorders was conducted in Spanish children; thus, 819 schoolchildren in Burgos, Spain, drew Archimedes spirals with each hand. Tremor in spirals was rated (0–2) by a blinded neurologist and an overall tremor rating (0–4) was assigned. Results The mean age was 10.9 ± 3.1 years. A tremor rating of 1 (mild tremor) was present in either hand in 424 (51.7%) children, and in both hands in 88 (10.7%) children. Higher tremor ratings were very uncommon. The overall tremor rating was higher in boys than girls (1.31 ± 0.41 vs. 1.22 ± 0.34, p = 0.002) and correlated weakly yet significantly with age (ρ = 0.09, p = 0.01). Within subjects, the left hand spiral rating was greater than the right (p < 0.001). Conclusions In this cross-sectional study of 819 Spanish schoolchildren, mild tremor was commonly observed. As in adults, males had more tremor than females, tremor scores increased with age, and tremor scores were higher in the left than right arm, demonstrating that these clinical correlations seem to be more broadly generalizable to children. The functional significance of tremor in children, particularly as it relates to handwriting proficiency, deserves additional scrutiny. Copyright © 2011 S. Karger AG, Basel PMID:21894047

Upper-limb tremor suppression with a 7DOF exoskeleton power-assist robot.

PubMed

Kiguchi, Kazuo; Hayashi, Yoshiaki

2013-01-01

A tremor which is one of the involuntary motions is somewhat rhythmic motion that may occur in various body parts. Although there are several kinds of the tremor, an essential tremor is the most common tremor disorder of the arm. The essential tremor is a disorder of unknown cause, and it is common in the elderly. The essential tremor interferes with a patient's daily living activity, because it may occur during a voluntary motion. If a patient of an essential tremor uses an EMG-based controlled power-assist robot, the robot might misunderstand the user's motion intention because of the effect of the essential tremor. In that case, upper-limb power-assist robots must carry out tremor suppression as well as power-assist, since a person performs various precise tasks with certain tools by the upper-limb in daily living. Therefore, it is important to suppress the tremor at the hand and grasped tool. However, in the case of the tremor suppression control method which suppressed the vibrations of the hand and the tip of the tool, vibration of other part such as elbow might occur. In this paper, the tremor suppression control method for upper-limb power-assist robot is proposed. In the proposed method, the vibration of the elbow is suppressed in addition to the hand and the tip of the tool. The validity of the proposed method was verified by the experiments.

Analysis of Peer Interaction in Learning Activities with Personal Handhelds and Shared Displays

ERIC Educational Resources Information Center

Liu, Chen-Chung; Chung, Chen-Wei; Chen, Nian-Shing; Liu, Baw-Jhiune

2009-01-01

Collaborative learning is extensively applied in classroom activities, but the screens on handheld devices are designed for individual-user mobile applications and may constrain interaction among group learners. The small screen size may lead to fragmented and tete-a-tete communication patterns and frequently obstruct the externalization of the…

Improvement of mouse controlling in Essential tremor by a tremor filter: A case report.

PubMed

López-Blanco, Roberto; Méndez-Guerrero, Antonio; Velasco, Miguel A

2018-07-15

The interaction with electronic devices is crucial in our technological society. Hand kinetic tremor complicates mouse driving in Essential tremor patients. To solve this issue some technological solutions are available and accessible online. We present a 71-year-old patient with prominent mouse controlling tremor who improved with one of these systems. Copyright © 2018 Elsevier B.V. All rights reserved.

Slip rate and tremor genesis in Cascadia

USGS Publications Warehouse

Wech, Aaron G.; Bartlow, Noel M.

2014-01-01

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

Unusual tremor syndromes: know in order to recognise.

PubMed

Ure, Robert J; Dhanju, Sanveer; Lang, Anthony E; Fasano, Alfonso

2016-11-01

Tremor is a common neurological condition in clinical practice; yet, few syndromes are widely recognised and discussed in the literature. As a result, there is an overdiagnosis of well-known causes, such as essential tremor. Many important unusual syndromes should be considered in the differential diagnosis of patients with tremor. The objective of this review is to provide broad clinical information to aid in the recognition and treatment of various unusual tremor syndromes in the adult and paediatric populations. The review comprised of a comprehensive online search using PubMed, Ovid database and Google Scholar to identify the available literature for each unusual tremor syndrome. The review includes fragile X-associated tremor/ataxia syndrome, spinocerebellar ataxia type 12, tremors caused by autosomal recessive cerebellar ataxias, myorhythmia, isolated tongue tremor, Wilson's disease, slow orthostatic tremor, peripheral trauma-induced tremor, tardive tremor and rabbit syndrome, paroxysmal tremors (hereditary chin tremor, bilateral high-frequency synchronous discharges, head tremor, limb-shaking transient ischaemic attack), bobble-head doll syndrome, spasmus nutans and shuddering attacks. Rare tremors generally present with an action tremor and a variable combination of postural and kinetic components with resting tremors less frequently seen. The phenomenology of myorhythmia is still vague and a clinical definition is proposed. The recognition of these entities should facilitate the correct diagnosis and guide the physician to a prompt intervention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

PubMed

Kavanagh, Justin J; Wedderburn-Bisshop, Jacob; Keogh, Justin W L

2016-01-01

Although symptoms of Essential Tremor (ET) are typically controlled with medication, it is of interest to explore additional therapies to assist with functionality. The purpose of this study was to determine if a generalized upper limb resistance training (RT) program improves manual dexterity and reduces force tremor in older individuals with ET. Ten Essential Tremor and 9 controls were recruited into a dual group, pretest-posttest intervention study. Participants performed 6 weeks of upper-limb RT, and battery of manual dexterity and isometric force tremor assessments were performed before and after the RT to determine the benefits of the program. The six-week, high-load, RT program produced strength increases in each limb for the ET and healthy older group. These changes in strength aligned with improvements in manual dexterity and tremor-most notably for the ET group. The least affected limb and the most affected limb exhibited similar improvements in functional assessments of manual dexterity, whereas reductions in force tremor amplitude following the RT program were restricted to the most affected limb of the ET group. These findings suggest that generalized upper limb RT program has the potential to improve aspects of manual dexterity and reduce force tremor in older ET patients.

Intraoperative tremor in surgeons and trainees.

PubMed

Verrelli, David I; Qian, Yi; Wilson, Michael K; Wood, James; Savage, Craig

2016-09-01

Tremor may be expected to interfere with the performance of fine motor tasks such as surgery. While tremor is readily quantified in inactive subjects, it is more challenging to measure tremor as the subjects perform complex tasks. The objective of this work was to quantify tremor during the performance of a realistic simulated surgery. Our novel surgical simulator incorporates a force sensor that allows identification and quantification of the intraoperative effects of tremor on the manipulandum. We have collected preliminary data from trainees and experienced surgeons carrying out multiple simulated anastomoses on silicone vessels, mimicking a procedure such as distal coronary anastomosis. We calculated transient and overall tremor intensity, and tested for a hypothesized 'learning effect'. Several of the recordings of intraoperative force data manifested distinctive features corresponding to substantial oscillation in the range of 8-12 Hz. We attribute this to enhanced physiological tremor. These early results indicate a significant reduction in the transmission of surgeon's tremor to the operative field from the first attempt to later attempts (P = 0.039, standardized effect size = 0.91), which may be associated with increasing confidence. This new method does not just quantify tremor, but quantifies the transmission of tremor to a manipulandum in the operative field during high-fidelity simulated coronary surgery. This may be used to assess and provide feedback on the performance of trainees and experienced surgeons, along with other fields in which fine motor skills are of vital importance. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Medical and surgical treatment of tremors.

PubMed

Schneider, Susanne A; Deuschl, Günther

2015-02-01

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

Pathophysiology and Management of Parkinsonian Tremor.

PubMed

Helmich, Rick C; Dirkx, Michiel F

2017-04-01

Parkinson's tremor is one of the cardinal motor symptoms of Parkinson's disease. The pathophysiology of Parkinson's tremor is different from that of other motor symptoms such as bradykinesia and rigidity. In this review, the authors discuss evidence suggesting that tremor is a network disorder that arises from distinct pathophysiological changes in the basal ganglia and in the cerebellothalamocortical circuit. They also discuss how interventions in this circuitry, for example, deep brain surgery and noninvasive brain stimulation, can modulate or even treat tremor. Future research may focus on understanding sources for the large variability between patients in terms of treatment response, on understanding the contextual factors that modulate tremor (stress, voluntary movements), and on focused interventions in the tremor circuitry. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

PubMed

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

Corticomuscular Transmission of Tremor Signals by Propriospinal Neurons in Parkinson's Disease

PubMed Central

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

Monochromatic infrasonic tremor driven by persistent degassing and convection at Villarrica Volcano, Chile

NASA Astrophysics Data System (ADS)

Ripepe, M.; Marchetti, E.; Bonadonna, C.; Harris, A. J. L.; Pioli, L.; Ulivieri, G.

2010-08-01

Infrasonic data collected at Villarrica volcano (Chile) in March 2009 show a sustained, continuous, infrasonic oscillation (tremor) with a monochromatic low frequency content at ˜0.75 Hz. This tremor is extremely stable in time both at the summit and at a distal (˜4 km) small aperture array. Infrasonic tremor is characterized by discrete high amplitude bursts with a cyclic recurrence time of ˜40 s and is well correlated (0.93) with seismic tremor. These new data are compared with previous datasets collected in 2002 and 2004 during different levels of activity. All data show the same persistent infrasonic tremor and have the same strong correlation with seismic tremor. The stability and correlation of infrasonic and seismic tremor indicate the existence of a sustained and continuous process, which we suggest is related to the gravity-driven bubble column dynamics responsible for conduit convection.

Observations of volcanic tremor during January-February 2005 eruption of Mt. Veniaminof, Alaska

USGS Publications Warehouse

De Angelis, Slivio; McNutt, Stephen R.

2007-01-01

Mt. Veniaminof, Alaska Peninsula, is a stratovolcano with a summit ice-filled caldera containing a small intracaldera cone and active vent. From January 2 to February 21, 2005, Mt. Veniaminof erupted. The eruption was characterized by numerous small ash emissions (VEI 0 to 1) and accompanied by low-frequency earthquake activity and volcanic tremor. We have performed spectral analyses of the seismic signals in order to characterize them and to constrain their source. Continuous tremor has durations of minutes to hours with dominant energy in the band 0.5– 4.0 Hz, and spectra characterized by narrow peaks either irregularly (non-harmonic tremor) or regularly spaced (harmonic tremor). The spectra of non-harmonic tremor resemble those of low-frequency events recorded simultaneously with surface ash explosions, suggesting that the source mechanisms might be similar or related. We propose that non-harmonic tremor at Mt. Veniaminof results from the coalescence of gas bubbles while low-frequency events are related to the disruption of large gas pockets within the conduit. Harmonic tremor, characterized by regular and quasisinusoidal waveforms, has duration of hours. Spectra containing up to five harmonics suggest the presence of a resonating source volume that vibrates in a longitudinal acoustic mode. An interesting feature of harmonic tremor is that frequency is observed to change over time; spectral lines move towards higher or lower values while the harmonic nature of the spectra is maintained. Factors controlling the variable characteristics of harmonic tremor include changes in acoustic velocity at the source and variations of the effective size of the resonator.

Subthalamic and Cortical Local Field Potentials Associated with Pilocarpine-Induced Oral Tremor in the Rat

PubMed Central

Long, Lauren L.; Podurgiel, Samantha J.; Haque, Aileen F.; Errante, Emily L.; Chrobak, James J.; Salamone, John D.

2016-01-01

Tremulous jaw movements (TJMs) are rapid vertical deflections of the lower jaw that resemble chewing but are not directed at any particular stimulus. In rodents, TJMs are induced by neurochemical conditions that parallel those seen in human Parkinsonism, including neurotoxic or pharmacological depletion of striatal dopamine (DA), DA antagonism, and cholinomimetic administration. Moreover, TJMs in rodents can be attenuated by antiparkinsonian agents, including levodopa (L-DOPA), DA agonists, muscarinic antagonists, and adenosine A2A antagonists. In human Parkinsonian patients, exaggerated physiological synchrony is seen in the beta frequency band in various parts of the cortical/basal ganglia/thalamic circuitry, and activity in the tremor frequency range (3–7 Hz) also has been recorded. The present studies were undertaken to determine if tremor-related local field potential (LFP) activity could be recorded from motor cortex (M1) or subthalamic nucleus (STN) during the TJMs induced by the muscarinic agonist pilocarpine, which is a well-known tremorogenic agent. Pilocarpine induced a robust TJM response that was marked by rhythmic electromyographic (EMG) activity in the temporalis muscle. Compared to periods with no tremor activity, TJM epochs were characterized by increased LFP activity in the tremor frequency range in both neocortex and STN. Tremor activity was not associated with increased synchrony in the beta frequency band. These studies identified tremor-related LFP activity in parts of the cortical/basal ganglia circuitry that are involved in the pathophysiology of Parkinsonism. This research may ultimately lead to identification of the oscillatory neural mechanisms involved in the generation of tremulous activity, and promote development of novel treatments for tremor disorders. PMID:27378874

Beta-Adrenergic Modulation of Tremor and Corticomuscular Coherence in Humans

PubMed Central

Baker, Mark R.; Baker, Stuart N.

2012-01-01

Coherence between the bioelectric activity of sensorimotor cortex and contralateral muscles can be observed around 20 Hz. By contrast, physiological tremor has a dominant frequency around 10 Hz. Although tremor has multiple sources, it is partly central in origin, reflecting a component of motoneuron discharge at this frequency. The motoneuron response to ∼20 Hz descending input could be altered by non-linear interactions with ∼10 Hz motoneuron firing. We investigated this further in eight healthy human subjects by testing the effects of the beta-adrenergic agents propranolol (non-selective β-antagonist) and salbutamol (β2-agonist), which are known to alter the size of physiological tremor. Corticomuscular coherence was assessed during an auxotonic precision grip task; tremor was quantified using accelerometry during index finger extension. Experiments with propranolol used a double-blind, placebo-controlled crossover design. A single oral dose of propranolol (40 mg) significantly increased beta band (15.3–32.2 Hz) corticomuscular coherence compared with placebo, but reduced tremor in the 6.2–11.9 Hz range. Salbutamol (2.5 mg) was administered by inhalation. Whilst salbutamol significantly increased tremor amplitude as expected, it did not change corticomuscular coherence. The opposite direction of the effects of propranolol on corticomuscular coherence and tremor, and the fact that salbutamol enhances tremor but does not affect coherence, implies that the magnitude of corticomuscular coherence is little influenced by non-linear interactions with 10 Hz oscillations in motoneurons or the periphery. Instead, we suggest that propranolol and salbutamol may affect both tremor and corticomuscular coherence partly via a central site of action. PMID:23185297

Handheld juggernaut.

PubMed

Hagland, Mark

2010-08-01

Not only are hospital, health system, and medical group ClOs and clinical informaticists deploying handheld mobile devices across their enterprises as clinical computing tools; clinicians, especially physicians, are increasingly bringing their own BlackBerrys, iPhones, iPads, Android devices, and other handhelds, into patient care organizations for their personal clinical use. Not surprisingly, the challenges--as well as the opportunities--are multilayered and complex, and include the strategic planning, infrastructure, clinician preference, clinician workflow, and security issues involved in the emerging mobile handheld revolution. The diversity of approaches among ClOs and other healthcare IT leaders on such issues is striking, and underscores the need for flexibility and nimbleness going forward.

The long-term outcome of orthostatic tremor.

PubMed

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

2016-02-01

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

Characterizing Orthostatic Tremor Using a Smartphone Application.

PubMed

Balachandar, Arjun; Fasano, Alfonso

2017-01-01

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

Tremor evidence for dynamically triggered creep events on the deep San Andreas Fault

NASA Astrophysics Data System (ADS)

Peng, Z.; Shelly, D. R.; Hill, D. P.; Aiken, C.

2010-12-01

Deep tectonic tremor has been observed along major subduction zones and the San Andreas fault (SAF) in central and southern California. It appears to reflect deep fault slip, and it is often seen to be triggered by small stresses, including passing seismic waves from large regional and teleseismic earthquakes. Here we examine tremor activity along the Parkfield-Cholame section of the SAF from mid-2001 to early 2010, scrutinizing its relationship with regional and teleseismic earthquakes. Based on similarities in the shape and timing of seismic waveforms, we conclude that triggered and ambient tremor share common sources and a common physical mechanism. Utilizing this similarity in waveforms, we detect tremor triggered by numerous large events, including previously unreported triggering from the recent 2009 Mw7.3 Honduras, 2009 Mw8.1 Samoa, and 2010 Mw8.8 Chile earthquakes at teleseismic distances, and the relatively small 2007 Mw5.4 Alum Rock and 2008 Mw5.4 Chino Hills earthquakes at regional distances. We also find multiple examples of systematic migration in triggered tremor, similar to ambient tremor migration episodes observed at other times. Because these episodes propagate much more slowly than the triggering waves, the migration likely reflects a small, triggered creep event. As with ambient tremor bursts, triggered tremor at times persists for multiple days, probably indicating a somewhat larger creep event. This activity provides a clear example of delayed dynamic triggering, with a mechanism perhaps also relevant for triggering of regular earthquakes.

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

PubMed

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

2015-10-01

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

A Foothold for Handhelds.

ERIC Educational Resources Information Center

Joyner, Amy

2003-01-01

Handheld computers provide students tremendous computing and learning power at about a 10th the cost of a regular computer. Describes the evolution of handhelds; provides some examples of their uses; and cites research indicating they are effective classroom tools that can improve efficiency and instruction. A sidebar lists handheld resources.…

How to treat tremor.

PubMed

Rektor, Ivan; Rektorová, Irena; Suchý, Václav

2004-05-01

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

Surface-wave potential for triggering tectonic (nonvolcanic) tremor-corrected

USGS Publications Warehouse

Hill, David P.

2012-01-01

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 are 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 megathrust and the San Andreas fault (SAF) in central California resulting from shear failure on weak faults (apparent friction is μ* ≤ 0:2). Documented instances of tremor triggered by surface waves with strike-parallel incidence along the Nankai megathrust beneath Shikoku, Japan, however, are 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 (μ ~ 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.

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

PubMed

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

1996-08-01

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

Ground-motion prediction from tremor

USGS Publications Warehouse

Baltay, Annemarie S.; Beroza, Gregory C.

2013-01-01

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

Seismic moulin tremor

NASA Astrophysics Data System (ADS)

Roeoesli, Claudia; Walter, Fabian; Ampuero, Jean-Paul; Kissling, Edi

2016-08-01

Through glacial moulins, meltwater is routed from the glacier surface to its base. Moulins are a main feature feeding subglacial drainage systems and thus influencing basal motion and ice dynamics, but their geometry remains poorly known. Here we show that analysis of the seismic wavefield generated by water falling into a moulin can help constrain its geometry. We present modeling results of hour-long seimic tremors emitted from a vertical moulin shaft, observed with a seismometer array installed at the surface of the Greenland Ice Sheet. The tremor was triggered when the moulin water level exceeded a certain height, which we associate with the threshold for the waterfall to hit directly the surface of the moulin water column. The amplitude of the tremor signal changed over each tremor episode, in close relation to the amount of inflowing water. The tremor spectrum features multiple prominent peaks, whose characteristic frequencies are distributed like the resonant modes of a semiopen organ pipe and were found to depend on the moulin water level, consistent with a source composed of resonant tube waves (water pressure waves coupled to elastic deformation of the moulin walls) along the water-filled moulin pipe. Analysis of surface particle motions lends further support to this interpretation. The seismic wavefield was modeled as a superposition of sustained wave radiation by pressure sources on the side walls and at the bottom of the moulin. The former was found to dominate the wave field at close distance and the latter at large distance to the moulin.

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

PubMed

Dietrichson, P; Espen, E

1981-08-01

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

Measurement of tremor transmission during microsurgery.

PubMed

Verrelli, David I; Qian, Yi; Wood, James; Wilson, Michael K

2016-12-01

Tremor is a major impediment to performing fine motor tasks, as in microsurgery. However, conventional measurements do not involve tasks representative of microsurgery. We developed a low-cost surgical simulator incorporating a force transducer capable of detecting and quantifying the effects of tremor upon high-fidelity silicone replicas of cardiac vessels and substrate muscle. Experienced and trainee surgeons performed simulated anastomoses on this rig. We characterized procedures in terms of tremor intensity, based on Lomb-Scargle periodograms. Distinctive force oscillations occurred at 8-12 Hz, characteristic of enhanced physiological tremor, yielding peaks in power spectral density. These early results suggest a significantly lower transmission of tremor to the operative field by the experienced surgeon in comparison to the trainees. This new device quantifies the action of tremor upon a manipulandum during a complex task, which may be used for assessment and providing feedback to trainee surgeons. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Prevalence and characteristics of tremor in the NARCOMS multiple sclerosis registry: a cross-sectional survey

PubMed Central

Rinker, John R; Salter, Amber R; Walker, Harrison; Amara, Amy; Meador, William; Cutter, Gary R

2015-01-01

Objectives (1)To describe the prevalence and severity of tremor in patients with multiple sclerosis (MS) registered within a large North American MS registry; (2) to provide detailed descriptions on the characteristics and severity of tremor in a subset of registrants and (3) to compare several measures of tremor severity for strength of agreement. Setting The North American Research Committee on MS (NARCOMS) registry. Participants Registrants of NARCOMS reporting mild or greater tremor severity. Outcome measures We determined the cross-sectional prevalence of tremor in the NARCOMS registry over three semiannual updates between fall 2010 and fall 2011. A subset of registrants (n=552) completed a supplemental survey providing detailed descriptions of their tremor. Outcomes included descriptive characteristics of their tremors and correlations between outcome measures to determine the strength of agreement in assessing tremor severity. Results The estimated prevalence of tremor in NARCOMS ranged from 45% to 46.8%, with severe tremor affecting 5.5–5.9% of respondents. In the subset completing the supplemental survey, mild tremor severity was associated with younger age of MS diagnosis and tremor onset than those with moderate or severe tremor. However, tremor severity did not differ by duration of disease or tremor. Respondents provided descriptions of tremor symptoms on the Clinical Ataxia Rating Scale, which had a moderate to good (ρ=0.595) correlation with the Tremor Related Activities of Daily Living (TRADL) scale. Objectively scored Archimedes’ spirals had a weaker (ρ=0.358) correlation with the TRADL. Rates of unemployment, disability and symptomatic medication use increased with tremor severity, but were high even among those with mild tremor. Conclusions Tremor is common among NARCOMS registrants and severely disabling for some. Both ADL-based and symptom-descriptive measures of tremor severity can be used to stratify patients. PMID:25573524

Migrating tremors illuminate complex deformation beneath the seismogenic San Andreas fault

USGS Publications Warehouse

Shelly, David R.

2010-01-01

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.

Physiological and harmonic components in neural and muscular coherence in Parkinsonian tremor.

PubMed

Wang, Shouyan; Aziz, Tipu Z; Stein, John F; Bain, Peter G; Liu, Xuguang

2006-07-01

To differentiate physiological from harmonic components in coherence analysis of the tremor-related neural and muscular signals by comparing power, cross-power and coherence spectra. Influences of waveform, burst-width and additional noise on generating harmonic peaks in the power, cross-power and coherence spectra were studied using simulated signals. The local field potentials (LFPs) of the subthalamic nucleus (STN) and the EMGs of the contralateral forearm muscles in PD patients with rest tremor were analysed. (1) Waveform had significant effect on generating harmonics; (2) noise significantly decreased the coherence values in a frequency-dependent fashion; and (3) cross-spectrum showed high resistance to harmonics. Among six examples of paired LFP-EMG signals, significant coherence appeared at the tremor frequency only, both the tremor and double tremor frequencies and the double-tremor frequency only. In coherence analysis of neural and muscular signals, distortion in waveform generates significant harmonic peaks in the coherence spectra and the coherence values of both physiological and harmonic components are modulated by extra noise or non-tremor related activity. The physiological or harmonic nature of a coherence peak at the double tremor frequency may be differentiated when the coherence spectra are compared with the power and in particular the cross-power spectra.

An approach to source characterization of tremor signals associated with eruptions and lahars

NASA Astrophysics Data System (ADS)

Kumagai, Hiroyuki; Mothes, Patricia; Ruiz, Mario; Maeda, Yuta

2015-11-01

Tremor signals are observed in association with eruption activity and lahar descents. Reduced displacement ( D R) derived from tremor signals has been used to quantify tremor sources. However, tremor duration is not considered in D R, which makes it difficult to compare D R values estimated for different tremor episodes. We propose application of the amplitude source location (ASL) method to characterize the sources of tremor signals. We used this method to estimate the tremor source location and source amplitude from high-frequency (5-10 Hz) seismic amplitudes under the assumption of isotropic S-wave radiation. We considered the source amplitude to be the maximum value during tremor. We estimated the cumulative source amplitude ( I s) as the offset value of the time-integrated envelope of the vertical seismogram of tremor corrected for geometrical spreading and medium attenuation in the 5-10-Hz band. For eruption tremor signals, we also estimated the cumulative source pressure ( I p) from an infrasonic envelope waveform corrected for geometrical spreading. We studied these parameters of tremor signals associated with eruptions and lahars and explosion events at Tungurahua volcano, Ecuador. We identified two types of eruption tremor at Tungurahua: noise-like inharmonic waveforms and harmonic oscillatory signals. We found that I s increased linearly with increasing source amplitude for lahar tremor signals and explosion events, but I s increased exponentially with increasing source amplitude for inharmonic eruption tremor signals. The source characteristics of harmonic eruption tremor signals differed from those of inharmonic tremor signals. We found a linear relation between I s and I p for both explosion events and eruption tremor. Because I p may be proportional to the total mass involved during an eruption episode, this linear relation suggests that I s may be useful to quantify eruption size. The I s values we estimated for inharmonic eruption tremor were

Akinetic-rigid and tremor-dominant Parkinson's disease patients show different patterns of intrinsic brain activity.

PubMed

Zhang, Jiuquan; Wei, Luqing; Hu, Xiaofei; Xie, Bing; Zhang, Yanling; Wu, Guo-Rong; Wang, Jian

2015-01-01

Parkinson's disease (PD) is a surprisingly heterogeneous neurodegenerative disorder. It is well established that different subtypes of PD present with different clinical courses and prognoses. However, the neural mechanism underlying these disparate presentations is uncertain. Here we used resting-state fMRI (rs-fMRI) and the regional homogeneity (ReHo) method to determine neural activity patterns in the two main clinical subgroups of PD (akinetic-rigid and tremor-dominant). Compared with healthy controls, akinetic-rigid (AR) subjects had increased ReHo mainly in right amygdala, left putamen, bilateral angular gyrus, bilateral medial prefrontal cortex (MPFC), and decreased ReHo in left post cingulate gyrus/precuneus (PCC/PCu) and bilateral thalamus. In contrast, tremor-dominant (TD) patients showed higher ReHo mostly in bilateral angular gyrus, left PCC, cerebellum_crus1, and cerebellum_6, while ReHo was decreased in right putamen, primary sensory cortex (S1), vermis_3, and cerebellum_4_5. These results indicate that AR and TD subgroups both represent altered spontaneous neural activity in default-mode regions and striatum, and AR subjects exhibit more changed neural activity in the mesolimbic cortex (amygdala) but TD in the cerebellar regions. Of note, direct comparison of the two subgroups revealed a distinct ReHo pattern primarily located in the striatal-thalamo-cortical (STC) and cerebello-thalamo-cortical (CTC) loops. Overall, our findings highlight the involvement of default mode network (DMN) and STC circuit both in AR and TD subtypes, but also underscore the importance of integrating mesolimbic-striatal and CTC loops in understanding neural systems of akinesia and rigidity, as well as resting tremor in PD. This study provides improved understanding of the pathophysiological models of different subtypes of PD. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Network Model of Local Field Potential Activity in Essential Tremor and the Impact of Deep Brain Stimulation

PubMed Central

Mace, Michael; Pavese, Nicola; Borisyuk, Roman; Bain, Peter

2017-01-01

Essential tremor (ET), a movement disorder characterised by an uncontrollable shaking of the affected body part, is often professed to be the most common movement disorder, affecting up to one percent of adults over 40 years of age. The precise cause of ET is unknown, however pathological oscillations of a network of a number of brain regions are implicated in leading to the disorder. Deep brain stimulation (DBS) is a clinical therapy used to alleviate the symptoms of a number of movement disorders. DBS involves the surgical implantation of electrodes into specific nuclei in the brain. For ET the targeted region is the ventralis intermedius (Vim) nucleus of the thalamus. Though DBS is effective for treating ET, the mechanism through which the therapeutic effect is obtained is not understood. To elucidate the mechanism underlying the pathological network activity and the effect of DBS on such activity, we take a computational modelling approach combined with electrophysiological data. The pathological brain activity was recorded intra-operatively via implanted DBS electrodes, whilst simultaneously recording muscle activity of the affected limbs. We modelled the network hypothesised to underlie ET using the Wilson-Cowan approach. The modelled network exhibited oscillatory behaviour within the tremor frequency range, as did our electrophysiological data. By applying a DBS-like input we suppressed these oscillations. This study shows that the dynamics of the ET network support oscillations at the tremor frequency and the application of a DBS-like input disrupts this activity, which could be one mechanism underlying the therapeutic benefit. PMID:28068428

Tremors Triggered along the Queen Charlotte Fault

NASA Astrophysics Data System (ADS)

Aiken, C.; Peng, Z.; Chao, K.

2012-12-01

In the past decade, deep tectonic tremors have been observed in numerous tectonic environments surrounding the Pacific and Caribbean plates. In these regions, tremors triggered by both regional and distant earthquakes have also been observed. Despite the ubiquitous observations of triggered tremors, tremors triggered in differing strike-slip environments are less understood. Here, we conduct a preliminary search of tremors triggered by teleseismic earthquakes along the transpressive Queen Charlotte Fault (QCF) located between the Cascadia subduction zone and Alaska. Tectonic tremors have not been previously reported along the QCF. We select teleseismic earthquakes during the 1990-2012 period as having magnitude M ≥ 6.5 and occurring at least 1,000 km away from the region. We reduce the number of mainshocks by selecting those that generate greater than 1 kPa dynamic stress estimated from surface-wave magnitude equations [e.g. van der Elst and Brodsky, 2010]. Our mainshock waveforms are retrieved from the Canadian National Seismograph Network (CNSN), processed, and filtered for triggered tremor observations. We characterize triggered tremors as high-frequency signals visible among several stations and coincident with broadband surface wave peaks. So far, we have found tremors triggered along the QCF by surface waves of five great earthquakes - the 2002/11/03 Mw7.9 Denali Fault, 2004/12/26 Mw9.0 Sumatra, 2010/02/27 Mw8.8 Chile, 2011/03/11 Mw9.0 Japan, and 2012/04/11 Mw8.6 Sumatra earthquakes. We compare our results to tremors triggered by teleseismic earthquakes on strike-slip faults in central and southern California, as well as Cuba [Peng et al., 2012]. Among strike-slip faults in these regions, we also compare triggered tremor amplitudes to peak ground velocities from the mainshocks and compute dynamic stresses to determine a triggering threshold for the QCF. We find that in most cases tremors in the QCF are triggered primarily by the Love waves, and additional

Frictional-faulting model for harmonic tremor before Redoubt Volcano eruptions

NASA Astrophysics Data System (ADS)

Dmitrieva, Ksenia; Hotovec-Ellis, Alicia J.; Prejean, Stephanie; Dunham, Eric M.

2013-08-01

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 0.5-5Hz. 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.

Frictional-faulting model for harmonic tremor before Redoubt Volcano eruptions

USGS Publications Warehouse

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.

Analysis of the tremor in juvenile myoclonic epilepsy.

PubMed

Aydin-Özemir, Zeynep; Matur, Zeliha; Baykan, Betul; Bilgic, Başar; Tekturk, Pınar; Bebek, Nerses; Gurses, Candan; Hanagasi, Hasmet; Oge, Ali Emre

2016-12-01

We aimed to investigate juvenile myoclonic epilepsy (JME) patients complaining of tremor unrelated to valproate (VPA) treatment and evaluate if there were differences between JME patients with and without tremor and essential tremor (ET) patients to exclude comorbidity. Fifteen JME cases with the complaint of tremor, 14 JME patients without tremor, 14 patients with ET and 14 healthy subjects (HS) were included. Regularity, frequency and amplitude of the tremor and superimposed myoclonia were assessed by accelerometric analysis. Cortical SEPs evoked by the stimulation of the median nerve were recorded bilaterally. Clinical and neurophysiologic features were statistically compared between the groups. Amplitude of postural tremor of the left hand was significantly increased in the ET group compared to JME patients with tremor, but there were no differences regarding to frequency. Strikingly, there were superimposed irregular, low-amplitude inconstant myoclonic jerks located to distal part of the fingers in JME group with tremor. Initial frequency of myoclonic seizures was also significantly higher in this group compared to JME patients without tremor but this difference disappeared after treatment. The group of JME with tremor had the highest N20-P25 and P25-N35 amplitudes, followed by JME without tremor, ET and HS, respectively. Tremulous hand movements in JME resembled ET, but their amplitude was lower and characterized with accompanying irregular myoclonic jerks. The presence of tremor in JME patients should be taken into consideration to create more homogeneous groups in genetic and pathophysiological studies of JME. Copyright © 2016 Elsevier B.V. All rights reserved.

Motion-compensated hand-held common-path Fourier-domain optical coherence tomography probe for image-guided intervention

NASA Astrophysics Data System (ADS)

Huang, Yong; Song, Cheol; Liu, Xuan; Kang, Jin U.

2013-03-01

A motion-compensated hand-held common-path Fourier-domain optical coherence tomography imaging probe has been developed for image guided intervention during microsurgery. A hand-held prototype instrument was designed and fabricated by integrating an imaging fiber probe inside a stainless steel needle which is attached to the ceramic shaft of a piezoelectric motor housed in an aluminum handle. The fiber probe obtains A-scan images. The distance information was extracted from the A-scans to track the sample surface distance and a fixed distance was maintained by a feedback motor control which effectively compensated hand tremor and target movements in the axial direction. Graphical user interface, real-time data processing, and visualization based on a CPU-GPU hybrid programming architecture were developed and used in the implantation of this system. To validate the system, free-hand optical coherence tomography images using various samples were obtained. The system can be easily integrated into microsurgical tools and robotics for a wide range of clinical applications. Such tools could offer physicians the freedom to easily image sites of interest with reduced risk and higher image quality.

Triggered tremor sweet spots in Alaska

NASA Astrophysics Data System (ADS)

Gomberg, Joan; Prejean, Stephanie

2013-12-01

To better understand what controls fault slip along plate boundaries, we have exploited the abundance of seismic and geodetic data available from the richly varied tectonic environments composing Alaska. A search for tremor triggered by 11 large earthquakes throughout all of seismically monitored Alaska reveals two tremor "sweet spots"—regions where large-amplitude seismic waves repeatedly triggered tremor between 2006 and 2012. The two sweet spots locate in very different tectonic environments—one just trenchward and between the Aleutian islands of Unalaska and Akutan and the other in central mainland Alaska. The Unalaska/Akutan spot corroborates previous evidence that the region is ripe for tremor, perhaps because it is located where plate-interface frictional properties transition between stick-slip and stably sliding in both the dip direction and laterally. The mainland sweet spot coincides with a region of complex and uncertain plate interactions, and where no slow slip events or major crustal faults have been noted previously. Analyses showed that larger triggering wave amplitudes, and perhaps lower frequencies (< 0.03 Hz), may enhance the probability of triggering tremor. However, neither the maximum amplitude in the time domain or in a particular frequency band, nor the geometric relationship of the wavefield to the tremor source faults alone ensures a high probability of triggering. Triggered tremor at the two sweet spots also does not occur during slow slip events visually detectable in GPS data, although slow slip below the detection threshold may have facilitated tremor triggering.

Triggered tremor sweet spots in Alaska

USGS Publications Warehouse

Gomberg, Joan; Prejean, Stephanie

2013-01-01

To better understand what controls fault slip along plate boundaries, we have exploited the abundance of seismic and geodetic data available from the richly varied tectonic environments composing Alaska. A search for tremor triggered by 11 large earthquakes throughout all of seismically monitored Alaska reveals two tremor “sweet spots”—regions where large-amplitude seismic waves repeatedly triggered tremor between 2006 and 2012. The two sweet spots locate in very different tectonic environments—one just trenchward and between the Aleutian islands of Unalaska and Akutan and the other in central mainland Alaska. The Unalaska/Akutan spot corroborates previous evidence that the region is ripe for tremor, perhaps because it is located where plate-interface frictional properties transition between stick-slip and stably sliding in both the dip direction and laterally. The mainland sweet spot coincides with a region of complex and uncertain plate interactions, and where no slow slip events or major crustal faults have been noted previously. Analyses showed that larger triggering wave amplitudes, and perhaps lower frequencies (<~0.03 Hz), may enhance the probability of triggering tremor. However, neither the maximum amplitude in the time domain or in a particular frequency band, nor the geometric relationship of the wavefield to the tremor source faults alone ensures a high probability of triggering. Triggered tremor at the two sweet spots also does not occur during slow slip events visually detectable in GPS data, although slow slip below the detection threshold may have facilitated tremor triggering.

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

PubMed Central

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

What is This Thing Called Tremor?

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

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

PubMed Central

Dietrichson, P; Espen, E

1981-01-01

Two different beta-adrenoreceptor antagonists, atenolol and timolol, were separately compared with a placebo in the suppression of essential tremor. In two-week single-blind placebo-controlled studies with cross-over, timolol (5 mg twice daily) and atenolol (100 mg once daily) produced an equal reduction in sitting heart rate and sitting blood pressure. Timolol was effective in reducing tremor while atenolol failed to reduce tremor amplitude. These results indicate that essential tremor can be reduced but not blocked, by the adrenergic blocker timolol with both beta 1 and beta 2 blocking properties; but not by the relatively selective beta 1 blocking drug atenolol. Possibly, the tremor reduction is medicated by a peripheral effect on beta 2 adrenoreceptors. Images PMID:7028921

Control of lithium tremor with propranolol.

PubMed

Lapierre, Y D

1976-04-03

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

Control of lithium tremor with propranolol.

PubMed Central

Lapierre, Y. D.

1976-01-01

Lithium tremor is an irregular, nonrhythmic tremor of the distal extremities, variable in both intensity and frequency. It is clinically differentiated from essential tremor and tremors due to anxiety and neuroleptics. The pathophysiologic mechanisms are hypothesized to be of perpheral origin. Five patients were successfully treated with propranolol. In general, the dosage of propranolol must be individually adjusted and is usually from 30 to 40 mg daily in divided doses. This blocker of beta-adrenergic receptors remains effective with long-term administration and increases in dosage are not required. PMID:1260604

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

NASA Astrophysics Data System (ADS)

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

Deep brain stimulation for the treatment of uncommon tremor syndromes.

PubMed

Ramirez-Zamora, Adolfo; Okun, Michael S

2016-08-01

Deep brain stimulation (DBS) has become a standard therapy for the treatment of select cases of medication refractory essential tremor and Parkinson's disease however the effectiveness and long-term outcomes of DBS in other uncommon and complex tremor syndromes has not been well established. Traditionally, the ventralis intermedius nucleus (VIM) of the thalamus has been considered the main target for medically intractable tremors; however alternative brain regions and improvements in stereotactic techniques and hardware may soon change the horizon for treatment of complex tremors. In this article, we conducted a PubMed search using different combinations between the terms 'Uncommon tremors', 'Dystonic tremor', 'Holmes tremor' 'Midbrain tremor', 'Rubral tremor', 'Cerebellar tremor', 'outflow tremor', 'Multiple Sclerosis tremor', 'Post-traumatic tremor', 'Neuropathic tremor', and 'Deep Brain Stimulation/DBS'. Additionally, we examined and summarized the current state of evolving interventions for treatment of complex tremor syndromes. Expert commentary: Recently reported interventions for rare tremors include stimulation of the posterior subthalamic area, globus pallidus internus, ventralis oralis anterior/posterior thalamic subnuclei, and the use of dual lead stimulation in one or more of these targets. Treatment should be individualized and dictated by tremor phenomenology and associated clinical features.

The 2011 unrest at Katla volcano: Characterization and interpretation of the tremor sources

NASA Astrophysics Data System (ADS)

Sgattoni, Giulia; Gudmundsson, Ólafur; Einarsson, Páll; Lucchi, Federico; Li, Ka Lok; Sadeghisorkhani, Hamzeh; Roberts, Roland; Tryggvason, Ari

2017-05-01

A 23-hour tremor burst was recorded on July 8-9th 2011 at the Katla subglacial volcano, one of the most active and hazardous volcanoes in Iceland. This was associated with deepening of cauldrons on the ice cap and a glacial flood that caused damage to infrastructure. Increased earthquake activity within the caldera started a few days before and lasted for months afterwards and new seismic activity started on the southern flank. No visible eruption broke the ice and the question arose as to whether this episode relates to a minor subglacial eruption with the tremor being generated by volcanic processes, or by the flood. The tremor signal consisted of bursts with varying amplitude and duration. We have identified and described three different tremor phases, based on amplitude and frequency features. A tremor phase associated with the flood was recorded only at stations closest to the river that flooded, correlating in time with rising water level observed at gauging stations. Using back-projection of double cross-correlations, two other phases have been located near the active ice cauldrons and are interpreted to be caused by volcanic or hydrothermal processes. The greatly increased seismicity and evidence of rapid melting of the glacier may be explained by a minor sub-glacial eruption. A less plausible interpretation is that the tremor was generated by hydrothermal boiling and/or explosions with no magma involved. This may have been induced by pressure drop triggered by the release of water when the glacial flood started. All interpretations require an increase of heat released by the volcano.

Peripheral beta-adrenergic blockade treatment of parkinsonian tremor.

PubMed

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

1984-10-01

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

The nature of primary vocal tremor.

PubMed

Hachinski, V C; Thomsen, I V; Buch, N H

1975-08-01

Three elderly women with marked progressive voice tremor, without other neurological symptoms, and negative family histories were investigated. All had a 4-5 Hz respiratory tremor in expiration and, to a lesser degree, in inspiration; and all had vocal tremulousness synchronous with their respiratory irregularity. Articulation of phonemes was normal. In two cases the neurological examination was otherwise normal; in the third case there was a minimal 71/2 Hz tremor in the left thumb and index finger. Simultaneous speech and vocal air pressure recordings, as well as cinematographic studies of the vocal apparatus and diaphragm were carried out. It is suggested that these cases represent primarily an action tremor of respiration, that they belong in the spectrum of essential tremor, and hence may be amenable to treatment with propranolol.

Characteristics of Tremor During the Entire July 2004 Cascadia Episodic Tremor and Slip event

NASA Astrophysics Data System (ADS)

McCausland, W. A.; Malone, S.; La Rocca, M.; Creager, K.

2005-12-01

The July 2004 Cascadia episodic tremor and slip (ETS) event was recorded and analyzed using three geographically distributed small aperture seismic arrays (600m) located near Sooke, BC, Sequim, WA, and on Lopez Island, WA. We analyzed the tremor sequence in the 1 to 6 Hz frequency band in overlapping windows (12s length)using zero-lag cross correlation and polarization analysis in order to obtain a continuous record of the back-azimuth, slowness, and particle motion of tremor sources throughout the ETS episode. During periods without tremor, the average interstation correlations for each array range between 0.2 and 0.4, and observed azimuths are randomly distributed. During periods of strong tremor, the average correlation for each array is typically between 0.5 and 0.8, and azimuths are stable over periods of minutes. Observed apparent velocities are greater than 4 km/s and polarization analysis indicates that the wave-field is composed primarily of SH-waves, both of which are consistent with a deep source of shear wave energy. Azimuths and slownesses are consistent with previously obtained hypocentral locations and apparent velocities calculated using the relative arrival times of energy bursts on Pacific Northwest Seismograph Network.

Multi-asperity models of slow slip and tremor

NASA Astrophysics Data System (ADS)

Ampuero, Jean Paul; Luo, Yingdi; Lengline, Olivier; Inbal, Asaf

2016-04-01

Field observations of exhumed faults indicate that fault zones can comprise mixtures of materials with different dominant deformation mechanisms, including contrasts in strength, frictional stability and hydrothermal transport properties. Computational modeling helps quantify the potential effects of fault zone heterogeneity on fault slip styles from seismic to aseismic slip, including slow slip and tremor phenomena, foreshocks sequences and swarms, high- and low-frequency radiation during large earthquakes. We will summarize results of ongoing modeling studies of slow slip and tremor in which fault zone structure comprises a collection of frictionally unstable patches capable of seismic slip (tremorgenic asperities) embedded in a frictionally stable matrix hosting aseismic transient slips. Such models are consistent with the current view that tremors result from repeated shear failure of multiple asperities as Low Frequency Earthquakes (LFEs). The collective behavior of asperities embedded in creeping faults generate a rich spectrum of tremor migration patterns, as observed in natural faults, whose seismicity rate, recurrence time and migration speed can be mechanically related to the underlying transient slow slip rate. Tremor activity and slow slip also responds to periodic loadings induced by tides or surface waves, and models relate tremor tidal sensitivity to frictional properties, fluid pressure and creep rate. The overall behavior of a heterogeneous fault is affected by structural parameters, such as the ratio of stable to unstable materials, but also by time-dependent variables, such as pore pressure and loading rate. Some behaviors are well predicted by homogenization theory based on spatially-averaged frictional properties, but others are somewhat unexpected, such as seismic slip behavior found in asperities that are much smaller than their nucleation size. Two end-member regimes are obtained in rate-and-state models with velocity-weakening asperities

Psychogenic Tremor: A Video Guide to Its Distinguishing Features

PubMed Central

Thenganatt, Mary Ann; Jankovic, Joseph

2014-01-01

Background Psychogenic tremor is the most common psychogenic movement disorder. It has characteristic clinical features that can help distinguish it from other tremor disorders. There is no diagnostic gold standard and the diagnosis is based primarily on clinical history and examination. Despite proposed diagnostic criteria, the diagnosis of psychogenic tremor can be challenging. While there are numerous studies evaluating psychogenic tremor in the literature, there are no publications that provide a video/visual guide that demonstrate the clinical characteristics of psychogenic tremor. Educating clinicians about psychogenic tremor will hopefully lead to earlier diagnosis and treatment. Methods We selected videos from the database at the Parkinson’s Disease Center and Movement Disorders Clinic at Baylor College of Medicine that illustrate classic findings supporting the diagnosis of psychogenic tremor. Results We include 10 clinical vignettes with accompanying videos that highlight characteristic clinical signs of psychogenic tremor including distractibility, variability, entrainability, suggestibility, and coherence. Discussion Psychogenic tremor should be considered in the differential diagnosis of patients presenting with tremor, particularly if it is of abrupt onset, intermittent, variable and not congruous with organic tremor. The diagnosis of psychogenic tremor, however, should not be simply based on exclusion of organic tremor, such as essential, parkinsonian, or cerebellar tremor, but on positive criteria demonstrating characteristic features. Early recognition and management are critical for good long-term outcome. PMID:25243097

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

PubMed

Suemaru, K; Kawasaki, H; Gomita, Y

1997-06-01

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

Cascadia subduction tremor muted by crustal faults

USGS Publications Warehouse

Wells, Ray; Blakely, Richard J.; Wech, Aaron G.; McCrory, Patricia A.; Michael, Andrew

2017-01-01

Deep, episodic slow slip on the Cascadia subduction megathrust of western North America is accompanied by low-frequency tremor in a zone of high fluid pressure between 30 and 40 km depth. Tremor density (tremor epicenters per square kilometer) varies along strike, and lower tremor density statistically correlates with upper plate faults that accommodate northward motion and rotation of forearc blocks. Upper plate earthquakes occur to 35 km depth beneath the faults. We suggest that the faults extend to the overpressured megathrust, where they provide fracture pathways for fluid escape into the upper plate. This locally reduces megathrust fluid pressure and tremor occurrence beneath the faults. Damping of tremor and related slow slip caused by fluid escape could affect fault properties of the megathrust, possibly influencing the behavior of great earthquakes.

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

NASA Astrophysics Data System (ADS)

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.

An Ambulatory Tremor Score for Parkinson's Disease.

PubMed

Braybrook, Michelle; O'Connor, Sam; Churchward, Philip; Perera, Thushara; Farzanehfar, Parisa; Horne, Malcolm

2016-10-19

While tremor in Parkinson's Disease (PD) can be characterised in the consulting room, its relationship to treatment and fluctuations can be clinically helpful. To develop an ambulatory assessment of tremor of PD. Accelerometry data was collected using the Parkinson's KinetiGraph System (PKG, Global Kinetics). An algorithm was developed, which could successfully distinguish been subjects with a resting or postural tremor that involved the wrist whose frequency was greater than 3 Hz. Percent of time that tremor was present (PTT) between 09 : 00 and 18 : 00 was calculated. This algorithm was applied to 85 people with PD who had been assessed clinically for the presence and nature of tremor. The Sensitivity and Selectivity of a PTT ≥0.8% was 92.5% and 92.9% in identifying tremor, providing that the tremor was not a fine kinetic and postural tremor or was not in the upper limb. A PTT >1% provide high likely hood of the presence of clinical meaningful tremor. These cut-offs were retested on a second cohort (n = 87) with a similar outcome. The Sensitivity and Selectivity of the combined group was 88.7% and 89.5% respectively. Using the PTT, 50% of 22 newly diagnosed patients had a PTT >1.0%.The PKG's simultaneous bradykinesia scores was used to find a threshold for the emergence of tremor. Tremor produced artefactual increase in the PKG's dyskinesia score in 1% of this sample. We propose this as a means of assessing the presence of tremor and its relationship to bradykinesia.

What is It? Difficult to Pigeon Hole Tremor: a Clinical–Pathological Study of a Man with Jaw Tremor

PubMed Central

Louis, Elan D.; Bain, Peter G.; Hallett, Mark; Jankovic, Joseph; Vonsattel, Jean-Paul G.

2013-01-01

Background The phenomenology of tremor is broad and its classification is complicated. Furthermore, the full range of tremor phenomenology with respect to specific neurological and neurodegenerative diseases has not been fully elaborated. Case Report This right-handed man had a chief complaint of jaw tremor, which began approximately 20 years prior to death at age 101 years. He had been diagnosed with essential tremor (ET) by a local doctor. His examination at age 100 years was notable for marked jaw tremor at rest in the absence of other clear features of parkinsonism, mild kinetic tremor of the hands and, in the last year of life, a score of 22/41 on a cognitive screen. A senior movement disorder neurologist raised doubt about the “ET” diagnosis. The history and videotaped examination were reviewed by three additional senior tremor experts, who raised a number of diagnostic possibilities. A complete postmortem examination was performed by a senior neuropathologist, and was notable for the presence of tufted astrocytes, AT8-labeled glial cytoplasmic inclusions, and globose neuronal tangles. These changes were widespread and definitive. A neuropathological diagnosis of progressive supranuclear palsy was assigned. Discussion This case presents with mixed and difficult to clinically classify tremor phenomenology and other neurological findings. The postmortem diagnosis was not predicted based on the clinical features, and it is possible that it does not account for all of the features. The case raises many interesting issues and provides a window into the complexity of the interpretation, nosology, and classification of tremor phenomenology. PMID:23864988

Resolving the detailed spatiotemporal slip evolution of deep tremor in western Japan

NASA Astrophysics Data System (ADS)

Ohta, K.; Ide, S.

2017-12-01

A quantitative evaluation of the slip evolution of tremor is essential to understand the generation mechanism of slow earthquakes. The recent studies have revealed the most part of tremor signals can be expressed as the superposition of low frequency earthquakes (LFE). However, it is still challenging to explain the entire waveforms of tremor, because a conventional slip inversion analysis is not available for tremor due to insufficient knowledge of source locations and Green's functions. Here we investigate the detailed spatiotemporal behavior of deep tremor in western Japan through the development and application of a new slip inversion method. 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 <100 s regularly occur. We attribute these heterogeneous spatiotemporal slip patterns to heterogeneous material properties along the plate interface. For central Shikoku, where we focus on a 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.

Essential Tremor Is More Than a Tremor

MedlinePlus

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

NASA Astrophysics Data System (ADS)

Villafuerte, Carlos; Cruz-Atienza, Víctor M.

2017-08-01

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

Postural Tremor and Ataxia Progression in Spinocerebellar Ataxias

PubMed Central

Gan, Shi-Rui; Wang, Jie; Figueroa, Karla P.; Pulst, Stefan M.; Tomishon, Darya; Lee, Danielle; Perlman, Susan; Wilmot, George; Gomez, Christopher M.; Schmahmann, Jeremy; Paulson, Henry; Shakkottai, Vikram G.; Ying, Sarah H.; Zesiewicz, Theresa; Bushara, Khalaf; Geschwind, Michael D.; Xia, Guangbin; Subramony, S. H.; Ashizawa, Tetsuo; Kuo, Sheng-Han

2017-01-01

Background Postural tremor can sometimes occur in spinocerebellar ataxias (SCAs). However, the prevalence and clinical characteristics of postural tremor in SCAs are poorly understood, and whether SCA patients with postural tremor have different ataxia progression is not known. Methods We studied postural tremor in 315 patients with SCA1, 2, 3, and 6 recruited from the Clinical Research Consortium for Spinocerebellar Ataxias (CRC-SCA), which consists of 12 participating centers in the United States, and we evaluated ataxia progression in these patients from January 2010 to August 2012. Results Among 315 SCA patients, postural tremor was most common in SCA2 patients (SCA1, 5.8%; SCA2, 27.5%; SCA3, 12.4%; SCA6, 16.9%; p = 0.007). SCA3 patients with postural tremor had longer CAG repeat expansions than SCA3 patients without postural tremor (73.67 ± 3.12 vs. 70.42 ± 3.96, p = 0.003). Interestingly, SCA1 and SCA6 patients with postural tremor had a slower rate of ataxia progression (SCA1, β = –0.91, p < 0.001; SCA6, β = –1.28, p = 0.025), while SCA2 patients with postural tremor had a faster rate of ataxia progression (β = 1.54, p = 0.034). We also found that the presence of postural tremor in SCA2 patients could be influenced by repeat expansions of ATXN1 (β = –1.53, p = 0.037) and ATXN3 (β = 0.57, p = 0.018), whereas postural tremor in SCA3 was associated with repeat lengths in TBP (β = 0.63, p = 0.041) and PPP2R2B (β = –0.40, p = 0.032). Discussion Postural tremor could be a clinical feature of SCAs, and the presence of postural tremor could be associated with different rates of ataxia progression. Genetic interactions between ataxia genes might influence the brain circuitry and thus affect the clinical presentation of postural tremor. PMID:29057148

Postural Tremor and Ataxia Progression in Spinocerebellar Ataxias.

PubMed

Gan, Shi-Rui; Wang, Jie; Figueroa, Karla P; Pulst, Stefan M; Tomishon, Darya; Lee, Danielle; Perlman, Susan; Wilmot, George; Gomez, Christopher M; Schmahmann, Jeremy; Paulson, Henry; Shakkottai, Vikram G; Ying, Sarah H; Zesiewicz, Theresa; Bushara, Khalaf; Geschwind, Michael D; Xia, Guangbin; Subramony, S H; Ashizawa, Tetsuo; Kuo, Sheng-Han

2017-01-01

Postural tremor can sometimes occur in spinocerebellar ataxias (SCAs). However, the prevalence and clinical characteristics of postural tremor in SCAs are poorly understood, and whether SCA patients with postural tremor have different ataxia progression is not known. We studied postural tremor in 315 patients with SCA1, 2, 3, and 6 recruited from the Clinical Research Consortium for Spinocerebellar Ataxias (CRC-SCA), which consists of 12 participating centers in the United States, and we evaluated ataxia progression in these patients from January 2010 to August 2012. Among 315 SCA patients, postural tremor was most common in SCA2 patients (SCA1, 5.8%; SCA2, 27.5%; SCA3, 12.4%; SCA6, 16.9%; p = 0.007). SCA3 patients with postural tremor had longer CAG repeat expansions than SCA3 patients without postural tremor (73.67 ± 3.12 vs. 70.42 ± 3.96, p = 0.003). Interestingly, SCA1 and SCA6 patients with postural tremor had a slower rate of ataxia progression (SCA1, β = -0.91, p < 0.001; SCA6, β = -1.28, p = 0.025), while SCA2 patients with postural tremor had a faster rate of ataxia progression (β = 1.54, p = 0.034). We also found that the presence of postural tremor in SCA2 patients could be influenced by repeat expansions of ATXN1 (β = -1.53, p = 0.037) and ATXN3 (β = 0.57, p = 0.018), whereas postural tremor in SCA3 was associated with repeat lengths in TBP (β = 0.63, p = 0.041) and PPP2R2B (β = -0.40, p = 0.032). Postural tremor could be a clinical feature of SCAs, and the presence of postural tremor could be associated with different rates of ataxia progression. Genetic interactions between ataxia genes might influence the brain circuitry and thus affect the clinical presentation of postural tremor.

Continuous Monitoring of Essential Tremor Using a Portable System Based on Smartwatch.

PubMed

Zheng, Xiaochen; Vieira Campos, Alba; Ordieres-Meré, Joaquín; Balseiro, Jose; Labrador Marcos, Sergio; Aladro, Yolanda

2017-01-01

Essential tremor (ET) shows amplitude fluctuations throughout the day, presenting challenges in both clinical and treatment monitoring. Tremor severity is currently evaluated by validated rating scales, which only provide a timely and subjective assessment during a clinical visit. Motor sensors have shown favorable performances in quantifying tremor objectively. A new highly portable system was used to monitor tremor continuously during daily lives. It consists of a smartwatch with a triaxial accelerometer, a smartphone, and a remote server. An experiment was conducted involving eight ET patients. The average effective data collection time per patient was 26 (±6.05) hours. Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS) was adopted as the gold standard to classify tremor and to validate the performance of the system. Quantitative analysis of tremor severity on different time scales is validated. Significant correlations were observed between neurologist's FTMTRS and patient's FTMTRS auto-assessment scores ( r  = 0.84; p  = 0.009), between the device quantitative measures and the scores from the standardized assessments of neurologists ( r  = 0.80; p  = 0.005) and patient's auto-evaluation ( r  = 0.97; p  = 0.032), and between patient's FTMTRS auto-assessment scores day-to-day ( r  = 0.87; p  < 0.001). A graphical representation of four patients with different degrees of tremor was presented, and a representative system is proposed to summarize the tremor scoring at different time scales. This study demonstrates the feasibility of prolonged and continuous monitoring of tremor severity during daily activities by a highly portable non-restrictive system, a useful tool to analyze efficacy and effectiveness of treatment.

Unusual Volcanic Tremor Observations in Fogo Island, Cape Verde

NASA Astrophysics Data System (ADS)

Custodio, S. I.; Heleno, S. I.

2004-12-01

Volcanic tremor is a ground motion characterized by well-defined frequencies, and has traditionally been explained by the movement of fluids, namely magma, in conduits or cracks (Chouet, 1996). Thus tremor has the potential to reveal key aspects of volcanic structure and dynamics. Two types of previously unreported seismic signals have been observed in Fogo volcano: a) tide-modulated seismic noise and volcanic tremor, and b) high-frequency low-attenuation harmonic tremor. Amplitude modulation of seismic noise can be detected by simple eye-inspection of raw data in some stations of the VIGIL Network, Fogo Volcano. A more detailed analysis shows that certain frequency bands which we interpret as volcanic tremor, mainly in the range 2.0-3.0Hz, are preferentially modulated. The main frequency of modulation is 1.93 c.p.d., which corresponds to M2, the semi-diurnal lunar harmonic. Air pressure and temperature, which are continuously monitored in Fogo Island, have been analyzed and cannot explain the observed periodicity. Thus we conclude that seismic noise and tremor amplitudes are controlled by tides (Custodio et al., 2003). A relation between the tidal modulation and hydrothermal systems activity is suspected and under investigation. High-frequency (HF) tremor (5-20 Hz) has been recorded simultaneously in several stations in Fogo Island and even in different islands of the Cape Verde archipelago (up to distances of 120 km). In volcanic environments high-frequency motions are normally recorded in a small area close to the source, due to the strong attenuation of seismic waves. Non-volcanic origins for HF tremor were examined: cultural noise, whale vocalizations, ship noise, electronic/processing artifacts and path and/or site effects were all considered and dismissed. Emergent arrivals and strong site effects render source location a difficult task, but the analysis of wave polarizations and amplitude distributions seems to point to an offshore source. Two alternative

Treatment of resting tremor by beta-adrenergic blockade.

PubMed

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

1984-10-01

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

A Kinematic Model of Slow Slip Constrained by Tremor-Derived Slip Histories in Cascadia

NASA Astrophysics Data System (ADS)

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

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

NASA Astrophysics Data System (ADS)

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 <100 s regularly occur. We attribute these heterogeneous spatiotemporal slip patterns to heterogeneous material properties along the plate interface. For central Shikoku, where we focus on a 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.

Remotely triggered nonvolcanic tremor in Sumbawa, Indonesia

NASA Astrophysics Data System (ADS)

Fuchs, Florian; Lupi, Matteo; Miller, Stephen

2015-04-01

Nonvolcanic (or tectonic) tremor is a seismic phenomenom which can provide important information about dynamics of plate boundaries but the underlying mechanisms are not well understood. Tectonic tremor is often associated with slow-slip (termed episodic tremor and slip) and understanding the mechanisms driving tremor presents an important challenge because it is likely a dominant aspect of the evolutionary processes leading to tsunamigenic, megathrust subduction zone earthquakes. Tectonic tremor is observed worldwide, mainly along major subduction zones and plate boundaries such as in Alaska/Aleutians, Cascadia, the San Andreas Fault, Japan or Taiwan. We present, for the first time, evidence for triggered tremor beneath the island of Sumbawa, Indonesia. The island of Sumbawa, Indonesia, is part of the Lesser Sunda Group about 250 km north of the Australian/Eurasian plate collision at the Java Trench with a convergence rate of approximately 70 mm/yr. We show surface wave triggered tremor beneath Sumbawa in response to three teleseismic earthquakes: the Mw9.0 2011 Tohoku earthquake and two oceanic strike-slip earthquakes (Mw 8.6 and Mw8.2) offshore of Sumatra in 2012. Tremor amplitudes scale with ground motion and peak at 180 nm/s ground velocity on the horizontal components. A comparison of ground motion of the three triggering events and a similar (nontriggering) Mw7.6 2012 Philippines event constrains an apparent triggering threshold of approximately 1 mm/s ground velocity or 8 kPa dynamic stress. Surface wave periods of 45-65 s appear optimal for triggering tremor at Sumbawa which predominantly correlates with Rayleigh waves, even though the 2012 oceanic events have stronger Love wave amplitudes and triggering potential. Rayleigh wave triggering, low-triggering amplitudes, and the tectonic setting all favor a model of tremor generated by localized fluid transport. We could not locate the tremor because of minimal station coverage, but data indicate several

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

PubMed

Oran, Yael; Bar-Gad, Izhar

2018-02-14

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

Infrasonic component of volcano-seismic eruption tremor

NASA Astrophysics Data System (ADS)

Matoza, Robin S.; Fee, David

2014-03-01

Air-ground and ground-air elastic wave coupling are key processes in the rapidly developing field of seismoacoustics and are particularly relevant for volcanoes. During a sustained explosive volcanic eruption, it is typical to record a sustained broadband signal on seismometers, termed eruption tremor. Eruption tremor is usually attributed to a subsurface seismic source process, such as the upward migration of magma and gases through the shallow conduit and vent. However, it is now known that sustained explosive volcanic eruptions also generate powerful tremor signals in the atmosphere, termed infrasonic tremor. We investigate infrasonic tremor coupling down into the ground and its contribution to the observed seismic tremor. Our methodology builds on that proposed by Ichihara et al. (2012) and involves cross-correlation, coherence, and cross-phase spectra between waveforms from nearly collocated seismic and infrasonic sensors; we apply it to datasets from Mount St. Helens, Tungurahua, and Redoubt Volcanoes.

Pretherapeutic functional neuroimaging predicts tremor arrest after thalamotomy.

PubMed

Tuleasca, C; Najdenovska, E; Régis, J; Witjas, T; Girard, N; Champoudry, J; Faouzi, M; Thiran, J-P; Bach Cuadra, M; Levivier, M; Van De Ville, D

2018-05-01

Essential tremor (ET) represents the most common movement disorder. Drug-resistant ET can benefit from standard stereotactic procedures (deep brain stimulation or radiofrequency thalamotomy) or alternatively minimally invasive high-focused ultrasound or radiosurgery. All aim at same target, thalamic ventro-intermediate nucleus (Vim). The study included a cohort of 17 consecutive patients, with ET, treated only with left unilateral stereotactic radiosurgical thalamotomy (SRS-T) between September 2014 and August 2015. The mean time to tremor improvement was 3.32 months (SD 2.7, 0.5-10). Neuroimaging data were collected at baseline (n = 17). Standard tremor scores, including activities of daily living (ADL) and tremor score on treated hand (TSTH), were completed pretherapeutically and 1 year later. We further correlate these scores with baseline inter-connectivity in twenty major large-scale brain networks. We report as predictive three networks, with the interconnected statistically significant clusters: primary motor cortex interconnected with inferior olivary nucleus, bilateral thalamus interconnected with motor cerebellum lobule V 2 (ADL), and anterior default-mode network interconnected with Brodmann area 10 3 (TSTH). For all, more positive pretherapeutic interconnectivity correlated with higher drop in points on the respective scores. Age, disease duration, or time-to-response after SRS-T were not statistically correlated with pretherapeutic brain connectivity measures (P > .05). The same applied to pretherapeutic tremor scores, after using the same methodology described above. Our findings have clinical implications for predicting clinical response after SRS-T. Here, using pretherapeutic magnetic resonance imaging and data processing without prior hypothesis, we show that pretherapeutic network(s) interconnectivity strength predicts tremor arrest in drug-naïve ET, following stereotactic radiosurgical thalamotomy. © 2018 John Wiley & Sons A/S. Published

Statistical analyses and characteristics of volcanic tremor on Stromboli Volcano (Italy)

NASA Astrophysics Data System (ADS)

Falsaperla, S.; Langer, H.; Spampinato, S.

A study of volcanic tremor on Stromboli is carried out on the basis of data recorded daily between 1993 and 1995 by a permanent seismic station (STR) located 1.8km away from the active craters. We also consider the signal of a second station (TF1), which operated for a shorter time span. Changes in the spectral tremor characteristics can be related to modifications in volcanic activity, particularly to lava effusions and explosive sequences. Statistical analyses were carried out on a set of spectra calculated daily from seismic signals where explosion quakes were present or excluded. Principal component analysis and cluster analysis were applied to identify different classes of spectra. Three clusters of spectra are associated with two different states of volcanic activity. One cluster corresponds to a state of low to moderate activity, whereas the two other clusters are present during phases with a high magma column as inferred from the occurrence of lava fountains or effusions. We therefore conclude that variations in volcanic activity at Stromboli are usually linked to changes in the spectral characteristics of volcanic tremor. Site effects are evident when comparing the spectra calculated from signals synchronously recorded at STR and TF1. However, some major spectral peaks at both stations may reflect source properties. Statistical considerations and polarization analysis are in favor of a prevailing presence of P-waves in the tremor signal along with a position of the source northwest of the craters and at shallow depth.

Deep low-frequency earthquakes in tremor localize to the plate interface in multiple subduction zones

USGS Publications Warehouse

Brown, Justin R.; Beroza, Gregory C.; Ide, Satoshi; Ohta, Kazuaki; Shelly, David R.; Schwartz, Susan Y.; Rabbel, Wolfgang; Thorwart, M.; Kao, Honn

2009-01-01

Deep tremor under Shikoku, Japan, consists primarily, and perhaps entirely, of swarms of low-frequency earthquakes (LFEs) that occur as shear slip on the plate interface. Although tremor is observed at other plate boundaries, the lack of cataloged low-frequency earthquakes has precluded a similar conclusion about tremor in those locales. We use a network autocorrelation approach to detect and locate LFEs within tremor recorded at three subduction zones characterized by different thermal structures and levels of interplate seismicity: southwest Japan, northern Cascadia, and Costa Rica. In each case we find that LFEs are the primary constituent of tremor and that they locate on the deep continuation of the plate boundary. This suggests that tremor in these regions shares a common mechanism and that temperature is not the primary control on such activity.

Episodic tremor and slip on the Cascadia subduction zone: the chatter of silent slip.

PubMed

Rogers, Garry; Dragert, Herb

2003-06-20

We found that repeated slow slip events observed on the deeper interface of the northern Cascadia subduction zone, which were at first thought to be silent, have unique nonearthquake seismic signatures. Tremorlike seismic signals were found to correlate temporally and spatially with slip events identified from crustal motion data spanning the past 6 years. During the period between slips, tremor activity is minor or nonexistent. We call this associated tremor and slip phenomenon episodic tremor and slip (ETS) and propose that ETS activity can be used as a real-time indicator of stress loading of the Cascadia megathrust earthquake zone.

Network-Based Detection and Classification of Seismovolcanic Tremors: Example From the Klyuchevskoy Volcanic Group in Kamchatka

NASA Astrophysics Data System (ADS)

Soubestre, Jean; Shapiro, Nikolai M.; Seydoux, Léonard; de Rosny, Julien; Droznin, Dmitry V.; Droznina, Svetlana Ya.; Senyukov, Sergey L.; Gordeev, Evgeniy I.

2018-01-01

We develop a network-based method for detecting and classifying seismovolcanic tremors. The proposed approach exploits the coherence of tremor signals across the network that is estimated from the array covariance matrix. The method is applied to four and a half years of continuous seismic data recorded by 19 permanent seismic stations in the vicinity of the Klyuchevskoy volcanic group in Kamchatka (Russia), where five volcanoes were erupting during the considered time period. We compute and analyze daily covariance matrices together with their eigenvalues and eigenvectors. As a first step, most coherent signals corresponding to dominating tremor sources are detected based on the width of the covariance matrix eigenvalues distribution. Thus, volcanic tremors of the two volcanoes known as most active during the considered period, Klyuchevskoy and Tolbachik, are efficiently detected. As a next step, we consider the daily array covariance matrix's first eigenvector. Our main hypothesis is that these eigenvectors represent the principal components of the daily seismic wavefield and, for days with tremor activity, characterize dominant tremor sources. Those daily first eigenvectors, which can be used as network-based fingerprints of tremor sources, are then grouped into clusters using correlation coefficient as a measure of the vector similarity. As a result, we identify seven clusters associated with different periods of activity of four volcanoes: Tolbachik, Klyuchevskoy, Shiveluch, and Kizimen. The developed method does not require a priori knowledge and is fully automatic; and the database of the network-based tremor fingerprints can be continuously enriched with newly available data.

Quantitatively measured tremor in hand-arm vibration-exposed workers.

PubMed

Edlund, Maria; Burström, Lage; Hagberg, Mats; Lundström, Ronnie; Nilsson, Tohr; Sandén, Helena; Wastensson, Gunilla

2015-04-01

The aim of the present study was to investigate the possible increase in hand tremor in relation to hand-arm vibration (HAV) exposure in a cohort of exposed and unexposed workers. Participants were 178 male workers with or without exposure to HAV. The study is cross-sectional regarding the outcome of tremor and has a longitudinal design with respect to exposure. The dose of HAV exposure was collected via questionnaires and measurements at several follow-ups. The CATSYS Tremor Pen(®) was used for measuring postural tremor. Multiple linear regression methods were used to analyze associations between different tremor variables and HAV exposure, along with predictor variables with biological relevance. There were no statistically significant associations between the different tremor variables and cumulative HAV or current exposure. Age was a statistically significant predictor of variation in tremor outcomes for three of the four tremor variables, whereas nicotine use was a statistically significant predictor of either left or right hand or both hands for all four tremor variables. In the present study, there was no evidence of an exposure-response association between HAV exposure and measured postural tremor. Increase in age and nicotine use appeared to be the strongest predictors of tremor.

Fluid Dynamic Analysis of Volcanic Tremor,

DTIC Science & Technology

1982-10-01

information regarding the fluid system Fiske (1969) Kilauea volcano : The 1967-68 summit configuration, tremor magnitudes and source loca- eruption...Koyanagi (1981) Deep volcanic tremor logicalSociety of America, vol. 40, p. 175-194. and magma ascent mechanism under Kilauea , Hawaii . Omori, F...dynamics Seismology Tremors Volcanoes 40 M\\ TlACT (amhue ai revers if5 neeeeiy md ide~Wify by block number) Low-frequency (< 10 Hz) volcanic earthquakes

Tectonic Tremor along the San Jacinto Fault Zone near Anza, California

NASA Astrophysics Data System (ADS)

Brown, J. R.

2013-12-01

In several tectonic settings where it is observed, low frequency tremor is proven as a useful tool to probe slow fault slip at depth (e.g., southwest Japan, Cascadia, Parkfield). However, tremor is difficult to detect due to its long durations and low amplitudes close to the noise band. This is particularly true in southern California where cultural noise sources are both spatially and temporally pervasive. Visually scanning continuous seismic recordings of the Southern California Seismic Network from 2001-2011 we find three pervasive occurrences of tremor: fall 2001, summer 2005 and summer 2010. In this presentation we focus on our analysis of the summer 2010 tremors on account of the enhanced instrumentation from the EarthScope Plate Boundary Observatory. During summer 2010 we detect ~240 hours of tremor-like signals in vicinity of the San Jacinto fault zone (SJFZ) near Anza. Visual inspection of continuous recordings up to 100 km northeast and southwest of the SJFZ do not record tremor-like signals indicating the source is both weak and local. Tremor is discriminated from other noise sources by calculating their spectral shapes to assure the signals are distinct from local noise sources and earthquakes. Similar to tremor spectra in other settings, the tremor signals in vicinity of the SJFZ are spectrally flat up to 9 Hz. In order to characterize the tremor source, we employ a combination of running autocorrelation and matched-filter techniques to detect and locate low frequency earthquakes (LFE) along the SJFZ one hour at a time. The autocorrelation of the north and vertical components of 14 stations detects over 13500 LFEs. We identify S-wave arrivals using the cross-correlation of 6 s windows for event pairs using the north component. Preliminary analysis of S-waves reveals a localized swarm of LFE epicenters extending 5 to 10 km SE of the Anza Gap with a horizontal error of +/- 4 km. Tremor depths are poorly constrained due to the lack of clear P

Data Mining for Tectonic Tremor in a Large Global Seismogram Database using Preprocessed Data Quality Measurements

NASA Astrophysics Data System (ADS)

Rasor, B. A.; Brudzinski, M. R.

2013-12-01

The collision of plates at subduction zones yields the potential for disastrous earthquakes, yet the processes that lead up to these events are still largely unclear and make them difficult to forecast. Recent advancements in seismic monitoring has revealed subtle ground vibrations termed tectonic tremor that occur as long-lived swarms of narrow bandwidth activity, different from local earthquakes of comparable amplitude that create brief signals of broader, higher frequency. The close proximity of detected tremor events to the lower edge of the seismogenic zone along the subduction interface suggests a potential triggering relationship between tremor and megathrust earthquakes. Most tremor catalogs are constructed with detection methods that involve an exhausting download of years of high sample rate seismic data, as well as large computation power to process the large data volume and identify temporal patterns of tremor activity. We have developed a tremor detection method that employs the underutilized Quality Analysis Control Kit (QuACK), originally built to analyze station performance and identify instrument problems across the many seismic networks that contribute data to one of the largest seismogram databases in the world (IRIS DMC). The QuACK dataset stores seismogram amplitudes at a wide range of frequencies calculated every hour since 2005 for most stations achieved in the IRIS DMC. Such a preprocessed dataset is advantageous considering several tremor detection techniques use hourly seismic amplitudes in the frequency band where tremor is most active (2-5 Hz) to characterize the time history of tremor. Yet these previous detection techniques have relied on downloading years of 40-100 sample-per-second data to make the calculations, which typically takes several days on a 36-node high-performance cluster to calculate the amplitude variations for a single station. Processing times are even longer for a recently developed detection algorithm that utilize

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

PubMed

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.

Handheld computer use in U.S. family practice residency programs.

PubMed

Criswell, Dan F; Parchman, Michael L

2002-01-01

The purpose of the study was to evaluate the uses of handheld computers (also called personal digital assistants, or PDAs) in family practice residency programs in the United States. In November 2000, the authors mailed a questionnaire to the program directors of all American Academy of Family Physicians (AAFP) and American College of Osteopathic Family Practice (ACOFP) residency programs in the United States. Data and patterns of the use and non-use of handheld computers were identified. Approximately 50 percent (306 of 610) of the programs responded to the survey. Two thirds of the programs reported that handheld computers were used in their residencies, and an additional 14 percent had plans for implementation within 24 months. Both the Palm and the Windows CE operating systems were used, with the Palm operating system the most common. Military programs had the highest rate of use (8 of 10 programs, 80 percent), and osteopathic programs had the lowest (23 of 55 programs, 42 percent). Of programs that reported handheld computer use, 45 percent had required handheld computer applications that are used uniformly by all users. Funding for handheld computers and related applications was non-budgeted in 76percent of the programs in which handheld computers were used. In programs providing a budget for handheld computers, the average annual budget per user was 461.58 dollars. Interested faculty or residents, rather than computer information services personnel, performed upkeep and maintenance of handheld computers in 72 percent of the programs in which the computers are used. In addition to the installed calendar, memo pad, and address book, the most common clinical uses of handheld computers in the programs were as medication reference tools, electronic textbooks, and clinical computational or calculator-type programs. Handheld computers are widely used in family practice residency programs in the United States. Although handheld computers were designed as electronic

Essential Tremor with Aspartic Acidemia.

PubMed

Miura, Shiroh; Fujioka, Ryuta; Taniwaki, Takayuki

2017-05-08

We describe two cases of typical essential tremor with aspartic acidemia and mildly increased concentrations of plasma glutamic acid. Although this is a preliminary report, we emphasize the possibility of using amino acids, including aspartic acid, as biomarkers for the detection of essential tremor.

Essential Tremor: What We Can Learn from Current Pharmacotherapy.

PubMed

Ondo, William

2016-01-01

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

Essential Tremor: What We Can Learn from Current Pharmacotherapy

PubMed Central

Ondo, William

2016-01-01

Background The pathophysiology of essential tremor, especially at the cellular level, is poorly understood. Although no drug has been specifically designed to treat essential tremor, several medications improve tremor, and others worsen it. Studying the mechanism of actions of these medications can help our understanding of tremor pathophysiology and contribute to future rational drug design. Methods We reviewed literature, concentrating on mechanisms of action, of various medications that mitigate tremor. Results Many medications have multiple mechanisms of actions, making simple correlations difficult. Medications that increase the duration of opening of gamma-aminobutyric acid (GABA)-A receptors are most consistently associated with tremor improvement. Interestingly, drugs that increase GABA availability have not been associated with improved tremor. Other mechanisms possibly associated with tremor improvement include antagonism of alpha-2 delta subunits associated with calcium channels, inhibition of carbonic anhydrase, and inhibition of the synaptic vesicle protein 2A. Drugs that block voltage-gaited sodium channels do not affect tremor. The ideal beta-adrenergic blocker requires B2 affinity (non-cardiac selective), has no sympathomimetic properties, does not require membrane stabilization properties, and may benefit from good central nervous system penetration. Discussion To date, serendipitous observations have provided most of our understanding of tremor cellular physiology. Based on similarities to currently effective drugs or rational approximations and inferences, several currently available agents should be considered for tremor trials. PMID:26989572

Discriminating Simulated Vocal Tremor Source Using Amplitude Modulation Spectra

PubMed Central

Carbonell, Kathy M.; Lester, Rosemary A.; Story, Brad H.; Lotto, Andrew J.

2014-01-01

Objectives/Hypothesis Sources of vocal tremor are difficult to categorize perceptually and acoustically. This paper describes a preliminary attempt to discriminate vocal tremor sources through the use of spectral measures of the amplitude envelope. The hypothesis is that different vocal tremor sources are associated with distinct patterns of acoustic amplitude modulations. Study Design Statistical categorization methods (discriminant function analysis) were used to discriminate signals from simulated vocal tremor with different sources using only acoustic measures derived from the amplitude envelopes. Methods Simulations of vocal tremor were created by modulating parameters of a vocal fold model corresponding to oscillations of respiratory driving pressure (respiratory tremor), degree of vocal fold adduction (adductory tremor) and fundamental frequency of vocal fold vibration (F0 tremor). The acoustic measures were based on spectral analyses of the amplitude envelope computed across the entire signal and within select frequency bands. Results The signals could be categorized (with accuracy well above chance) in terms of the simulated tremor source using only measures of the amplitude envelope spectrum even when multiple sources of tremor were included. Conclusions These results supply initial support for an amplitude-envelope based approach to identify the source of vocal tremor and provide further evidence for the rich information about talker characteristics present in the temporal structure of the amplitude envelope. PMID:25532813

Development of a closed-loop system for tremor suppression in patients with Parkinson's disease.

PubMed

Xu, F L; Hao, M Z; Xu, S Q; Hu, Z X; Xiao, Q; Lan, N

2016-08-01

More than 70% of patients suffering Parkinson's disease (PD) exhibit resting tremor in their extremities, hampering their ability to perform daily activities. Based on our earlier studies on corticospinal transmission of tremor signals [10,11], we hypothesize that cutaneous afferents evoked by surface stimulation can produce an inhibitory effect on propriospinal neurons (PN), which in turn will suppress tremor signals passing through the PN. This paper presents the development of a closed-loop system for tremor suppression by transcutaneous electrical nerve stimulation (TENS) of sensory fibers beneath the skin. The closed-loop system senses EMGs of forearm muscles, and detects rhythmic bursting in the EMG signal. When a tremor is detected by the system, a command signal triggers a stimulator to output a train of bi-phasic, current regulated pulses to a pair of surface electrodes. The stimulation electrode is placed on the dorsal hand skin near the metacarpophalangeal joint of index finger, which is innervated by the superficial radial nerve that projects an inhibitory afferent to PNs of forearm muscles. We tested the closed-loop system in 3 normal subjects to verify the algorithm and in 2 tremor dominated PD subjects for feasibility of tremor detecting and suppression. Preliminary results indicate that the closed-loop system can detect tremor in all subjects, and tremor in PD patients was suppressed significantly by electrical stimulation of cutaneous afferents.

Tremor

MedlinePlus

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

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

PubMed

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

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

PubMed

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.

Fundamental Principles of Tremor Propagation in the Upper Limb.

PubMed

Davidson, Andrew D; Charles, Steven K

2017-04-01

Although tremor is the most common movement disorder, there exist few effective tremor-suppressing devices, in part because the characteristics of tremor throughout the upper limb are unknown. To clarify, optimally suppressing tremor requires a knowledge of the mechanical origin, propagation, and distribution of tremor throughout the upper limb. Here we present the first systematic investigation of how tremor propagates between the shoulder, elbow, forearm, and wrist. We simulated tremor propagation using a linear, time-invariant, lumped-parameter model relating joint torques and the resulting joint displacements. The model focused on the seven main degrees of freedom from the shoulder to the wrist and included coupled joint inertia, damping, and stiffness. We deliberately implemented a simple model to focus first on the most basic effects. Simulating tremorogenic joint torque as a sinusoidal input, we used the model to establish fundamental principles describing how input parameters (torque location and frequency) and joint impedance (inertia, damping, and stiffness) affect tremor propagation. We expect that the methods and principles presented here will serve as the groundwork for future refining studies to understand the origin, propagation, and distribution of tremor throughout the upper limb in order to enable the future development of optimal tremor-suppressing devices.

Fundamental Principles of Tremor Propagation in the Upper Limb

PubMed Central

Davidson, Andrew D.; Charles, Steven K.

2017-01-01

Although tremor is the most common movement disorder, there exist few effective tremor-suppressing devices, in part because the characteristics of tremor throughout the upper limb are unknown. To clarify, optimally suppressing tremor requires a knowledge of the mechanical origin, propagation, and distribution of tremor throughout the upper limb. Here we present the first systematic investigation of how tremor propagates between the shoulder, elbow, forearm, and wrist. We simulated tremor propagation using a linear, time-invariant, lumped-parameter model relating joint torques and the resulting joint displacements. The model focused on the seven main degrees of freedom from the shoulder to the wrist and included coupled joint inertia, damping, and stiffness. We deliberately implemented a simple model to focus first on the most basic effects. Simulating tremorogenic joint torque as a sinusoidal input, we used the model to establish fundamental principles describing how input parameters (torque location and frequency) and joint impedance (inertia, damping, and stiffness) affect tremor propagation. We expect that the methods and principles presented here will serve as the groundwork for future refining studies to understand the origin, propagation, and distribution of tremor throughout the upper limb in order to enable the future development of optimal tremor-suppressing devices. PMID:27957608

Classification of involuntary movements in dogs: Tremors and twitches.

PubMed

Lowrie, Mark; Garosi, Laurent

2016-08-01

This review focuses on important new findings in the field of involuntary movements (IM) in dogs and illustrates the importance of developing a clear classification tool for diagnosing tremor and twitches. Developments over the last decade have changed our understanding of IM and highlight several caveats in the current tremor classification. Given the ambiguous association between tremor phenomenology and tremor aetiology, a more cautious definition of tremors based on clinical assessment is required. An algorithm for the characterisation of tremors is presented herein. The classification of tremors is based on the distinction between tremors that occur at rest and tremors that are action-related; tremors associated with action are divided into postural or kinetic. Controversial issues are outlined and thus reflect the open questions that are yet to be answered from an evidence base of peer-reviewed published literature. Peripheral nerve hyper-excitability (PNH; cramps and twitches) may manifest as fasciculations, myokymia, neuromyotonia, cramps, tetany and tetanus. It is anticipated that as we learn more about the aetiology and pathogenesis of IMs, future revisions to the classification will be needed. It is therefore the intent of this work to stimulate discussions and thus contribute to the development of IM research. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Hcn1 Is a Tremorgenic Genetic Component in a Rat Model of Essential Tremor

PubMed Central

Ohno, Yukihiro; Shimizu, Saki; Tatara, Ayaka; Imaoku, Takuji; Ishii, Takahiro; Sasa, Masashi; Serikawa, Tadao; Kuramoto, Takashi

2015-01-01

Genetic factors are thought to play a major role in the etiology of essential tremor (ET); however, few genetic changes that induce ET have been identified to date. In the present study, to find genes responsible for the development of ET, we employed a rat model system consisting of a tremulous mutant strain, TRM/Kyo (TRM), and its substrain TRMR/Kyo (TRMR). The TRM rat is homozygous for the tremor (tm) mutation and shows spontaneous tremors resembling human ET. The TRMR rat also carries a homozygous tm mutation but shows no tremor, leading us to hypothesize that TRM rats carry one or more genes implicated in the development of ET in addition to the tm mutation. We used a positional cloning approach and found a missense mutation (c. 1061 C>T, p. A354V) in the hyperpolarization-activated cyclic nucleotide-gated 1 channel (Hcn1) gene. The A354V HCN1 failed to conduct hyperpolarization-activated currents in vitro, implicating it as a loss-of-function mutation. Blocking HCN1 channels with ZD7288 in vivo evoked kinetic tremors in nontremulous TRMR rats. We also found neuronal activation of the inferior olive (IO) in both ZD7288-treated TRMR and non-treated TRM rats and a reduced incidence of tremor in the IO-lesioned TRM rats, suggesting a critical role of the IO in tremorgenesis. A rat strain carrying the A354V mutation alone on a genetic background identical to that of the TRM rats showed no tremor. Together, these data indicate that body tremors emerge when the two mutant loci, tm and Hcn1A354V, are combined in a rat model of ET. In this model, HCN1 channels play an important role in the tremorgenesis of ET. We propose that oligogenic, most probably digenic, inheritance is responsible for the genetic heterogeneity of ET. PMID:25970616

Facial emotion recognition is inversely correlated with tremor severity in essential tremor.

PubMed

Auzou, Nicolas; Foubert-Samier, Alexandra; Dupouy, Sandrine; Meissner, Wassilios G

2014-04-01

We here assess limbic and orbitofrontal control in 20 patients with essential tremor (ET) and 18 age-matched healthy controls using the Ekman Facial Emotion Recognition Task and the IOWA Gambling Task. Our results show an inverse relation between facial emotion recognition and tremor severity. ET patients also showed worse performance in joy and fear recognition, as well as subtle abnormalities in risk detection, but these differences did not reach significance after correction for multiple testing.

Optimal digital filtering for tremor suppression.

PubMed

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

2000-05-01

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

A review of primary writing tremor.

PubMed

Rana, Abdul Qayyum; Vaid, Haris M

2012-03-01

A task-specific tremor (TST) is a rare form of movement disorder that appears while performing or attempting to perform a particular task. Primary writing tremor (PWT) is the most common form of TST which only occurs during the act of writing and hinders it. (Bain PG, Findley LJ, Britton TC, Rothwell JC, Gresty MA, Thompson PD, Marsden CD. MRC Human Movement, and Balance Unit, Institute of Neurology, London, UK. Primary writing tremor. Brain. 1995;118(6):1461-72.) Primary writing tremor type B is present not only during the act of writing but also when the hand assumes a writing posture. (Bain PG, Findley LJ, Britton TC, Rothwell JC, Gresty MA, Thompson PD, Marsden CD. MRC Human Movement and Balance Unit, Institute of Neurology, London, UK. Primary writing tremor. Brain. 1995;118(6):1461-72.) We first of all describe a remarkable case study of a 50-year old, right-handed male who started experiencing a primary writing tremor in his right hand about a year ago. This case was found to be of particular interest because the patient had it relatively difficult when attempting to write numbers as opposed to writing letters. This review further discusses the clinical manifestations of PWT. In addition, three main hypotheses have been proposed for the causation of PWT, although the exact pathophysiology of PWT still remains unknown. It has been suggested that PWT is a separate entity, a variant of essential tremor and not a separate entity, or a type of dystonia. The various treatment options for PWT are discussed including botulinum toxin and oral pharmacotherapy.

Validation of Digital Spiral Analysis as Outcome Parameter for Clinical Trials in Essential Tremor

PubMed Central

Haubenberger, Dietrich; Kalowitz, Daniel; Nahab, Fatta B.; Toro, Camilo; Ippolito, Dominic; Luckenbaugh, David A.; Wittevrongel, Loretta; Hallett, Mark

2014-01-01

Essential tremor, one of the most prevalent movement disorders, is characterized by kinetic and postural tremor affecting activities of daily living. Spiral drawing is commonly used to visually rate tremor intensity, as part of the routine clinical assessment of tremor and as a tool in clinical trials. We present a strategy to quantify tremor severity from spirals drawn on a digitizing tablet. We validate our method against a well-established visual spiral rating method and compare both methods on their capacity to capture a therapeutic effect, as defined by the change in clinical essential tremor rating scale after an ethanol challenge. Fifty-four Archimedes spirals were drawn using a digitizing tablet by nine ethanol-responsive patients with essential tremor before and at five consecutive time points after the administration of ethanol in a standardized treatment intervention. Quantitative spiral tremor severity was estimated from the velocity tremor peak amplitude after numerical derivation and Fourier transformation of pen-tip positions. In randomly ordered sets, spirals were scored by seven trained raters, using Bain and Findley’s 0 to 10 rating scale. Computerized scores correlated with visual ratings (P < 0.0001). The correlation was significant at each time point before and after ethanol (P < 0.005). Quantitative ratings provided better sensitivity than visual rating to capture the effects of an ethanol challenge (P < 0.05). Using a standardized treatment approach, we were able to demonstrate that spirography time-series analysis is a valid, reliable method to document tremor intensity and a more sensitive measure for small effects than currently available visual spiral rating methods. PMID:21714004

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

USGS Publications Warehouse

Montgomery-Brown, Emily; Syracuse, Ellen M.

2015-01-01

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

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

USGS Publications Warehouse

Denlinger, Roger P.; Moran, Seth C.

2014-01-01

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

Subclinical Tremor in Normal Controls with vs. without a Family History of Essential Tremor: Data from the United States and Turkey

PubMed Central

Louis, Elan D.; Dogu, Okan; Ottman, Ruth

2009-01-01

Background Mild action tremor is very common in the population. One fundamental question is whether this tremor is related to the neurological disease essential tremor (ET), which occurs in a much smaller segment of the population? ET is often genetic and variable phenotypic expression is well-documented in the literature. We determined whether normal controls who report a family history of ET have greater action tremor than normal controls who do not report such a history. Methods Controls, enrolled in two epidemiological studies (New York and Turkey), were examined in detail and action tremor was rated using a valid and reliable clinical rating scale, resulting in a total tremor score (range 0 – 36). Results In New York, the total tremor score was higher in 44/406 (10.8%) controls who reported a family history of ET than in 362/406 controls with no such history (4.25 ± 2.51 vs. 3.78 ± 2.93, p = 0.02). Controls who reported a first-degree relative with ET had the highest total tremor scores. In Turkey, the total tremor score was higher in 7/89 (7.9%) controls with a family history than in 82/89 controls with no family history (3.43 ± 4.54 vs. 1.13 ± 2.54, p = 0.048). All affected relatives in Turkey were first-degree. Conclusions These data suggest that some of the normal tremor exhibited by people in the population is likely to be subclinical, partially-expressed ET and that the sphere of ET is wider than is apparent from a consideration of clinically-diagnosed cases. PMID:19968704

Multiple coincident eruptive seismic tremor sources during the 2014-2015 eruption at Holuhraun, Iceland

NASA Astrophysics Data System (ADS)

Eibl, Eva P. S.; Bean, Christopher J.; Jónsdóttir, Ingibjörg; Höskuldsson, Armann; Thordarson, Thorvaldur; Coppola, Diego; Witt, Tanja; Walter, Thomas R.

2017-04-01

We analyze eruptive tremor during one of the largest effusive eruptions in historical times in Iceland (2014/2015 Holuhraun eruption). Seismic array recordings are compared with effusion rates deduced from Moderate Resolution Imaging Spectroradiometer recordings and ground video monitoring data and lead to the identification of three coexisting eruptive tremor sources. This contrasts other tremor studies that generally link eruptive tremor to only one source usually associated with the vent. The three sources are (i) a source that is stable in back azimuth and shows bursts with ramp-like decrease in amplitude at the beginning of the eruption: we link it to a process below the open vents where the bursts correlate with the opening of new vents and temporary increases in the lava fountaining height; (ii) a source moving by a few degrees per month while the tremor amplitude suddenly increases and decreases: back azimuth and slowness correlate with the growing margins of the lava flow field, whilst new contact with a river led to fast increases of the tremor amplitude; and (iii) a source moving by up to 25° southward in 4 days that cannot be related to any observed surface activity and might be linked to intrusions. We therefore suggest that eruptive tremor amplitudes/energies are used with caution when estimating eruptive volumes, effusion rates, or the eruption explosivity as multiple sources can coexist during the eruption phase. Our results suggest that arrays can monitor both the growth of a lava flow field and the activity in the vents.

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

PubMed

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.

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

PubMed

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

2015-12-01

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

Handheld Computer Use in U.S. Family Practice Residency Programs

PubMed Central

Criswell, Dan F.; Parchman, Michael L.

2002-01-01

. Although handheld computers were designed as electronic organizers, in family practice residencies they are used as medication reference tools, electronic textbooks, and clinical computational programs and to track activities that were previously associated with desktop database applications. PMID:11751806

Improving car passengers' comfort and experience by supporting the use of handheld devices.

PubMed

van Veen, S A T; Hiemstra-van Mastrigt, S; Kamp, I; Vink, P

2014-01-01

There is a demand for interiors to support other activities in a car than controlling the vehicle. Currently, this is the case for the car passengers and--in the future--autonomous driving cars will also facilitate drivers to perform other activities. One of these activities is working with handheld devices. Previous research shows that people experience problems when using handheld devices in a moving vehicle and the use of handheld devices generally causes unwanted neck flexion [Young et al. 2012; Sin and Zu 2011; Gold et al.2011]. In this study, armrests are designed to support the arms when using handheld devices in a driving car in order to decrease neck flexion. Neck flexion was measured by attaching markers on the C7 and tragus. Discomfort was indicated on a body map on a scale 1-10. User experience was evaluated in a semi-structured interview. Neck flexion is significantly decreased by the support of the armrests and approaches a neutral position. Furthermore, overall comfort and comfort in the neck region specifically are significantly increased. Subjects appreciate the body posture facilitated by the armrests and 9 out of 10 prefer using handheld devices with the armrests compared to using handheld devices without the armrests. More efforts are needed to develop the mock-up into an established product, but the angles and dimensions presented in this study could serve as guidelines.

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

PubMed

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

2017-08-22

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

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

PubMed

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 < 0.001). Direct targeting of the DRTt in DBS is an effective strategy for 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.

Handheld Sensor for UXO Discrimination:

DTIC Science & Technology

2006-06-01

between buried UXO and clutter. This project demonstrated the use of commercially available technology (Geonics EM61-HH handheld metal detector ) for...determine whether each target was UXO or clutter. The Geonics EM61-HH handheld metal detector is a pulsed electromagnetic induction (EMI) sensor. The...processing, the EM61-HH handheld metal detector can 2 be used in a cued identification mode to reliably discriminate between buried UXO and clutter

Neuroimaging essentials in essential tremor: A systematic review

PubMed Central

Sharifi, Sarvi; Nederveen, Aart J.; Booij, Jan; van Rootselaar, Anne-Fleur

2014-01-01

Background Essential tremor is regarded to be a disease of the central nervous system. Neuroimaging is a rapidly growing field with potential benefits to both diagnostics and research. The exact role of imaging techniques with respect to essential tremor in research and clinical practice is not clear. A systematic review of the different imaging techniques in essential tremor is lacking in the literature. Methods We performed a systematic literature search combining the terms essential tremor and familial tremor with the following keywords: imaging, MRI, VBM, DWI, fMRI, PET and SPECT, both in abbreviated form as well as in full form. We summarize and discuss the quality and the external validity of each study and place the results in the context of existing knowledge regarding the pathophysiology of essential tremor. Results A total of 48 neuroimaging studies met our search criteria, roughly divided into 19 structural and 29 functional and metabolic studies. The quality of the studies varied, especially concerning inclusion criteria. Functional imaging studies indicated cerebellar hyperactivity during rest and during tremor. The studies also pointed to the involvement of the thalamus, the inferior olive and the red nucleus. Structural studies showed less consistent results. Discussion and conclusion Neuroimaging techniques in essential tremor give insight into the pathophysiology of essential tremor indicating the involvement of the cerebellum as the most consistent finding. GABAergic dysfunction might be a major premise in the pathophysiological hypotheses. Inconsistencies between studies can be partly explained by the inclusion of heterogeneous patient groups. Improvement of scientific research requires more stringent inclusion criteria and application of advanced analysis techniques. Also, the use of multimodal neuroimaging techniques is a promising development in movement disorders research. Currently, the role of imaging techniques in essential tremor in daily

Quality of life and its determinants in essential tremor.

PubMed

Chandran, Vijay; Pal, Pramod Kumar

2013-01-01

Despite Essential Tremor (ET) being the commonest movement disorder, there are few studies on the quality of life (QOL) in patients with ET, with most studies employing generic questionnaires. We studied QOL in 50 patients with ET attending the outpatient of a hospital using the Quality of life in Essential Tremor (QUEST) questionnaire a disease specific QOL instrument. The severity of tremor was assessed using a modified Fahn Tolosa Marin tremor rating scale (mFTMRS), co morbid anxiety and depression were studied using the Hamilton Anxiety (HARS) and Depression (HDRS) rating scales respectively. We also analyzed the influence of gender, age at presentation, age of onset, duration of tremor, distribution of tremor, family history and use of medications on the QOL. The mean age of onset of tremor was 32.2 ± 18.9 years, mean duration of tremor was 8.4 ± 10.0 years, mean QUEST summary index (QSI) was 24.2 ± 19.2; mean scores in each of the domains were as follows--physical 29.3 ± 26.7, psychosocial 36.4 ± 28.7, communication 23.9 ± 36.9, work & finance 23.5 ± 29.9, hobbies 6.8 ± 17.3. The QSI had significant positive correlation with the mFTMRS, HARS and HDRS. Gender, age at presentation, age of onset, duration of tremor, distribution of tremor, family history and use of medication did not influence the QOL. Psychosocial aspects are important in determining the QOL in patients with ET. Tremor severity, co morbid anxiety and depression are associated with a lower QOL whereas tremor characteristics like age of onset, duration, distribution do not influence the QOL. Copyright © 2012 Elsevier Ltd. All rights reserved.

Afterslip, tremor, and the Denali fault earthquake

USGS Publications Warehouse

Gomberg, Joan; Prejean, Stephanie; Ruppert, Natalia

2012-01-01

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

Beta 1 versus nonselective blockade in therapy of essential tremor.

PubMed

Larsen, T A; Teräväinen, H

1983-01-01

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

At Ease in the Handheld World.

ERIC Educational Resources Information Center

Levinson, Eliot; Grohe, Barbara

2001-01-01

Provides educational decision-makers with an overview of the offerings and issues related to adopting handheld computers. Describes several handheld products available to schools, including: Palm, iPAQ, Mindsurf, Symbol Technologies, Texas Instruments, and Gateway Handspring Visor. Compares handhelds to PCs, in terms of functionality, operating…

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

PubMed

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

2018-03-06

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

Eye movement abnormalities in essential tremor

PubMed Central

Plinta, Klaudia; Krzak-Kubica, Agnieszka; Zajdel, Katarzyna; Falkiewicz, Marcel; Dylak, Jacek; Ober, Jan; Szczudlik, Andrzej; Rudzińska, Monika

2016-01-01

Abstract Essential tremor (ET) is the most prevalent movement disorder, characterized mainly by an action tremor of the arms. Only a few studies published as yet have assessed oculomotor abnormalities in ET and their results are unequivocal. The aim of this study was to assess the oculomotor abnormalities in ET patients compared with the control group and to find the relationship between oculomotor abnormalities and clinical features of ET patients. We studied 50 ET patients and 42 matched by age and gender healthy controls. Saccadometer Advanced (Ober Consulting, Poland) was used to investigate reflexive, pace-induced and cued saccades and conventional electrooculography for evaluation of smooth pursuit and fixation. The severity of the tremor was assessed by the Clinical Rating Scale for Tremor. Significant differences between ET patients and controls were found for the incidence of reflexive saccades dysmetria and deficit of smooth pursuit. Reflexive saccades dysmetria was more frequent in patients in the second and third phase of ET compared to the first phase. The reflexive saccades latency increase was correlated with severity of the tremor. In conclusion, oculomotor abnormalities were significantly more common in ET patients than in healthy subjects. The most common oculomotor disturbances in ET were reflexive saccades dysmetria and slowing of smooth pursuit. The frequency of reflexive saccades dysmetria increased with progression of ET. The reflexive saccades latency increase was related to the severity of tremor. PMID:28149393

Median Filtering Methods for Non-volcanic Tremor Detection

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

Spike shape analysis of electromyography for parkinsonian tremor evaluation.

PubMed

Marusiak, Jarosław; Andrzejewska, Renata; Świercz, Dominika; Kisiel-Sajewicz, Katarzyna; Jaskólska, Anna; Jaskólski, Artur

2015-12-01

Standard electromyography (EMG) parameters have limited utility for evaluation of Parkinson disease (PD) tremor. Spike shape analysis (SSA) EMG parameters are more sensitive than standard EMG parameters for studying motor control mechanisms in healthy subjects. SSA of EMG has not been used to assess parkinsonian tremor. This study assessed the utility of SSA and standard time and frequency analysis for electromyographic evaluation of PD-related resting tremor. We analyzed 1-s periods of EMG recordings to detect nontremor and tremor signals in relaxed biceps brachii muscle of seven mild to moderate PD patients. SSA revealed higher mean spike amplitude, duration, and slope and lower mean spike frequency in tremor signals than in nontremor signals. Standard EMG parameters (root mean square, median, and mean frequency) did not show differences between the tremor and nontremor signals. SSA of EMG data is a sensitive method for parkinsonian tremor evaluation. © 2015 Wiley Periodicals, Inc.

Brain SPECT can differentiate between essential tremor and early-stage tremor-dominant Parkinson's disease.

PubMed

Song, In-Uk; Park, Jeong-Wook; Chung, Sung-Woo; Chung, Yong-An

2014-09-01

There are no confirmatory or diagnostic tests or tools to differentiate between essential tremor (ET) and tremor in idiopathic Parkinson's disease (PD). Although a number of imaging studies have indicated that there are differences between ET and PD, the functional imaging study findings are controversial. Therefore, we analyzed regional cerebral blood flow (CBF) by perfusion brain single-photon emission computed tomography (SPECT) to identify differences between ET and tremor-dominant Parkinson's disease (TPD). We recruited 33 patients with TPD, 16 patients with ET, and 33 healthy controls. We compared the severity of tremor symptoms by comparing the Fahn-Tolosa-Marin rating scale (FTM) score and the tremor score from Unified Parkinson's Disease Rating Scale (UPDRS) between TPD and ET patients. Subjects were evaluated by neuropsychological assessments, MRI and perfusion SPECT of the brain. Total FTM score was significantly higher in ET patients than TPD patients. However, there was no significant difference in FTM Part A scores between the two patient groups, while the scores for FTM Part B and C were significantly higher in ET patients than TPD patients. Brain SPECT analysis of the TPD group demonstrated significant hypoperfusion of both the lentiform nucleus and thalamus compared to the ET group. Brain perfusion SPECT may be a useful clinical method to differentiate between TPD and ET even during early-phase PD, because the lentiform nucleus and thalamus show differences in regional perfusion between these two groups during this time period. Additionally, we found evidence of cerebellar dysfunction in both TPT and ET. Copyright © 2014 Elsevier Ltd. All rights reserved.

Dramatic response to levetiracetam in post-ischaemic Holmes’ tremor

PubMed Central

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

2009-01-01

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

Complex behavior and source model of the tremor at Arenal volcano, Costa Rica

NASA Astrophysics Data System (ADS)

Lesage, Philippe; Mora, Mauricio M.; Alvarado, Guillermo E.; Pacheco, Javier; Métaxian, Jean-Philippe

2006-09-01

related to variations of the pressure in the conduit, which modify the gas fraction, the wave velocity and, possibly, the length of the resonator. Moreover, several observations suggest that two seismic sources, associated with two magmatic conduits, are active in Arenal volcano. They could explain in particular the apparent independence of tremor and explosions and the episodes of tremor displaying two simultaneous systems of spectral peaks.

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

NASA Astrophysics Data System (ADS)

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

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

Variability of hand tremor in rest and in posture--a pilot study.

PubMed

Rahimi, Fariborz; Bee, Carina; South, Angela; Debicki, Derek; Jog, Mandar

2011-01-01

Previous, studies have demonstrated variability in the frequency and amplitude in tremor between subjects and between trials in both healthy individuals and those with disease states. However, to date, few studies have examined the composition of tremor. Efficacy of treatment for tremor using techniques such as Botulinum neurotoxin type A (BoNT A) injection may benefit from a better understanding of tremor variability, but more importantly, tremor composition. In the present study, we evaluated tremor variability and composition in 8 participants with either essential tremor or Parkinson disease tremor using kinematic recording methods. Our preliminary findings suggest that while individual patients may have more intra-trial and intra-task variability, overall, task effect was significant only for amplitude of tremor. Composition of tremor varied among patients and the data suggest that tremor composition is complex involving multiple muscle groups. These results may support the value of kinematic assessment methods and the improved understanding of tremor composition in the management of tremor.

Pharmacotherapy of Essential Tremor

PubMed Central

Hedera, Peter; Cibulčík, František; Davis, Thomas L.

2013-01-01

Essential tremor (ET) is a common movement disorder but its pathogenesis remains poorly understood. This has limited the development of effective pharmacotherapy. The current therapeutic armamentaria for ET represent the product of careful clinical observation rather than targeted molecular modeling. Here we review their pharmacokinetics, metabolism, dosing, and adverse effect profiles and propose a treatment algorithm. We also discuss the concept of medically refractory tremor, as therapeutic trials should be limited unless invasive therapy is contraindicated or not desired by patients. PMID:24385718

Non-volcanic tremor driven by large transient shear stresses

USGS Publications Warehouse

Rubinstein, J.L.; Vidale, J.E.; Gomberg, J.; Bodin, P.; Creager, K.C.; Malone, S.D.

2007-01-01

Non-impulsive seismic radiation or 'tremor' has long been observed at volcanoes and more recently around subduction zones. Although the number of observations of non-volcanic tremor is steadily increasing, the causative mechanism remains unclear. Some have attributed non-volcanic tremor to the movement of fluids, while its coincidence with geodetically observed slow-slip events at regular intervals has led others to consider slip on the plate interface as its cause. Low-frequency earthquakes in Japan, which are believed to make up at least part of non-volcanic tremor, have focal mechanisms and locations that are consistent with tremor being generated by shear slip on the subduction interface. In Cascadia, however, tremor locations appear to be more distributed in depth than in Japan, making them harder to reconcile with a plate interface shear-slip model. Here we identify bursts of tremor that radiated from the Cascadia subduction zone near Vancouver Island, Canada, during the strongest shaking from the moment magnitude Mw = 7.8, 2002 Denali, Alaska, earthquake. Tremor occurs when the Love wave displacements are to the southwest (the direction of plate convergence of the overriding plate), implying that the Love waves trigger the tremor. We show that these displacements correspond to shear stresses of approximately 40 kPa on the plate interface, which suggests that the effective stress on the plate interface is very low. These observations indicate that tremor and possibly slow slip can be instantaneously induced by shear stress increases on the subduction interface - effectively a frictional failure response to the driving stress. ??2007 Nature Publishing Group.

Non-volcanic tremor driven by large transient shear stresses.

PubMed

Rubinstein, Justin L; Vidale, John E; Gomberg, Joan; Bodin, Paul; Creager, Kenneth C; Malone, Stephen D

2007-08-02

Non-impulsive seismic radiation or 'tremor' has long been observed at volcanoes and more recently around subduction zones. Although the number of observations of non-volcanic tremor is steadily increasing, the causative mechanism remains unclear. Some have attributed non-volcanic tremor to the movement of fluids, while its coincidence with geodetically observed slow-slip events at regular intervals has led others to consider slip on the plate interface as its cause. Low-frequency earthquakes in Japan, which are believed to make up at least part of non-volcanic tremor, have focal mechanisms and locations that are consistent with tremor being generated by shear slip on the subduction interface. In Cascadia, however, tremor locations appear to be more distributed in depth than in Japan, making them harder to reconcile with a plate interface shear-slip model. Here we identify bursts of tremor that radiated from the Cascadia subduction zone near Vancouver Island, Canada, during the strongest shaking from the moment magnitude M(w) = 7.8, 2002 Denali, Alaska, earthquake. Tremor occurs when the Love wave displacements are to the southwest (the direction of plate convergence of the overriding plate), implying that the Love waves trigger the tremor. We show that these displacements correspond to shear stresses of approximately 40 kPa on the plate interface, which suggests that the effective stress on the plate interface is very low. These observations indicate that tremor and possibly slow slip can be instantaneously induced by shear stress increases on the subduction interface-effectively a frictional failure response to the driving stress.

Validation of "laboratory-supported" criteria for functional (psychogenic) tremor.

PubMed

Schwingenschuh, Petra; Saifee, Tabish A; Katschnig-Winter, Petra; Macerollo, Antonella; Koegl-Wallner, Mariella; Culea, Valeriu; Ghadery, Christine; Hofer, Edith; Pendl, Tamara; Seiler, Stephan; Werner, Ulrike; Franthal, Sebastian; Maurits, Natasha M; Tijssen, Marina A; Schmidt, Reinhold; Rothwell, John C; Bhatia, Kailash P; Edwards, Mark J

2016-04-01

In a small group of patients, we have previously shown that a combination of electrophysiological tests was able to distinguish functional (psychogenic) tremor and organic tremor with excellent sensitivity and specificity. This study aims to validate an electrophysiological test battery as a tool to diagnose patients with functional tremor with a "laboratory-supported" level of certainty. For this prospective data collection study, we recruited 38 new patients with functional tremor (mean age 37.9 ± 24.5 years; mean disease duration 5.9 ± 9.0 years) and 73 new patients with organic tremor (mean age 55.4 ± 25.4 years; mean disease duration 15.8 ± 17.7 years). Tremor was recorded at rest, posture (with and without loading), action, while performing tapping tasks (1, 3, and 5 Hz), and while performing ballistic movements with the less-affected hand. Electrophysiological tests were performed by raters blinded to the clinical diagnosis. We calculated a sum score for all performed tests (maximum of 10 points) and used a previously suggested cut-off score of 3 points for a diagnosis of laboratory-supported functional tremor. We demonstrated good interrater reliability and test-retest reliability. Patients with functional tremor had a higher average score on the test battery when compared with patients with organic tremor (3.6 ± 1.4 points vs 1.0 ± 0.8 points; P < .001), and the predefined cut-off score for laboratory-supported functional tremor yielded a test sensitivity of 89.5% and a specificity of 95.9%. We now propose this test battery as the basis of laboratory-supported criteria for the diagnosis of functional tremor, and we encourage its use in clinical and research practice. © 2016 International Parkinson and Movement Disorder Society.

Stereotactic radiosurgery for tremor: systematic review.

PubMed

Martínez-Moreno, Nuria E; Sahgal, Arjun; De Salles, Antonio; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Paddick, Ian; Régis, Jean; Ryu, Sam; Slotman, Ben J; Martínez-Álvarez, Roberto

2018-02-23

OBJECTIVE The aim of this systematic review is to offer an objective summary of the published literature relating to stereotactic radiosurgery (SRS) for tremor and consensus guideline recommendations. METHODS This systematic review was performed up to December 2016. Article selection was performed by searching the MEDLINE (PubMed) and EMBASE electronic bibliographic databases. The following key words were used: "radiosurgery" and "tremor" or "Parkinson's disease" or "multiple sclerosis" or "essential tremor" or "thalamotomy" or "pallidotomy." The search strategy was not limited by study design but only included key words in the English language, so at least the abstract had to be in English. RESULTS A total of 34 full-text articles were included in the analysis. Three studies were prospective studies, 1 was a retrospective comparative study, and the remaining 30 were retrospective studies. The one retrospective comparative study evaluating deep brain stimulation (DBS), radiofrequency thermocoagulation (RFT), and SRS reported similar tremor control rates, more permanent complications after DBS and RFT, more recurrence after RFT, and a longer latency period to clinical response with SRS. Similar tremor reduction rates in most of the reports were observed with SRS thalamotomy (mean 88%). Clinical complications were rare and usually not permanent (range 0%-100%, mean 17%, median 2%). Follow-up in general was too short to confirm long-term results. CONCLUSIONS SRS to the unilateral thalamic ventral intermediate nucleus, with a dose of 130-150 Gy, is a well-tolerated and effective treatment for reducing medically refractory tremor, and one that is recommended by the International Stereotactic Radiosurgery Society.

CaV3.1 is a tremor rhythm pacemaker in the inferior olive

PubMed Central

Park, Young-Gyun; Park, Hye-Yeon; Lee, C. Justin; Choi, Soonwook; Jo, Seonmi; Choi, Hansol; Kim, Yang-Hann; Shin, Hee-Sup; Llinas, Rodolfo R.; Kim, Daesoo

2010-01-01

The rhythmic motor pathway activation by pacemaker neurons or circuits in the brain has been proposed as the mechanism for the timing of motor coordination, and the abnormal potentiation of this mechanism may lead to a pathological tremor. Here, we show that the potentiation of CaV3.1 T-type Ca2+ channels in the inferior olive contributes to the onset of the tremor in a pharmacological model of essential tremor. After administration of harmaline, 4- to 10-Hz synchronous neuronal activities arose from the IO and then propagated to cerebellar motor circuits in wild-type mice, but those rhythmic activities were absent in mice lacking CaV3.1 gene. Intracellular recordings in brain-stem slices revealed that the CaV3.1-deficient inferior olive neurons lacked the subthreshold oscillation of membrane potentials and failed to trigger 4- to 10-Hz rhythmic burst discharges in the presence of harmaline. In addition, the selective knockdown of CaV3.1 gene in the inferior olive by shRNA efficiently suppressed the harmaline-induced tremor in wild-type mice. A mathematical model constructed based on data obtained from patch-clamping experiments indicated that harmaline could efficiently potentiate CaV3.1 channels by changing voltage-dependent responsiveness in the hyperpolarizing direction. Thus, CaV3.1 is a molecular pacemaker substrate for intrinsic neuronal oscillations of inferior olive neurons, and the potentiation of this mechanism can be considered as a pathological cause of essential tremor. PMID:20498062

Exercise-induced hand tremor: a possible test for beta 2-adrenoceptor selectivity in man?

PubMed Central

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

1986-01-01

The effects of intravenous doses of propranolol, sotalol, timolol, atenolol and placebo on exercise-induced tachycardia and exercise-induced increases in hand tremor were assessed in four healthy volunteers. All active drugs produced significant reductions in exercise-induced tachycardia. Exercise caused consistent significant increases in hand tremor which were blocked by the three non-cardioselective drugs but not by atenolol or placebo. The blockade of exercise-induced hand tremor is suggested as a possible test for the assessment of the selectivity of beta-adrenoceptor blockade in man. PMID:2874824

The Dynamics of Voluntary Force Production in Afferented Muscle Influence Involuntary Tremor

PubMed Central

Laine, Christopher M.; Nagamori, Akira; Valero-Cuevas, Francisco J.

2016-01-01

Voluntary control of force is always marked by some degree of error and unsteadiness. Both neural and mechanical factors contribute to these fluctuations, but how they interact to produce them is poorly understood. In this study, we identify and characterize a previously undescribed neuromechanical interaction where the dynamics of voluntary force production suffice to generate involuntary tremor. Specifically, participants were asked to produce isometric force with the index finger and use visual feedback to track a sinusoidal target spanning 5–9% of each individual's maximal voluntary force level. Force fluctuations and EMG activity over the flexor digitorum superficialis (FDS) muscle were recorded and their frequency content was analyzed as a function of target phase. Force variability in either the 1–5 or 6–15 Hz frequency ranges tended to be largest at the peaks and valleys of the target sinusoid. In those same periods, FDS EMG activity was synchronized with force fluctuations. We then constructed a physiologically-realistic computer simulation in which a muscle-tendon complex was set inside of a feedback-driven control loop. Surprisingly, the model sufficed to produce phase-dependent modulation of tremor similar to that observed in humans. Further, the gain of afferent feedback from muscle spindles was critical for appropriately amplifying and shaping this tremor. We suggest that the experimentally-induced tremor may represent the response of a viscoelastic muscle-tendon system to dynamic drive, and therefore does not fall into known categories of tremor generation, such as tremorogenic descending drive, stretch-reflex loop oscillations, motor unit behavior, or mechanical resonance. Our findings motivate future efforts to understand tremor from a perspective that considers neuromechanical coupling within the context of closed-loop control. The strategy of combining experimental recordings with physiologically-sound simulations will enable thorough

Moment tensor inversion of tremor events at Arenal Volcano (Costa Rica)

NASA Astrophysics Data System (ADS)

Davi, Rosalia; O'Brien, Gareth; Lokmer, Ivan; Bean, Christopher; Lesage, Philippe; de Barros, Louis

2010-05-01

Arenal is a small, andesitic stratovolcano located in north-western Costa Rica, 97 km from the capital San Josè. Arenal's explosive activity is preceded, and accompanied, by different types of seismic events such as long period events, explosions, tremor and sporadic tectonic swarms. Tremor is the most common type of event recorded at Arenal with durations of up to several hours. Both spasmodic (1-6 Hz) and harmonic (0.9-2 Hz) tremor are observed with no clear difference in the genesis of each; the former can progressively evolve into the latter and vice-versa. However, the origin of the tremor is, at present, not fully understood. In order to retrieve the source mechanism generating these types of events, a moment tensor inversion is performed. A dataset recorded on the volcano, during a seismic experiment carried out in 2005, is used for the inversion. This dataset consists of ten days of data, from which two main groups of tremor at different frequencies (group one at 0.8-1.5 Hz and group two at 1.8-2.5 Hz) have been selected. A major difficulty in any inversion of tremor is that a clear onset can rarely be determined and hence retrieving the direct arrivals from the source is impossible. Usually, these arrivals are heavily contaminated by scattered waves. On Arenal the initial part of the tremor bands can be isolated, therefore offering a good opportunity to invert tremor for the source mechanism. The Green's functions used in the inversion were calculated using 3D numerical simulations including the real topography of the volcano and the best estimation of the velocity model available for Arenal. This velocity model was retrieved from seismic refraction experiments and sounding using the SPAC method. For each day, different tremor starting bands have been selected and divided into the groups mentioned above. For each band a source location is determined by performing a grid search through a volume of 4735 possible source points located under the crater summit

Multistation alarm system for eruptive activity based on the automatic classification of volcanic tremor: specifications and performance

NASA Astrophysics Data System (ADS)

Langer, Horst; Falsaperla, Susanna; Messina, Alfio; Spampinato, Salvatore

2015-04-01

With over fifty eruptive episodes (Strombolian activity, lava fountains, and lava flows) between 2006 and 2013, Mt Etna, Italy, underscored its role as the most active volcano in Europe. Seven paroxysmal lava fountains at the South East Crater occurred in 2007-2008 and 46 at the New South East Crater between 2011 and 2013. Month-lasting lava emissions affected the upper eastern flank of the volcano in 2006 and 2008-2009. On this background, effective monitoring and forecast of volcanic phenomena are a first order issue for their potential socio-economic impact in a densely populated region like the town of Catania and its surroundings. For example, explosive activity has often formed thick ash clouds with widespread tephra fall able to disrupt the air traffic, as well as to cause severe problems at infrastructures, such as highways and roads. For timely information on changes in the state of the volcano and possible onset of dangerous eruptive phenomena, the analysis of the continuous background seismic signal, the so-called volcanic tremor, turned out of paramount importance. Changes in the state of the volcano as well as in its eruptive style are usually concurrent with variations of the spectral characteristics (amplitude and frequency content) of tremor. The huge amount of digital data continuously acquired by INGV's broadband seismic stations every day makes a manual analysis difficult, and techniques of automatic classification of the tremor signal are therefore applied. The application of unsupervised classification techniques to the tremor data revealed significant changes well before the onset of the eruptive episodes. This evidence led to the development of specific software packages related to real-time processing of the tremor data. The operational characteristics of these tools - fail-safe, robustness with respect to noise and data outages, as well as computational efficiency - allowed the identification of criteria for automatic alarm flagging. The

Rest tremor in Parkinson's disease: Body distribution and time of appearance.

PubMed

Gigante, Angelo Fabio; Pellicciari, Roberta; Iliceto, Giovanni; Liuzzi, Daniele; Mancino, Paola Vincenza; Custodero, Giacomo Emanuele; Guido, Marco; Livrea, Paolo; Defazio, Giovanni

2017-04-15

To assess body distribution and timing of appearance of rest tremor in Parkinson's disease. Information was obtained by a computerized database containing historical information collected at the first visit and data collected during the subsequent follow-up visits. Information on rest tremor developed during the follow-up could be therefore obtained by our own observation in a proportion of patients. Among 289 patients, rest tremor was reported at disease onset in 65.4% of cases and detected at last follow-up examination in 74.4% of patients. Analysis of patients who did not report rest tremor at disease onset indicated that 26% of such patients (9% in the overall population) manifested rest tremor over the disease course. Rest tremor spread to new sites in 39% of patients who manifested rest tremor at disease onset. Regardless of tremor presentation at disease onset or during the follow-up, upper limb was the most frequent tremor localization. Over the follow-up, rest tremor developed faster in the upper limb than in other body sites. The risk of developing rest tremor during the follow-up was not affected by sex, side of motor symptom onset and site of tremor presentation. However, age of disease onset >63years was associated with an increased risk of rest tremor spread. This study provides new information about body distribution and timing of rest tremor appearance during the course of early stages of Parkinson's disease that may help clinicians in patients' counselling. Copyright © 2017 Elsevier B.V. All rights reserved.

21 CFR 882.1950 - Tremor transducer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tremor transducer. 882.1950 Section 882.1950 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1950 Tremor transducer. (a...

21 CFR 882.1950 - Tremor transducer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Tremor transducer. 882.1950 Section 882.1950 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1950 Tremor transducer. (a...

What does tremor really look like? Initial results from an 84-element array

NASA Astrophysics Data System (ADS)

Vidale, J. E.; Sweet, J.; Creager, K. C.; Ghosh, A.

2008-12-01

Aspiring to see more intimate details, we placed an 84-element short-period vertical-component array with an aperture of 1km on a hard rock mountain over the path of Cascadia tremor. This site is coincident with a stellar 6-station three-component CAFE array (see talk by K. Creager). Texans, which are convenient to deploy but require recycling for fresh batteries every four days, recorded the seismograms. We recorded 8 days in March and 17 days in May 2008. We find most of the arrivals at high frequencies, especially in the stacks, are P-waves, due to the network constitution. The March week contains only six intermittent hours of tremor detectable by the usual envelope analysis of data from the regional network, but array beamforming shows much more continuous activity, and extending about a half day longer. We also pick up a later episode of weak tremor that contains probably the first glance of low-frequency earthquake in Cascadia (see abstract by J. Sweet). The May field season recorded full-blown tremor passing directly underneath in startling detail. The tremor source region in preliminary images is more compact than the cloud of locations determined from envelope correlation, but also with an apparently persistent patchwork of regions that do and do not generate tremor. Further analysis and future deployments with multiple dense arrays show great promise for getting to the bottom of the issue of tremor generation.

Estimation of the phase response curve from Parkinsonian tremor.

PubMed

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

2016-01-01

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

Estimation of the phase response curve from Parkinsonian tremor

PubMed Central

Saifee, Tabish A.; Edwards, Mark J.; Kassavetis, Panagiotis

2015-01-01

Phase response curves (PRCs), characterizing the response of an oscillator to weak external perturbation, have been estimated from a broad range of biological oscillators, including single neurons in vivo. PRC estimates, in turn, provide an intuitive insight into how oscillatory systems become entrained and how they can be desynchronized. Here, we explore the application of PRC theory to the case of Parkinsonian tremor. Initial attempts to establish a causal effect of subthreshold transcranial magnetic stimulation applied to primary motor cortex on the filtered tremor phase were unsuccessful. We explored the possible explanations of this and demonstrate that assumptions made when estimating the PRC in a traditional setting, such as a single neuron, are not arbitrary when applied to the case of tremor PRC estimation. We go on to extract the PRC of Parkinsonian tremor using an iterative method that requires varying the definition of the tremor cycle and estimating the PRC at multiple peristimulus time samples. Justification for this method is supported by estimates of PRC from simulated single neuron data. We provide an approach to estimating confidence limits for tremor PRC and discuss the interpretational caveats introduced by tremor harmonics and the intrinsic variability of the tremor's period. PMID:26561596

Seismic tremors and magma wagging during explosive volcanism.

PubMed

Jellinek, A Mark; Bercovici, David

2011-02-24

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

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

PubMed

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.

PubMed

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.

Quantitative Assessment of Parkinsonian Tremor Based on an Inertial Measurement Unit

PubMed Central

Dai, Houde; Zhang, Pengyue; Lueth, Tim C.

2015-01-01

Quantitative assessment of parkinsonian tremor based on inertial sensors can provide reliable feedback on the effect of medication. In this regard, the features of parkinsonian tremor and its unique properties such as motor fluctuations and dyskinesia are taken into account. Least-square-estimation models are used to assess the severities of rest, postural, and action tremors. In addition, a time-frequency signal analysis algorithm for tremor state detection was also included in the tremor assessment method. This inertial sensor-based method was verified through comparison with an electromagnetic motion tracking system. Seven Parkinson’s disease (PD) patients were tested using this tremor assessment system. The measured tremor amplitudes correlated well with the judgments of a neurologist (r = 0.98). The systematic analysis of sensor-based tremor quantification and the corresponding experiments could be of great help in monitoring the severity of parkinsonian tremor. PMID:26426020

Feasibility study of spectral pattern recognition reveals distinct classes of volcanic tremor

NASA Astrophysics Data System (ADS)

Unglert, K.; Jellinek, A. M.

2017-04-01

characteristics such as magma viscosity, storage depths, and the physical properties of volcanic edifices. Similarities among the spectral patterns detected at stations 4km and 8-10km distance from the centers of volcanic activity, respectively, indicate that path effects do not strongly influence spectral shapes at distances of a few kilometers from the inferred source of the signals. Our preliminary work shows that a global comparison of tremor is feasible. Our results suggest that further work on data from a larger sample and diverse range of volcano types will reveal additional classes of tremor signals and plausibly identify fingerprints of source processes that are specific to volcano type, but independent of volcano location.

Handheld computers in critical care.

PubMed

Lapinsky, S E; Weshler, J; Mehta, S; Varkul, M; Hallett, D; Stewart, T E

2001-08-01

Computing technology has the potential to improve health care management but is often underutilized. Handheld computers are versatile and relatively inexpensive, bringing the benefits of computers to the bedside. We evaluated the role of this technology for managing patient data and accessing medical reference information, in an academic intensive-care unit (ICU). Palm III series handheld devices were given to the ICU team, each installed with medical reference information, schedules, and contact numbers. Users underwent a 1-hour training session introducing the hardware and software. Various patient data management applications were assessed during the study period. Qualitative assessment of the benefits, drawbacks, and suggestions was performed by an independent company, using focus groups. An objective comparison between a paper and electronic handheld textbook was achieved using clinical scenario tests. During the 6-month study period, the 20 physicians and 6 paramedical staff who used the handheld devices found them convenient and functional but suggested more comprehensive training and improved search facilities. Comparison of the handheld computer with the conventional paper text revealed equivalence. Access to computerized patient information improved communication, particularly with regard to long-stay patients, but changes to the software and the process were suggested. The introduction of this technology was well received despite differences in users' familiarity with the devices. Handheld computers have potential in the ICU, but systems need to be developed specifically for the critical-care environment.

Handheld computers in critical care

PubMed Central

Lapinsky, Stephen E; Weshler, Jason; Mehta, Sangeeta; Varkul, Mark; Hallett, Dave; Stewart, Thomas E

2001-01-01

Background Computing technology has the potential to improve health care management but is often underutilized. Handheld computers are versatile and relatively inexpensive, bringing the benefits of computers to the bedside. We evaluated the role of this technology for managing patient data and accessing medical reference information, in an academic intensive-care unit (ICU). Methods Palm III series handheld devices were given to the ICU team, each installed with medical reference information, schedules, and contact numbers. Users underwent a 1-hour training session introducing the hardware and software. Various patient data management applications were assessed during the study period. Qualitative assessment of the benefits, drawbacks, and suggestions was performed by an independent company, using focus groups. An objective comparison between a paper and electronic handheld textbook was achieved using clinical scenario tests. Results During the 6-month study period, the 20 physicians and 6 paramedical staff who used the handheld devices found them convenient and functional but suggested more comprehensive training and improved search facilities. Comparison of the handheld computer with the conventional paper text revealed equivalence. Access to computerized patient information improved communication, particularly with regard to long-stay patients, but changes to the software and the process were suggested. Conclusions The introduction of this technology was well received despite differences in users' familiarity with the devices. Handheld computers have potential in the ICU, but systems need to be developed specifically for the critical-care environment. PMID:11511337

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

PubMed Central

Qasim, Salman E.; de Hemptinne, Coralie; Swann, Nicole C.; Miocinovic, Svjetlana; Ostrem, Jill L.; Starr, Philip A.

2015-01-01

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. PMID:26639855

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

PubMed

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

2016-03-15

Tremor characteristics-amplitude and frequency components-are primary quantitative clinical factors for diagnosis and monitoring of tremors. Few studies have investigated how different patient's conditions affect tremor frequency characteristics in Parkinson's disease (PD). Here, we analyzed tremor characteristics under resting-state and stress-state conditions. Tremor was recorded using an accelerometer on the finger, under resting-state and stress-state (calculation task) conditions, during rest tremor and postural tremor. The changes of peak power, peak frequency, mean frequency, and distribution of power spectral density (PSD) of tremor were evaluated across conditions. Patients whose tremors were considered more than "mild" were selected, for both rest (n=67) and postural (n=25) tremor. Stress resulted in both greater peak powers and higher peak frequencies for rest tremor (p<0.001), but not for postural tremor. Notably, peak frequencies were concentrated around 5 Hz under stress-state condition. The distributions of PSD of tremor were symmetrical, regardless of conditions. Tremor is more evident and typical tremor characteristics, namely a lower frequency as amplitude increases, are different in stressful condition. Patient's conditions directly affect neural oscillations related to tremor frequencies. Therefore, tremor characteristics in PD should be systematically standardized across patient's conditions such as attention and stress levels. Copyright © 2016. Published by Elsevier B.V.

Tremor analysis separates Parkinson's disease and dopamine receptor blockers induced parkinsonism.

PubMed

Shaikh, Aasef G

2017-05-01

Parkinson's disease, the most common cause of parkinsonism is often difficult to distinguish from its second most common etiology due to exposure to dopamine receptor blocking agents such as antiemetics and neuroleptics. Dual axis accelerometry was used to quantify tremor in 158 patients with parkinsonism; 62 had Parkinson's disease and 96 were clinically diagnosed with dopamine receptor blocking agent-induced parkinsonism. Tremor was measured while subjects rested arms (resting tremor), outstretched arms in front (postural tremor), and reached a target (kinetic tremor). Cycle-by-cycle analysis was performed to measure cycle duration, oscillation amplitude, and inter-cycle variations in the frequency. Patients with dopamine receptor blocker induced parkinsonism had lower resting and postural tremor amplitude. There was a substantial increase of kinetic tremor amplitude in both disorders. Postural and resting tremor in subjects with dopamine receptor blocking agent-induced parkinsonism was prominent in the abduction-adduction plane. In contrast, the Parkinson's disease tremor had equal amplitude in all three planes of motion. Tremor frequency was comparable in both groups. Remarkable variability in the width of the oscillatory cycles suggested irregularity in the oscillatory waveforms in both subtypes of parkinsonism. Quantitative tremor analysis can distinguish Parkinson's disease from dopamine receptor blocking agent-induced parkinsonism.

Quantitative assessment of arm tremor in people with neurological disorders.

PubMed

Jeonghee Kim; Parnell, Claire; Wichmann, Thomas; DeWeerth, Stephen P

2016-08-01

Abnormal oscillatory movement (i.e. tremor) is usually evaluated with qualitative assessment by clinicians, and quantified with subjective scoring methods. These methods are often inaccurate. We utilized a quantitative and standardized task based on the Fitts' law to assess the performance of arm movement with tremor by controlling a gyration mouse on a computer. The experiment included the center-out tapping (COT) and rectangular track navigation (RTN) tasks. We report the results of a pilot study in which we collected the performance for healthy participants in whom tremor was simulated by imposing oscillatory movements to the arm with a vibration motor. We compared their movement speed and accuracy with and without the artificial "tremor." We found that the artificial tremor significantly affected the path efficiency for both tasks (COT: 56.8 vs. 46.2%, p <; 0.05; RTN: 94.2 vs. 67.4%, p <; 0.05), and we were able to distinguish the presence of tremor. From this result, we expect to quantify severity of tremor and the effectiveness therapy for tremor patients.

A teaching videotape for the assessment of essential tremor.

PubMed

Louis, E D; Barnes, L; Wendt, K J; Ford, B; Sangiorgio, M; Tabbal, S; Lewis, L; Kaufmann, P; Moskowitz, C; Comella, C L; Goetz, C C; Lang, A E

2001-01-01

Teaching videotapes, developed to aid in the evaluation of several movement disorders, have not been used in essential tremor research. As part of the Washington Heights-Inwood Genetic Study of Essential Tremor (WHIGET), we developed a reliable and valid tremor rating scale. Because this rating scale is currently being used by investigators at other centers, we developed a teaching videotape to aid in the consistent application of this scale. To develop a teaching videotape for a revised version of the WHIGET Tremor Rating Scale and to assess the interrater agreement among raters who used this videotape to rate tremor. The revised WHIGET Tremor Rating Scale was used to rate action tremor from 0 to 4 during six tests: arm extension, pouring, drinking, using a spoon, finger-to-nose, and drawing spirals. A 22-minute teaching videotape was developed that includes a 29-item educational section and a self-assessment section consisting of 20 examples of tremor ratings chosen by the two WHIGET study neurologists. Eight raters, including senior movement disorder specialists, movement disorder fellows, general neurologists, and a movement disorder nurse practitioner, independently viewed the videotape and rated tremor during the self-assessment section. Interobserver reliability was assessed with weighted kappa statistics (kappa(w)). Eight raters each rated 20 items (160 ratings total). Total kappa(w) was 0.97 (nearly perfect agreement). Interrater reliability was as follows: kappa(w) = 0.99 (movement disorder specialists), kappa(w) = 0.98 (movement disorder fellows), and kappa(w) = 0.97 (general neurologists); all kappa(w) were nearly perfect. This teaching videotape may be used to improve the uniform application of the revised WHIGET Tremor Rating Scale by raters with various levels of experience in movement disorders.

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

PubMed

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

2017-07-01

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

Re-emergent tremor in Parkinson's disease: Clinical and accelerometric properties.

PubMed

Aytürk, Zübeyde; Yilmaz, Rezzak; Akbostanci, M Cenk

2017-03-01

Re-emergent tremor (RET) and the classical parkinsonian rest tremor were considered as two different phenomena of the same central tremor circuit. However, clinical and accelerometric characteristics of these tremors were not previously compared in a single study. We evaluated disease characteristics and accelerometric measurements of two tremor types in 42 patients with Parkinson's disease. Disease specific features and accelerometric measurements of peak frequency, amplitude at peak frequency and the root mean square (RMS) amplitude of two tremor types were compared. Eighteen patients had RET and the mean latency of the RET was 9.48 (±9.2)s. Groups of only rest tremor and RET did not differ significantly in age of disease onset, disease duration and severity and mean levodopa equivalent dose. Comparison of peak frequency and amplitude at peak frequency were not different between the groups, but RMS amplitude was significantly higher in the RET group (p=0.03). RMS amplitude of RET was also correlated with disease severity (r=.48, p=0.04). These results support the previous notion that rest tremor and RET are analogue, both are triggered by the same central ossilator with RET being only the suppression of the rest tremor due to arm repositioning. Copyright © 2016 Elsevier Ltd. All rights reserved.

On the Origin of Tremor in Parkinson’s Disease

PubMed Central

Dovzhenok, Andrey; Rubchinsky, Leonid L.

2012-01-01

The exact origin of tremor in Parkinson’s disease remains unknown. We explain why the existing data converge on the basal ganglia-thalamo-cortical loop as a tremor generator and consider a conductance-based model of subthalamo-pallidal circuits embedded into a simplified representation of the basal ganglia-thalamo-cortical circuit to investigate the dynamics of this loop. We show how variation of the strength of dopamine-modulated connections in the basal ganglia-thalamo-cortical loop (representing the decreasing dopamine level in Parkinson’s disease) leads to the occurrence of tremor-like burst firing. These tremor-like oscillations are suppressed when the connections are modulated back to represent a higher dopamine level (as it would be the case in dopaminergic therapy), as well as when the basal ganglia-thalamo-cortical loop is broken (as would be the case for ablative anti-parkinsonian surgeries). Thus, the proposed model provides an explanation for the basal ganglia-thalamo-cortical loop mechanism of tremor generation. The strengthening of the loop leads to tremor oscillations, while the weakening or disconnection of the loop suppresses them. The loop origin of parkinsonian tremor also suggests that new tremor-suppression therapies may have anatomical targets in different cortical and subcortical areas as long as they are within the basal ganglia-thalamo-cortical loop. PMID:22848541

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

PubMed

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.

A new method for the measurement of tremor at rest.

PubMed

Comby, B; Chevalier, G; Bouchoucha, M

1992-01-01

This paper establishes a standard method for measuring human tremor. The electronic instrument described is an application of this method. It solves the need for an effective and simple tremor-measuring instrument fit for wide distribution. This instrument consists of a piezoelectric accelerometer connected to an electronic circuit and to an LCD display. The signal is also analysed by a computer after accelerometer analogic/digital conversion in order to test the method. The tremor of 1079 healthy subjects was studied. Spectral analysis showed frequency peaks between 5.85 and 8.80 Hz. Chronic cigarette-smoking and coffee drinking did not modify the tremor as compared with controls. Relaxation session decreased tremor significantly in healthy subjects (P less than 0.01). This new tremor-measuring method opens new horizons in the understanding of physiological and pathological tremor, stress, anxiety and in the means to avoid or compensate them.

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

PubMed

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.

Sustained Medication Reduction Following Unilateral VIM Thalamic Stimulation for Essential Tremor

PubMed Central

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

2012-01-01

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. PMID:23440408

Cortical tremor: a variant of cortical reflex myoclonus.

PubMed

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

NASA Astrophysics Data System (ADS)

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.

Hand-held medical robots.

PubMed

Payne, Christopher J; Yang, Guang-Zhong

2014-08-01

Medical robots have evolved from autonomous systems to tele-operated platforms and mechanically-grounded, cooperatively-controlled robots. Whilst these approaches have seen both commercial and clinical success, uptake of these robots remains moderate because of their high cost, large physical footprint and long setup times. More recently, researchers have moved toward developing hand-held robots that are completely ungrounded and manipulated by surgeons in free space, in a similar manner to how conventional instruments are handled. These devices provide specific functions that assist the surgeon in accomplishing tasks that are otherwise challenging with manual manipulation. Hand-held robots have the advantages of being compact and easily integrated into the normal surgical workflow since there is typically little or no setup time. Hand-held devices can also have a significantly reduced cost to healthcare providers as they do not necessitate the complex, multi degree-of-freedom linkages that grounded robots require. However, the development of such devices is faced with many technical challenges, including miniaturization, cost and sterility, control stability, inertial and gravity compensation and robust instrument tracking. This review presents the emerging technical trends in hand-held medical robots and future development opportunities for promoting their wider clinical uptake.

Therapeutic effects of arotinolol, a beta-adrenergic blocker, on tremor in MPTP-induced parkinsonian monkeys.

PubMed

Kuno, S; Mizuta, E; Nishida, J; Takechi, M

1992-10-01

The effect of arotinolol, a peripherally acting beta-adrenergic-blocking agent, on postural or kinetic tremor was studied in monkeys with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism. Male cynomolgus monkeys (Macaca fascicularis) were treated with three injections of MPTP hydrochloride (0.3 mg/kg, i.v.) at an interval of 3-4 days, followed by several injections of the same dose every 7 days. Four monkeys with persistent parkinsonian symptoms manifested for greater than 1 year were used. The animals developed mild to moderate degrees of postural or kinetic tremor, and their motor activity was reduced. Arotinolol (20-30 mg/kg, s.c.) significantly suppressed postural tremor in a dose-dependent manner. Propranolol (20-30 mg/kg) was also effective in suppressing the tremor. However, the application of propranolol induced emesis, whereas arotinolol had no adverse effects. These results suggest that arotinolol is a useful adjunct to dopaminergic therapy for tremor in Parkinson's disease.

Tremor, remote triggering and earthquake cycle

NASA Astrophysics Data System (ADS)

Peng, Z.

2012-12-01

Deep tectonic tremor and episodic slow-slip events have been observed at major plate-boundary faults around the Pacific Rim. These events have much longer source durations than regular earthquakes, and are generally located near or below the seismogenic zone where regular earthquakes occur. Tremor and slow-slip events appear to be extremely stress sensitive, and could be instantaneously triggered by distant earthquakes and solid earth tides. However, many important questions remain open. For example, it is still not clear what are the necessary conditions for tremor generation, and how remote triggering could affect large earthquake cycle. Here I report a global search of tremor triggered by recent large teleseismic earthquakes. We mainly focus on major subduction zones around the Pacific Rim. These include the southwest and northeast Japan subduction zones, the Hikurangi subduction zone in New Zealand, the Cascadia subduction zone, and the major subduction zones in Central and South America. In addition, we examine major strike-slip faults around the Caribbean plate, the Queen Charlotte fault in northern Pacific Northwest Coast, and the San Andreas fault system in California. In each place, we first identify triggered tremor as a high-frequency non-impulsive signal that is in phase with the large-amplitude teleseismic waves. We also calculate the dynamic stress and check the triggering relationship with the Love and Rayleigh waves. Finally, we calculate the triggering potential with the local fault orientation and surface-wave incident angles. Our results suggest that tremor exists at many plate-boundary faults in different tectonic environments, and could be triggered by dynamic stress as low as a few kPas. In addition, we summarize recent observations of slow-slip events and earthquake swarms triggered by large distant earthquakes. Finally, we propose several mechanisms that could explain apparent clustering of large earthquakes around the world.

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

PubMed Central

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

Patient Perceptions of Physician Use of Handheld Computers

PubMed Central

Houston, Thomas K.; Ray, Midge N.; Crawford, Myra A.; Giddens, Tonya; Berner, Eta S.

2003-01-01

Background Handheld computers have advantages for physicians, including portability and integration into office workflow. However, negative patient perceptions of physician use of handheld computers in the examining room might limit integration. Objective To survey patients’ perceptions of handheld use, and compare those with their providers’ perceptions. Methods A survey of patient attitudes toward handhelds was conducted among patients at a low-income university clinic. Internal Medicine residents providing care were also surveyed. Results Patients (N=93) were mostly female (79%) and ethnic minorities (67%) with average age of 39. Only 10% of patients did not like the idea of a handheld computer in the exam room. Other negative attitudes were also seen in a minority of patients. Some physicians (23%) reported reservations about using the handheld with patients. Conclusions Negative attitudes were rare among patients, but some providers were concerned about using the handheld in the exam room. PMID:14728182

A wireless sensor network for monitoring volcanic tremors

NASA Astrophysics Data System (ADS)

Lopes Pereira, R.; Trindade, J.; Gonçalves, F.; Suresh, L.; Barbosa, D.; Vazão, T.

2013-08-01

Monitoring of volcanic activity is important to learn about the properties of each volcano and provide early warning systems to the population. Monitoring equipment can be expensive and thus, the degree of monitoring varies from volcano to volcano and from country to country, with many volcanoes not being monitored at all. This paper describes the development of a Wireless Sensor Network (WSN) capable of collecting geophysical measurements on remote active volcanoes. Our main goals were to create a flexible, easy to deploy and maintain, adaptable, low-cost WSN for temporary or permanent monitoring of seismic tremor. The WSN enables the easy installation of a sensor array on an area of tens of thousand of m2, allowing the location of the magma movements causing the seismic tremor to be calculated. This WSN can be used by recording data locally for latter analysis or by continuously transmitting it in real time to a remote laboratory for real-time analyses.

Triggering of tremors and slow slip event in Guerrero, Mexico, by the 2010 Mw 8.8 Maule, Chile, earthquake

NASA Astrophysics Data System (ADS)

Zigone, Dimitri; Rivet, Diane; Radiguet, Mathilde; Campillo, Michel; Voisin, Christophe; Cotte, Nathalie; Walpersdorf, Andrea; Shapiro, Nikolai M.; Cougoulat, Glenn; Roux, Philippe; Kostoglodov, Vladimir; Husker, Allen; Payero, Juan S.

2012-09-01

We investigate the triggering of seismic tremor and slow slip event in Guerrero (Mexico) by the February 27, 2010 Maule earthquake (Mw 8.8). Triggered tremors start with the arrival of S wave generated by the Maule earthquake, and keep occurring during the passing of ScS, SS, Love and Rayleigh waves. The Rayleigh wave dispersion curve footprints the high frequency energy envelope of the triggered tremor, indicating a strong modulation of the source of tremors by the passing surface wave. This correlation and modulation by the passing waves is progressively lost with time over a few hours. The tremor activity continues during the weeks/months after the earthquake. GPS time series suggest that the second sub-event of the 2009-2010 SSE in Guerrero is actually triggered by the Maule earthquake. The southward displacement of the GPS stations starts coincidently with the earthquake and tremors. The long duration of tremors indicate a continuing deformation process at depth, which we propose to be the second sub-event of the 2009-2010 SSE. We show a quasi-systematic correlation between surface displacement rate measured by GPS and tremor activity, suggesting that the NVT are controlled by the variations in the slip history of the SSE. This study shows that two types of tremors emerge: (1) Those directly triggered by the passing waves and (2) those triggered by the stress variations associated with slow slip. This indicates the prominent role of aseismic creep in the Mexican subduction zone response to a large teleseismic earthquake, possibly leading to large-scale stress redistribution.

Reversible Holmes' tremor due to spontaneous intracranial hypotension.

PubMed

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.

Deep volcanic tremor and magma ascent mechanism under Kilauea, Hawaii

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aki, K.; Koyanagi, R.

1981-08-10

Deep harmonic tremor originating at depths around 40 km under Kilauea was studied using records accumulated since 1962 at the Hawaii Volcano Observatory of the U. S. Geological Survey. The deep source of the tremor was determined by onset times and confirmed by the relative amplitude across the island-wide network of seismometers. The period of tremor was conclusively shown to be determined by the source effect and not by the path or station site effect because the period would change considerably in time but maintained uniformity across the seismic net during the tremor episode. The tremor appeared to be primarilymore » composed of P waves. We interpret the observation period and amplitude in terms of the stationary crack model of Aki et al. (1977) and find that the seismic moment rates for deep tremors are considerably larger than those for shallow-tremors suggesting mor vigorous transport for the former. We propose a kinematic source model which may be more appropriate for deep tremor. According to this model, a measurable quantity called 'reduced displacement' is directly proportional to the rate of magma flow. A systematic search for deep tremor episodes was made for the period from 1962 through 1979, and the amplitude, period, and duration of the tremor were tabulated. We then constructed a cumulative reduced-displacement plot over the 18-year period. The result shows a generally steady process which does not seem to be significantly affected by major eruptions and large earthquakes near the surface. The total magma flow estimated from the reduced displacement is however, one order of magnitude smaller than that estimated by Swanson (1972). It may be that most channels transport magma aseismically, and only those with strong barriers generate tremor.« less

Three-dimensional assessment of postural tremor during goal-directed aiming.

PubMed

Kelleran, K J; Morrison, S; Russell, D M

2016-12-01

The performance of fine motor tasks which require a degree of precision can be negatively affected by physiological tremor. This study examined the effect of different aiming positions on anterior-posterior (AP), medial-lateral (ML) and vertical (VT) postural tremor. Participants were required to aim a mock handgun at a target located in front of them at eye level. Changes in AP, ML and VT tremor from the forearm and gun barrel were assessed as a function of limb (i.e., whether one or both arms were used) and upper arm position (elbow bent or extended). Tremor was recorded using triaxial accelerometers. Results showed that, across all tasks, the ML and VT tremor for any point was characterized by two frequency peaks (between 1-4 and 8-12 Hz) with amplitude increasing from proximal (forearm) to distal (gun barrel). Interestingly, irrespective of the posture adopted, ML accelerations were of greater amplitude than VT oscillations. AP oscillations were markedly smaller compared to VT and ML tremor, did not display consistent frequency peaks, and were not altered by the arm conditions. Altering the aiming posture resulted in changes in VT and ML tremor amplitude, with oscillations being greater when using a single arm as compared to when two arms were used together. Similarly, tremor amplitude was reduced when the task was performed with the elbow bent compared to the straight arm condition. Overall, these results highlight that ML oscillations make as significant a contribution to the overall tremor dynamics as those observed in the VT direction. However, the origin of ML tremor is not simply the product of voluntary adjustments to maintain aim on the target, but also exhibits features similar to the neural generated 8-12-Hz tremor seen under postural conditions.

Deep volcanic tremor and magma ascent mechanism under Kilauea, Hawaii

USGS Publications Warehouse

Aki, Keiiti; Koyanagi, Robert Y

1981-01-01

Deep harmonic tremor originating at depths around 40 km under Kilauea was studied using records accumulated since 1962 at the Hawaii Volcano Observatory of the U.S. Geological Survey. The deep source of the tremor was determined by onset times and confirmed by the relative amplitude across the island-wide network of seismometers. The period of tremor was conclusively shown to be determined by the source effect and not by the path or station site effect because the period would change considerably in time but maintained uniformity across the seismic net during the tremor episode. The tremor appeared to be primarily composed of P waves. We interpret the observed period and amplitude in terms of the stationary crack model of Aki et al. (1977) and find that the seismic moment rates for deep tremors are considerably larger than those for shallow-tremors suggesting more vigorous transport for the former. We propose a kinematic source model which may be more appropriate for deep tremor. According to this model, a measurable quantity called ‘reduced displacement’ is directly proportional to the rate of magma flow. A systematic search for deep tremor episodes was made for the period from 1962 through 1979, and the amplitude, period, and duration of the tremor were tabulated. We then constructed a cumulative reduced-displacement plot over the 18-year period. The result shows a generally steady process which does not seem to be significantly affected by major eruptions and large earthquakes near the surface. The total magma flow estimated from the reduced displacement is however, one order of magnitude smaller than that estimated by Swanson (1972). It may be that most channels transport magma aseismically, and only those with strong barriers generate tremor.

Geometry and Pore Pressure Shape the Pattern of the Tectonic Tremors Activity on the Deep San Andreas Fault with Periodic, Period-Multiplying Recurrence Intervals

NASA Astrophysics Data System (ADS)

Mele Veedu, D.; Barbot, S.

2014-12-01

A never before recorded pattern of periodic, chaotic, and doubled, earthquake recurrence intervals was detected in the sequence of deep tectonic tremors of the Parkfield segment of the San Andreas Fault (Shelly, 2010). These observations may be the most puzzling seismological observations of the last decade: The pattern was regularly oscillating with a period doubling of 3 and 6 days from mid-2003 until it was disrupted by the 2004 Mw 6.0 Parkfield earthquake. But by the end of 2007, the previous pattern resumed. Here, we assume that the complex dynamics of the tremors is caused by slip on a single asperity on the San Andreas Fault with homogeneous friction properties. We developed a three-dimensional model based on the rate-and-state friction law with a single patch and simulated fault slip during all stages of the earthquake cycle using the boundary integral method of Lapusta & Liu (2009). We find that homogeneous penny-shaped asperities cannot induce the observed period doubling, and that the geometry itself of the velocity-weakening asperity is critical in enabling the characteristic behavior of the Parkfield tremors. We also find that the system is sensitive to perturbations in pore pressure, such that the ones induced by the 2004 Parkfield earthquake are sufficient to dramatically alter the dynamics of the tremors for two years, as observed by Shelly (2010). An important finding is that tremor magnitude is amplified more by macroscopic slip duration on the source asperity than by slip amplitude, indicative of a time-dependent process for the breakage of micro-asperities that leads to seismic emissions. Our simulated event duration is in the range of 25 to 150 seconds, closely comparable to the event duration of a typical Parkfield tectonic tremor. Our simulations reproduce the unique observations of the Parkfield tremor activity. This study vividly illustrates the critical role of geometry in shaping the dynamics of fault slip evolution on a seismogenic fault.

Tremor activity inhibited by well-drained conditions above a megathrust

PubMed Central

Nakajima, Junichi; Hasegawa, Akira

2016-01-01

Tremor occurs on megathrusts under conditions of near-lithostatic pore-fluid pressures and extremely weakened shear strengths. Although metamorphic reactions in the slab liberate large amounts of fluids, the mechanism for enhancing pore-fluid pressures along the megathrust to near-lithostatic values remains poorly understood. Here we show anti-correlation between low-frequency earthquake (LFE) activity and properties that are markers of the degree of metamorphism above the megathrust, whereby LFEs occur beneath the unmetamorphosed overlying plate but are rare or limited below portions that are metamorphosed. The extent of metamorphism in the overlying plate is likely controlled by along-strike contrasts in permeability. Undrained conditions are required for pore-fluid pressures to be enhanced to near-lithostatic values and for shear strength to reduce sufficiently for LFE generation, whereas well-drained conditions reduce pore-fluid pressures at the megathrust and LFEs no longer occur at the somewhat strengthened megathrust. Our observations suggest that undrained conditions are a key factor for the genesis of LFEs. PMID:27991588

Electrical Stimulation of Afferent Pathways for the Suppression of Pathological Tremor

PubMed Central

Dideriksen, Jakob L.; Laine, Christopher M.; Dosen, Strahinja; Muceli, Silvia; Rocon, Eduardo; Pons, José L.; Benito-Leon, Julian; Farina, Dario

2017-01-01

Pathological tremors are involuntary oscillatory movements which cannot be fully attenuated using conventional treatments. For this reason, several studies have investigated the use of neuromuscular electrical stimulation for tremor suppression. In a recent study, however, we found that electrical stimulation below the motor threshold also suppressed tremor, indicating involvement of afferent pathways. In this study, we further explored this possibility by systematically investigating how tremor suppression by afferent stimulation depends on the stimulation settings. In this way, we aimed at identifying the optimal stimulation strategy, as well as to elucidate the underlying physiological mechanisms of tremor suppression. Stimulation strategies varying the stimulation intensity and pulse timing were tested in nine tremor patients using either intramuscular or surface stimulation. Significant tremor suppression was observed in six patients (tremor suppression > 75% was observed in three patients) and the average optimal suppression level observed across all subjects was 52%. The efficiency for each stimulation setting, however, varied substantially across patients and it was not possible to identify a single set of stimulation parameters that yielded positive results in all patients. For example, tremor suppression was achieved both with stimulation delivered in an out-of-phase pattern with respect to the tremor, and with random timing of the stimulation. Overall, these results indicate that low-current stimulation of afferent fibers is a promising approach for tremor suppression, but that further research is required to identify how the effect can be maximized in the individual patient. PMID:28420958

Drug-induced tremor

MedlinePlus

... Drugs that can cause tremor include the following: Cancer medicines such as thalidomide and cytarabine Seizure medicines such as valproic acid (Depakote) and sodium valproate (Depakene) Asthma medicines such as theophylline and ...

Effects of volcanic tremor on noise-based measurements of temporal velocity changes at Hawaiian volcanoes

NASA Astrophysics Data System (ADS)

Ballmer, S.; Wolfe, C. J.; Okubo, P.; Haney, M. M.; Thurber, C. H.

2011-12-01

Green's functions calculated with ambient seismic noise may aid in volcano research and monitoring. The continuous character of ambient seismic noise and hence of the reconstructed Green's functions has enabled measurements of short-term (~days) temporal perturbations in seismic velocities. Very small but clear velocity decreases prior to some volcanic eruptions have been documented and motivate our present study. We apply this method to Hawaiian volcanoes using data from the USGS Hawaiian Volcano Observatory (HVO) seismic network. In order to obtain geologically relevant and reliable results, stable Green's functions need to be recovered from the ambient noise. Station timing problems, changes in noise source directivity, as well as changes in the source's spectral content are known biases that critically affect the Green's functions' stability and hence need to be considered. Here we show that volcanic tremor is a potential additional bias. During the time period of our study (2007-present), we find that volcanic tremor is a common feature in the HVO seismic data. Pu'u O'o tremor is continuously present before a dike intrusion into Kilauea's east rift zone in June 2007 and Halema'uma'u tremor occurs before and during resumed Kilauea summit activity from early 2008 and onward. For the frequency band considered (0.1-0.9 Hz), we find that these active tremor sources can drastically modify the recovered Green's functions for station pairs on the entire island at higher (> 0.5 Hz) frequencies, although the effect of tremor appears diminished at lower frequencies. In this presentation, we perform measurements of temporal velocity changes using ambient noise Green's functions and explore how volcanic tremor affects the results. Careful quality assessment of reconstructed Green's functions appears to be essential for the desired high precision measurements.

Thalamic DBS with a constant-current device in essential tremor: A controlled clinical trial.

PubMed

Wharen, Robert E; Okun, Michael S; Guthrie, Barton L; Uitti, Ryan J; Larson, Paul; Foote, Kelly; Walker, Harrison; Marshall, Frederick J; Schwalb, Jason; Ford, Blair; Jankovic, Joseph; Simpson, Richard; Dashtipour, Khashayar; Phibbs, Fenna; Neimat, Joseph S; Stewart, R Malcolm; Peichel, DeLea; Pahwa, Rajesh; Ostrem, Jill L

2017-07-01

This study of thalamic deep brain stimulation (DBS) investigated whether a novel constant-current device improves tremor and activities of daily living (ADL) in patients with essential tremor (ET). A prospective, controlled, multicenter study was conducted at 12 academic centers. We investigated the safety and efficacy of unilateral and bilateral constant-current DBS of the ventralis intermedius (VIM) nucleus of the thalamus in patients with essential tremor whose tremor was inadequately controlled by medications. The primary outcome measure was a rater-blinded assessment of the change in the target limb tremor score in the stimulation-on versus stimulation-off state six months following surgery. Multiple secondary outcomes were assessed at one-year follow-up, including motor, mood, and quality-of-life measures. 127 patients were implanted with VIM DBS. The blinded, primary outcome variable (n = 76) revealed a mean improvement of 1.25 ± 1.26 points in the target limb tremor rating scale (TRS) score in the arm contralateral to DBS (p < 0.001). Secondary outcome variables at one year revealed significant improvements (p ≤ 0.001) in quality of life, depression symptoms, and ADL scores. Forty-seven patients had a second contralateral VIM-DBS, and this group demonstrated reduction in second-sided tremor at 180 days (p < 0.001). Serious adverse events related to the surgery included infection (n = 3), intracranial hemorrhage (n = 3), and device explantation (n = 3). Unilateral and bilateral constant-current VIM DBS significantly improves upper extremity tremor, ADL, quality of life, and depression in patients with severe ET. Copyright © 2017 Elsevier Ltd. All rights reserved.

Autosomal dominant cortical tremor, myoclonus and epilepsy.

PubMed

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.

Tremor reveals stress shadowing, deep postseismic creep, and depth-dependent slip recurrence on the lower-crustal San Andreas fault near Parkfield

USGS Publications Warehouse

Shelly, David R.; Johnson, Kaj M.

2011-01-01

The 2003 magnitude 6.5 San Simeon and the 2004 magnitude 6.0 Parkfield earthquakes induced small, but significant, static stress changes in the lower crust on the central San Andreas fault, where recently detected tectonic tremor sources provide new constraints on deep fault creep processes. We find that these earthquakes affect tremor rates very differently, consistent with their differing transferred static shear stresses. The San Simeon event appears to have cast a "stress shadow" north of Parkfield, where tremor activity was stifled for 3-6 weeks. In contrast, the 2004 Parkfield earthquake dramatically increased tremor activity rates both north and south of Parkfield, allowing us to track deep postseismic slip. Following this event, rates initially increased by up to two orders of magnitude for the relatively shallow tremor sources closest to the rupture, with activity in some sources persisting above background rates for more than a year. We also observe strong depth dependence in tremor recurrence patterns, with shallower sources generally exhibiting larger, less-frequent bursts, possibly signaling a transition toward steady creep with increasing temperature and depth. Copyright 2011 by the American Geophysical Union.

Fragile X-associated tremor/ataxia syndrome.

PubMed

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.

Local vibration inhibits H-reflex but does not compromise manual dexterity and does not increase tremor.

PubMed

Budini, Francesco; Laudani, Luca; Bernardini, Sergio; Macaluso, Andrea

2017-10-01

The present work aimed at investigating the effects of local vibration on upper limb postural and kinetic tremor, on manual dexterity and on spinal reflex excitability. Previous studies have demonstrated a decrease in spinal reflex excitability and in force fluctuations in the lower limb but an increase in force fluctuation in the upper limbs. As hand steadiness is of vital importance in many daily-based tasks, and local vibration may also be applied in movement disorders, we decided to further explore this phenomenon. Ten healthy volunteers (26±3years) were tested for H reflex, postural and kinetic tremor and manual dexterity through a Purdue test. EMG was recorded from flexor carpi radialis (FCR) and extensor digitorum communis (EDC). Measurements were repeated at baseline, after a control period during which no vibration was delivered and after vibration. Intervention consisted in holding for two minutes a vibrating handle (frequency 75Hz, displacement∼7mm), control consisted in holding for two minutes the same handle powered off. Reflex excitability decreased after vibration whilst postural tremor and manual dexterity were not affected. Peak kinetic tremor frequency increased from baseline to control measurements (P=0.002). Co-activation EDC/FCR increased from control to vibration (P=0.021). These results show that two minutes local vibration lead to a decrease in spinal excitability, did not compromise manual dexterity and did not increase tremor; however, in contrast with expectations, tremor did not decrease. It is suggested that vibration activated several mechanisms with opposite effects, which resulted in a neutral outcome on postural and kinetic tremor. Copyright © 2017 Elsevier B.V. All rights reserved.

Treatment of lithium induced tremor with atenolol.

PubMed

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.

Investigation of Potential Triggered Tremor in Latin America and the Caribbean

NASA Astrophysics Data System (ADS)

Gonzalez-Huizar, H.; Velasco, A. A.; Peng, Z.

2012-12-01

Recent observations have shown that seismic waves generate transient stresses capable of triggering earthquakes and tectonic (or non-volcanic) tremor far away from the original earthquake source. However, the mechanisms behind remotely triggered seismicity still remain unclear. Triggered tremor signals can be particularly useful in investigating remote triggering processes, since in many cases, the tremor pulses are very clearly modulated by the passing surface waves. The temporal stress changes (magnitude and orientation) caused by seismic waves at the tremor source region can be calculated and correlated with tremor pulses, which allows for exploring the stresses involved in the triggering process. Some observations suggest that triggered and ambient tremor signals are generated under similar physical conditions; thus, investigating triggered tremor might also provide important clues on how and under what conditions ambient tremor signals generate. In this work we present some of the results and techniques we employ in the research of potential cases of triggered tectonic tremor in Latin America and the Caribbean. This investigation includes: (1) the triggered tremor detection, with the use of specific signal filters; (2) localization of the sources, using uncommon techniques like time reversal signals; (3) and the analysis of the stress conditions under which they are generated, by modeling the triggering waves related dynamic stress. Our results suggest that tremor can be dynamically triggered by both Love and Rayleigh waves and in broad variety of tectonic environments depending strongly on the dynamic stress amplitude and orientation. Investigating remotely triggered seismicity offers the opportunity to improve our knowledge about deformation mechanisms and the physics of rupture.

Infrasonic tremor observed at Kilauea Volcano, Hawaii'i

USGS Publications Warehouse

Garces, M.; Harris, A.; Hetzer, C.; Johnson, J.; Rowland, S.; Marchetti, E.; Okubo, P.

2003-01-01

Infrasonic array data collected at Ki??lauea Volcano, Hawai'i, during November 12-21, 2002 indicate that the active vents and lava tube system near the P'u 'O??'o?? vent complex emit almost continuous infrasound in the 0.310 Hz frequency band. The spectral content of these infrasonic signals matches well that of synchronous seismic tremor. In sites protected from wind noise, significant signal to noise ratios were recorded as far as ???13 km from the crater of Pu'u 'O??'o??. The infrasonic recordings suggest that one or more tremor sources may be close to the surface. In addition, these results demonstrate that adequate site and instrument selections for infrasonic arrays are essential in order to obtain consistent and reliable infrasonic detections. ?? 2003 by the American Geophysical Union.

Broadband Array Analysis of the 2005 Episodic Tremor and Slip Event in Northern Cascadia

NASA Astrophysics Data System (ADS)

Wech, A.; Creager, K.; McCausland, W.; Frassetto, A.; Qamar, A.; Derosier, S.; Carmichael, J.; Malone, S.; Johnson, D.

2005-12-01

The region of Cascadia from the Olympic Mountains through southern Vancouver Island and down-dip of the subduction megathrust has repeatedly experienced episodes of slow slip. This episodic slip, which has been observed to take place over a period of two to several weeks, is accompanied by a seismic tremor signal. Based on the average recurrence interval of 14 months, the next episodic tremor and slip (ETS) event should occur within six weeks of mid-September, 2005. Indeed, it appears to have begun on September 3, as this abstract was being written. In order to record this anticipated event, we deployed an array of 11 three-component seismometers on the northern side of the Olympic Peninsula augmenting Pacific Northwest Seismographic Network stations as well as the first few EarthScope BigFoot stations and Plate Boundary Observatory borehole seismometers. This seismic array was comprised of six short-period and five broadband instruments with spacings of 500 m and 2200 m respectively. In conjunction with this Earthscope seismic deployment, we also installed a dense network of 29 temporary, continuous GPS stations across the entire Olympic Peninsula to integrate seismic and geodetic observations. One of the primary goals of this research is to utilize the broadband instrumentation in the array to investigate the possible correlation of low frequency energy with the rest of the tremor activity. ETS has been carefully investigated at high-frequency (seismic tremor at 2-6 Hz) and very low-frequency (slip occurring over weeks, observed by GPS). An important goal of this experiment is to investigate the possibility that the tremor generates intermediate, low-frequency signals. Preliminary analysis of short-period array recordings of the July, 2004 ETS event suggests that the tremor displays signs of lower-frequency energy (~0.5 Hz) correlated with its higher frequency activity. Our array should enable us to distinguish low- frequency signals originating in the direction

Repeating Earthquake and Nonvolcanic Tremor Observations of Aseismic Deep Fault Transients in Central California.

NASA Astrophysics Data System (ADS)

Nadeau, R. M.; Traer, M.; Guilhem, A.

2005-12-01

Seismic indicators of fault zone deformation can complement geodetic measurements by providing information on aseismic transient deformation: 1) from deep within the fault zone, 2) on a regional scale, 3) with intermediate temporal resolution (weeks to months) and 4) that spans over 2 decades (1984 to early 2005), including pre- GPS and INSAR coverage. Along the San Andreas Fault (SAF) in central California, two types of seismic indicators are proving to be particularly useful for providing information on deep fault zone deformation. The first, characteristically repeating microearthquakes, provide long-term coverage (decades) on the evolution of aseismic fault slip rates at seismogenic depths along a large (~175 km) stretch of the SAF between the rupture zones of the ~M8 1906 San Francisco and 1857 Fort Tejon earthquakes. In Cascadia and Japan the second type of seismic indicator, nonvolcanic tremors, have shown a remarkable correlation between their activity rates and GPS and tiltmeter measurements of transient deformation in the deep (sub-seismogenic) fault zone. This correlation suggests that tremor rate changes and deep transient deformation are intimately related and that deformation associated with the tremor activity may be stressing the seismogenic zone in both areas. Along the SAF, nonvolcanic tremors have only recently been discovered (i.e., in the Parkfield-Cholame area), and knowledge of their full spatial extent is still relatively limited. Nonetheless the observed temporal correlation between earthquake and tremor activity in this area is consistent with a model in which sub-seismogenic deformation and seismogenic zone stress changes are closely related. We present observations of deep aseismic transient deformation associated with the 28 September 2004, M6 Parkfield earthquake from both repeating earthquake and nonvolcanic tremor data. Also presented are updated deep fault slip rate estimates from prepeating quakes in the San Juan Bautista area with

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

PubMed

Moraes, Bruno Teixeira de; Biase, Noemi Grigoletto de

2016-01-01

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

Brittle and ductile friction and the physics of tectonic tremor

USGS Publications Warehouse

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.

PubMed

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.

Blood Harmane, Blood Lead, and Severity of Hand Tremor: Evidence of Additive Effects

PubMed Central

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

2010-01-01

Background 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. Objectives We tested the hypothesis that tremor would be particularly severe among individuals who had high blood concentrations of both of these toxicants. Methods 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. Results The total tremor score ranged from 0 – 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). Conclusions 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. PMID:21145352

Differences in postural tremor dynamics with age and neurological disease.

PubMed

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

USGS Publications Warehouse

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.

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

USGS Publications Warehouse

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

2011-01-01

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

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

NASA Astrophysics Data System (ADS)

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.

Array observations and analyses of Cascadia deep tremor

NASA Astrophysics Data System (ADS)

McCausland, W. A.; Malone, S.; Creager, K.; Crosson, R.; La Rocca, M.; Saccoretti, G.

2004-12-01

The July 8-24, 2004 Cascadia Episodic Tremor and Slip (ETS) event was observed using three small aperture seismic arrays located near Sooke, BC, Sequim, WA, and on Lopez Island, WA. Initial tremor burst epicenters located in the Strait of Juan de Fuca and were calculated using the relative arrivals of band-passed, rectified regional network signals. Most subsequent epicenters migrated to the northwest along Vancouver Island and a few occurred in the central to southern Puget Sound. Tremor bursts lasting on the order of a few seconds can be identified across the stations of any of the three arrays. Individual bursts from distinct back-azimuths often occur within five seconds of each other, indicating the presence of spatially distributed but near simultaneous tremor. None of this was visible at such a fine scale using Pacific Northwest Seismograph Network (PNSN). Several array processing techniques, including beam-forming, zero-lag cross correlation and multiple signal classification (MUSIC), are being investigated to determine the optimal technique for exploring the temporal and spatial evolution of the tremor signals during the whole ETS. The back-azimuth and slowness of consecutive time windows for a one half-hour period of strong tremor were calculated using beam-forming with a linear stack, with an nth-root stack, and using zero-lag cross-correlation. Results for each array and each method yield consistent estimates of back azimuth and slowness. Beam-forming with a nonlinear stack produces results similar to the linear case but with larger uncertainty. Among the arrays, the back-azimuths give a reasonable estimate of the tremor epicenter that is consistent with the network determined epicentral locations.

Vocal Tremor Analysis with the Vocal Demodulator.

ERIC Educational Resources Information Center

Winholtz, William S.; Ramig, Lorraine Olson

1992-01-01

This paper describes the Vocal Demodulator as a new device for analysis of vocal tremor. The Vocal Demodulator produces amplitude-demodulated and frequency-demodulated outputs and measures the frequency and level of low-frequency tremor components in sustained phonation. The paper describes quantification of the demodulation process, validation…

Analysis of dystonic tremor in musicians using empirical mode decomposition.

PubMed

Lee, A; Schoonderwaldt, E; Chadde, M; Altenmüller, E

2015-01-01

Test the hypotheses that tremor amplitude in musicians with task-specific dystonia is higher at the affected finger (dystonic tremor, DT) or the adjacent finger (tremor associated with dystonia, TAD) than (1) in matched fingers of healthy musicians and non-musicians and (2) within patients in the unaffected and non-adjacent fingers of the affected side within patients. We measured 21 patients, 21 healthy musicians and 24 non-musicians. Participants exerted a flexion-extension movement. Instantaneous frequency and amplitude values were obtained with empirical mode decomposition and a Hilbert-transform, allowing to compare tremor amplitudes throughout the movement at various frequency ranges. We did not find a significant difference in tremor amplitude between patients and controls for either DT or TAD. Neither differed tremor amplitude in the within-patient comparisons. Both hypotheses were rejected and apparently neither DT nor TAD occur in musician's dystonia of the fingers. This is the first study assessing DT and TAD in musician's dystonia. Our finding suggests that even though MD is an excellent model for malplasticity due to excessive practice, it does not seem to provide a good model for DT. Rather it seems that musician's dystonia may manifest itself either as dystonic cramping without tremor or as task-specific tremor without overt dystonic cramping. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2017-12-01

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

[Evaluating the electrophysiological features of tremor in Parkinson's disease and essential tremor using accelerometry].

PubMed

Xu, C Y; Yin, H M; Zhang, B R

2016-11-08

Objective: To investigate the electrophysiological features of tremor intensity, frequency and frequency dispersion of Parkinsonian (PT group) and essential (ET group) tremors using accelerometry. Methods: The amplitude, frequency and frequency dispersion of rest tremor, postural tremor and the influence of weight on tremor of 35 PT patients and 40 ET patients in Department of Neurology, the Second Affiliated Hospital Zhejiang University School of Medicine from May 2015 to April 2016 were retrospectively analyzed and compared. Data of the more and less trembling hands were statistically elaborated. Results: In resting, postural and loading states, PT amplitudes of the less affected hand were smaller than the more affected one. The less affected hand were (147±32), (142±36), (157±40)μV, the more affected hand were (185±41), (164±29), (190±33)μV, respectively; ET amplitudes of the less affected hand were also smaller than the more affected one, and the less affected hand were (149±33), (157±33), (169±43)μV, the more affected hand were (176±39), (189±39), (213±36)μV, respectively; PT frequencies of the less affected hand were faster than the more affected one, with the less affected hand (6.1±1.1), (6.4±1.7), (6.5±2.0)Hz, the more affected hand (5.4±1.3), (5.5±1.1), (5.7±1.1)Hz, respectively, but ET frequencies of the less affected hand were similar to the more affected one, with the less affected hand (6.5±1.3), (7.0±1.2), (7.2±1.5)Hz, the more affected hand (7.0±1.0), (7.3±1.0), (7.6±1.1)Hz, respectively; in resting and postural states, PT frequency dispersions of the less affected hand were broader than the more affected one, the less affected hand were (2.1±0.6), (2.4±1.1)Hz, respectively; the more affected hand were (1.6±0.8), (1.7±0.9)Hz, respectively. But in loading state, PT frequency dispersions were similar in both sides (2.3±1.2, 2.2±1.1)Hz; In resting, postural and loading states, ET frequency dispersions were also similar

Maximal force and tremor changes across the menstrual cycle.

PubMed

Tenan, Matthew S; Hackney, Anthony C; Griffin, Lisa

2016-01-01

Sex hormones have profound effects on the nervous system in vitro and in vivo. The present study examines the effect of the menstrual cycle on maximal isometric force (MVC) and tremor during an endurance task. Nine eumenorrheic females participated in five study visits across their menstrual cycle. In each menstrual phase, an MVC and an endurance task to failure were performed. Tremor across the endurance task was quantified as the coefficient of variation in force and was assessed in absolute time and relative percent time to task failure. MVC decreases 23% from ovulation to the mid luteal phase of the menstrual cycle. In absolute time, the mid luteal phase has the highest initial tremor, though the early follicular phase has substantially higher tremor than other phases after 150 s of task performance. In relative time, the mid luteal phase has the highest level of tremor throughout the endurance task. Both MVC and tremor during an endurance task are modified by the menstrual cycle. Performance of tasks and sports which require high force and steadiness to exhaustion may be decreased in the mid luteal phase compared to other menstrual phases.

Analyzing the continuous volcanic tremors detected during the 2015 phreatic eruption of the Hakone volcano

NASA Astrophysics Data System (ADS)

Yukutake, Yohei; Honda, Ryou; Harada, Masatake; Doke, Ryosuke; Saito, Tatsuhiko; Ueno, Tomotake; Sakai, Shin'ichi; Morita, Yuichi

2017-12-01

In the present study, we analyze the seismic signals from a continuous volcanic tremor that occurred during a small phreatic eruption of the Hakone volcano, in the Owakudani geothermal region of central Japan, on June 29, 2015. The signals were detected for 2 days, from June 29 to July 1, at stations near the vents. The frequency component of the volcanic tremors showed a broad peak within 1-6 Hz. The characteristics of the frequency component did not vary with time and were independent of the amplitude of the tremor. The largest amplitude was observed at the end of the tremor activity, 2 days after the onset of the eruption. We estimated the location of the source using a cross-correlation analysis of waveform envelopes. The locations of volcanic tremors are determined near the vents of eruption and the surface, with the area of the upper extent of an open crack estimated using changes in the tilt. The duration-amplitude distribution of the volcanic tremor was consistent with the exponential scaling law rather than the power law, suggesting a scale-bound source process. This result suggests that the volcanic tremor originated from a similar physical process occurring practically in the same place. The increment of the tremor amplitude was coincident with the occurrence of impulsive infrasonic waves and vent formations. High-amplitude seismic phases were observed prior to the infrasonic onsets. The time difference between the seismic and infrasonic onsets can be explained assuming a common source located at the vent. This result suggests that both seismic and infrasonic waves are generated when a gas slug bursts at that location. The frequency components of the seismic phases observed just before the infrasonic onset were generally consistent with those of the tremor signals without infrasonic waves. The burst of a gas slug at the surface vent may be a reasonable model for the generation mechanism of the volcanic tremor and the occurrence of impulsive infrasonic

Tremor in the tension developed isometrically by soleus during the tonic vibration reflex in the decerebrate cat.

PubMed Central

Cussons, P D; Matthews, P B; Muir, R B

1979-01-01

1. Irregularities in the development of tension during the tonic vibration reflex of the soleus muscle of the decerebrate cat have been analysed into their frequency components. The reflex was recorded isometrically and elicited by longitudinal vibration, normally at 150 Hz. The amplitude of vibration was set so as to elicit a maximal reflex response, suggesting 1:1 driving of the majority of the Ia afferents at the frequency of vibration. 2. The resulting power spectrum regularly showed a well marked tremor peak separated by a trough from any slow irregularities. The predominant frequency of this tremor varied from 4 to 11 Hz in different preparations, with a mean of 7.4 Hz; on average, frequencies within 1.7 Hz on either side contained over half the power of the predominant frequency. Altering the frequency of vibration did not alter the distribution of tremor frequencies. 3. The root mean square value of the tension irregularities, over the range 4-14 Hz, varied from 12 to 110 mN in different preparations (median value, 23 mN); this was superimposed on mean active reflex tensions varying from 2 to 10 N. 4. The 'tremor' due to a single motor unit was estimated from spectral analysis of tetanic contractions of the whole muscle and decreased with increasing frequency of activation. Comparison of the single unit values with the tremor seen during vibration in the same preparations showed that equivalent amounts of tremor to the latter could typically have been produced by the continued synchronous contraction of about five 'average' motor units firing at the predominant tremor frequency. 5. When a tonic stretch reflex was present its tremor frequencies did not differ consistently from those of the tonic vibration reflex. On average, the tremor was smaller for the stretch reflex than for the tonic vibration reflex; the difference was usually slight and might have been related to the stretch refex tension being smaller. 6. Evidence was obtained that the tremor was not

IgM-monoclonal gammopathy neuropathy and tremor: A first epidemiologic case control study

PubMed Central

Ahlskog, Matthew C.; Kumar, Neeraj; Mauermann, Michelle L.; Klein, Christopher J.

2012-01-01

Introduction Small case series suggest tremor occurs frequently in IgM-monoclonal gammopathy of undetermined significance (IgM-MGUS) neuropathy. Epidemiologic study to confirm this association is lacking. Whether the neuropathy or another remote IgM-effect is causal remains unsettled. Materials and methods An IgM-MGUS neuropathy case cohort (n=207) was compared to age, gender, and neuropathy impairment score (NIS) matched, other-cause neuropathy controls (n=414). Tremor details were extracted from structured neurologic evaluation. All patients underwent nerve conductions. Results Tremor occurrence was significantly higher in IgM-MGUS case cohort (29%) than in control cohort (9.2%) (p=0.001). In IgM-MGUS cases, tremor was associated with worse NIS (p=0.025) and demyelinating nerve conductions (p=0.020), but 11 of 60 (18%) IgM-MGUS cases with tremor had axonal neuropathy. In other-cause neuropathy controls, tremor was associated with axonal nerve conductions (p=0.03) but not with NIS severity (p=0.57). Tremor occurrence associated with older age in controls, (p=0.004) but not in IgM-MGUS cases (p=0.272). Most IgM-MGUS tremor cases (49/60) had a postural-kinetic tremor, 8 had rest tremor, 3 had mixed rest-action. Alternative causes of tremor was identified in 42% of IgM-MGUS cases, the most common type is inherited essential tremor 6/60 (p=0.04). Conclusions This first epidemiologic case-control study validates association between IgM-MGUS neuropathy and tremor. Among IgM-MGUS neuropathy cases, severity as well as type of neuropathy (demyelinating over axonal) correlated with tremor occurrence. IgM-MGUS paraproteinemia may increase tremor expression in persons recognized with common other risk factors for tremor. PMID:22475624

Envisioning the Handheld-Centric Classroom

ERIC Educational Resources Information Center

Norris, Cathleen; Soloway, Elliot

2004-01-01

While appropriate as an initial focus, it is time that the educational community move beyond an emphasis on 1:1 computing (each child having his/her own personal computer) to a vision of a handheld-centric classroom, where each child not only has his/her own personal, handheld computer, but also has access to networked PCs, probeware, digital…

Proposing a Parkinson's disease-specific tremor scale from the MDS-UPDRS.

PubMed

Forjaz, Maria João; Ayala, Alba; Testa, Claudia M; Bain, Peter G; Elble, Rodger; Haubenberger, Dietrich; Rodriguez-Blazquez, Carmen; Deuschl, Günther; Martinez-Martin, Pablo

2015-07-01

This article proposes an International Parkinson and Movement Disorder Society (MDS)-UPDRS tremor-based scale and describes its measurement properties, with a view to developing an improved scale for assessing tremor in Parkinson's disease (PD). This was a cross-sectional, multicenter study of 435 PD patients. Rasch analysis was performed on the 11 MDS-UPDRS tremor items. Construct validity, precision, and test-retest reliability were also analyzed. After some modifications, which included removal of an item owing to redundancy, the obtained MDS-UPDRS tremor scale showed moderate reliability, unidimensionality, absence of differential item functioning, satisfactory convergent validity with medication, and better precision than the raw sum score. However, the scale displayed a floor effect and a need for more items measuring lower levels of tremor. The MDS-UPDRS tremor scale provides linear scores that can be used to assess tremor in PD in a valid, reliable way. The scale might benefit from modifications and studies that analyze its responsiveness. © 2015 International Parkinson and Movement Disorder Society.

Long-term effects of handheld cell phone laws on driver handheld cell phone use.

PubMed

McCartt, Anne T; Hellinga, Laurie A; Strouse, Laura M; Farmer, Charles M

2010-04-01

As of October 2009, seven U.S. states and the District of Columbia (D.C.) ban driving while talking on a handheld cell phone. Long-term effects on driver handheld phone use in D.C., New York State, and Connecticut were examined. The percentage of drivers talking on handheld cell phones was measured over time with daytime observation surveys in the jurisdictions with bans and comparison jurisdictions without bans. Trends were modeled using Poisson regression to estimate differences between actual rates and rates that would have been expected without a ban. The D.C. ban immediately lowered the percentage of drivers talking on handheld cell phones by 41 percent. Nearly 5 years later, the rate was 43 percent lower than would have been expected without the ban. Use in Connecticut declined 76 percent immediately after the ban; 3.5 years later, use was 65 percent lower than would have been expected without the ban. In New York, use declined 47 percent immediately after the ban; 7 years later, use was 24 percent lower than expected without the ban. Fifteen months after the laws took effect, compliance in New York was lower than in D.C., and the difference appeared due to more intensive enforcement in D.C. However, this linkage is no longer clear because enforcement in New York picked up such that 2008 levels of enforcement appeared comparable in D.C. and New York, whereas enforcement in Connecticut lagged behind. In all three jurisdictions, the chance that a violator would receive a citation was low, and there were no publicized targeted enforcement campaigns. Jurisdictional bans have reduced handheld phone use and appear capable of maintaining reductions for the long term. However, it is unknown whether overall phone use is lower because many drivers may have switched to hands-free devices. Further research is needed to determine whether reduced handheld cell phone use has reduced crashes.

The effect of cannabis on tremor in patients with multiple sclerosis.

PubMed

Fox, P; Bain, P G; Glickman, S; Carroll, C; Zajicek, J

2004-04-13

Disabling tremor is common in patients with multiple sclerosis (MS). Data from animal model experiments and subjective and small objective studies involving patients suggest that cannabis may be an effective treatment for tremor associated with MS. To our knowledge, there are no published double-blind randomized controlled trials of cannabis as a treatment for tremor in MS patients. The authors conducted a randomized double-blind placebo-controlled crossover trial to examine the effect of oral cannador (cannabis extract) on 14 patients with MS with upper limb tremors. There were eight women and six men, with a mean age of 45 years and mean Expanded Disability Status Scale score of 6.25. Patients were randomly assigned to receive each treatment and the doses escalated over a 2-week period before each assessment. The primary outcome was change on a tremor index, measured using a validated tremor rating scale. The study was powered to detect a functionally significant 50% improvement in the tremor index. Secondary outcomes included accelerometry, an ataxia scale, spiral drawing, finger tapping, and nine-hole pegboard test performance. Analysis of the data showed no significant improvement in any of the objective measures of upper limb tremor with cannabis extract compared to placebo. Finger tapping was faster on placebo compared to cannabis extract (p < 0.02). However, there was a nonsignificant trend for patients to experience more subjective relief from their tremors while on cannabis extract compared to placebo. Cannabis extract does not produce a functionally significant improvement in MS-associated tremor.

Contrasts in the Behavior of Tremor Episodes in Cascadia and Japan

NASA Astrophysics Data System (ADS)

Armbruster, J. G.

2016-12-01

Tectonic tremor is observed in episodes with varying duration, intensity and spatial extent. In Cascadia the POLARIS broadband deployment, 2003-2006, provides good coverage of the southern Vancouver Island region with strong, widely distributed tremor sources extending 100 km along the plate interface. There the tremor can be classified into major episodes occurring at 14 month intervals with duration 20-30 days and minor episodes lasting hours to 10 days. Within that shorter duration minor episodes can produce strong signals. There is a clear pattern that minor episodes are located at the deeper part of the plate interface, 43-50 km deep. Major episodes are mostly generated from the shallower, 33-43 km deep, portion of the plate interface with some activation of the deeper sources. This suggests a simple mechanism of stress loading from below, transmitted upward by the tremor/slow-slip episodes. We compare this to the northern Kii Peninsula region of southwest Japan which has strong tremor sources extending 100 km along strike covered by HINET stations and find differences. The spectrum of episode durations in Japan, from less than an hour to 13 days, are not easily classified into major and minor. The range in depth observed in Japan is narrower than in Cascadia, 34-45 km for 98% of the clustered events. Here we divide the episodes into three groups based on their spatial extent. Large episodes occur at intervals of 6 months and occupy the southern 2/3, northern 2/3 or whole of the 100 km long zone. The small episodes are predominately seen from paired sources at the top and bottom of the active zone located where large episodes terminate. Intermediate episodes are the fewest in number and extend from the bottom to the top, often encompassing pairs of small sources. The observations in Japan will require a more complex model of stress loading. These results were achieved with the cross-station location method. The envelope location method might not have

The association between handheld phone bans and the prevalence of handheld phone conversations among young drivers in the United States.

PubMed

Zhu, Motao; Rudisill, Toni M; Heeringa, Steven; Swedler, David; Redelmeier, Donald A

2016-12-01

Fourteen US states and the District of Columbia have banned handheld phone use for all drivers. We examined whether such legislation was associated with reduced handheld phone conversations among drivers aged younger than 25 years. Data from the 2008 to 2013 National Occupant Protection Use Survey were merged with states' legislation. The outcome was roadside-observed handheld phone conversation at stop signs or lights. Logistic regression was used. A total of 32,784 young drivers were observed. Relative to drivers who were observed in states without a universal handheld phone ban, the adjusted odds ratio of phone conversation was 0.42 (95% confidence interval, 0.33-0.53) for drivers who were observed in states with bans. The relative reduction in phone conversation was 46% (23%, 61%) for laws that were effective less than 1 year, 55% (32%, 70%) for 1-2 years, 63% (51%, 72%) for 2 years or more, relative to no laws. Universal handheld phone bans may be effective at reducing handheld phone use among young drivers. Copyright © 2016 Elsevier Inc. All rights reserved.

Tremor in X-linked recessive spinal and bulbar muscular atrophy (Kennedy's disease).

PubMed

Dias, Francisco A; Munhoz, Renato P; Raskin, Salmo; Werneck, Lineu César; Teive, Hélio A G

2011-01-01

To study tremor in patients with X-linked recessive spinobulbar muscular atrophy or Kennedy's disease. Ten patients (from 7 families) with a genetic diagnosis of Kennedy's disease were screened for the presence of tremor using a standardized clinical protocol and followed up at a neurology outpatient clinic. All index patients were genotyped and showed an expanded allele in the androgen receptor gene. Mean patient age was 37.6 years and mean number of CAG repeats 47 (44-53). Tremor was present in 8 (80%) patients and was predominantly postural hand tremor. Alcohol responsiveness was detected in 7 (88%) patients with tremor, who all responded well to treatment with a β-blocker (propranolol). Tremor is a common feature in patients with Kennedy's disease and has characteristics similar to those of essential tremor.

Octanoic acid in alcohol-responsive essential tremor

PubMed Central

McCrossin, Gayle; Lungu, Codrin; Considine, Elaine; Toro, Camilo; Nahab, Fatta B.; Auh, Sungyoung; Buchwald, Peter; Grimes, George J.; Starling, Judith; Potti, Gopal; Scheider, Linda; Kalowitz, Daniel; Bowen, Daniel; Carnie, Andrea; Hallett, Mark

2013-01-01

Objective: To assess safety and efficacy of an oral, single, low dose of octanoic acid (OA) in subjects with alcohol-responsive essential tremor (ET). Methods: We conducted a double-blind, placebo-controlled, crossover, phase I/II clinical trial evaluating the effect of 4 mg/kg OA in 19 subjects with ET. The primary outcome was accelerometric postural tremor power of the dominant hand 80 minutes after administration. Secondary outcomes included digital spiral analysis, pharmacokinetic sampling, as well as safety measures. Results: OA was safe and well tolerated. Nonserious adverse events were mild (Common Terminology Criteria for Adverse Events grade 1) and equally present after OA and placebo. At the primary outcome, OA effects were not different from placebo. Secondary outcome analyses of digital spiral analysis, comparison across the entire time course in weighted and nonweighted accelerometry, as well as nondominant hand tremor power did not show a benefit of OA over placebo. The analysis of individual time points showed that OA improved tremor at 300 minutes (dominant hand, F1,16 = 5.49, p = 0.032 vs placebo), with a maximum benefit at 180 minutes after OA (both hands, F1,16 = 6.1, p = 0.025). Conclusions: Although the effects of OA and placebo at the primary outcome were not different, secondary outcome measures suggest superiority of OA in reducing tremor at later time points, warranting further trials at higher dose levels. Classification of evidence: This study provides Class I evidence that a single 4-mg/kg dose of OA is not effective in reducing postural tremor in patients with ET at a primary outcome of 80 minutes, but is effective for a secondary outcome after 180 minutes. PMID:23408867

Listener Perception of Respiratory-Induced Voice Tremor

ERIC Educational Resources Information Center

Farinella, Kimberly A.; Hixon, Thomas J.; Hoit, Jeannette D.; Story, Brad H.; Jones, Patricia A.

2006-01-01

Purpose: The purpose of this study was to determine the relation of respiratory oscillation to the perception of voice tremor. Method: Forced oscillation of the respiratory system was used to simulate variations in alveolar pressure such as are characteristic of voice tremor of respiratory origin. Five healthy men served as speakers, and 6…

Deep brain stimulation for the treatment of uncommon tremor syndromes

PubMed Central

Ramirez-Zamora, Adolfo; Okun, Michael S.

2016-01-01

ABSTRACT Introduction: Deep brain stimulation (DBS) has become a standard therapy for the treatment of select cases of medication refractory essential tremor and Parkinson’s disease however the effectiveness and long-term outcomes of DBS in other uncommon and complex tremor syndromes has not been well established. Traditionally, the ventralis intermedius nucleus (VIM) of the thalamus has been considered the main target for medically intractable tremors; however alternative brain regions and improvements in stereotactic techniques and hardware may soon change the horizon for treatment of complex tremors. Areas covered: In this article, we conducted a PubMed search using different combinations between the terms ‘Uncommon tremors’, ‘Dystonic tremor’, ‘Holmes tremor’ ‘Midbrain tremor’, ‘Rubral tremor’, ‘Cerebellar tremor’, ‘outflow tremor’, ‘Multiple Sclerosis tremor’, ‘Post-traumatic tremor’, ‘Neuropathic tremor’, and ‘Deep Brain Stimulation/DBS’. Additionally, we examined and summarized the current state of evolving interventions for treatment of complex tremor syndromes. Expert c ommentary: Recently reported interventions for rare tremors include stimulation of the posterior subthalamic area, globus pallidus internus, ventralis oralis anterior/posterior thalamic subnuclei, and the use of dual lead stimulation in one or more of these targets. Treatment should be individualized and dictated by tremor phenomenology and associated clinical features. PMID:27228280

Handheld, point-of-care laser speckle imaging

PubMed Central

Farraro, Ryan; Fathi, Omid; Choi, Bernard

2016-01-01

Abstract. Laser speckle imaging (LSI) enables measurement of relative changes in blood flow in biological tissues. We postulate that a point-of-care form factor will lower barriers to routine clinical use of LSI. Here, we describe a first-generation handheld LSI device based on a tablet computer. The coefficient of variation of speckle contrast was <2% after averaging imaging data collected over an acquisition period of 5.3 s. With a single, experienced user, handheld motion artifacts had a negligible effect on data collection. With operation by multiple users, we did not identify any significant difference (p>0.05) between the measured speckle contrast values using either a handheld or mounted configuration. In vivo data collected during occlusion experiments demonstrate that a handheld LSI is capable of both quantitative and qualitative assessment of changes in blood flow. Finally, as a practical application of handheld LSI, we collected data from a 53-day-old neonate with confirmed compromised blood flow in the hand. We readily identified with LSI a region of diminished blood flow in the thumb of the affected hand. Our data collectively suggest that handheld LSI is a promising technique to enable clinicians to obtain point-of-care measurements of blood flow. PMID:27579578

Handheld, point-of-care laser speckle imaging

NASA Astrophysics Data System (ADS)

Farraro, Ryan; Fathi, Omid; Choi, Bernard

2016-09-01

Laser speckle imaging (LSI) enables measurement of relative changes in blood flow in biological tissues. We postulate that a point-of-care form factor will lower barriers to routine clinical use of LSI. Here, we describe a first-generation handheld LSI device based on a tablet computer. The coefficient of variation of speckle contrast was <2% after averaging imaging data collected over an acquisition period of 5.3 s. With a single, experienced user, handheld motion artifacts had a negligible effect on data collection. With operation by multiple users, we did not identify any significant difference (p>0.05) between the measured speckle contrast values using either a handheld or mounted configuration. In vivo data collected during occlusion experiments demonstrate that a handheld LSI is capable of both quantitative and qualitative assessment of changes in blood flow. Finally, as a practical application of handheld LSI, we collected data from a 53-day-old neonate with confirmed compromised blood flow in the hand. We readily identified with LSI a region of diminished blood flow in the thumb of the affected hand. Our data collectively suggest that handheld LSI is a promising technique to enable clinicians to obtain point-of-care measurements of blood flow.

Tectonic Tremor analysis with the Taiwan Chelungpu-Fault Drilling Program (TCDP) downhole seismometer array

NASA Astrophysics Data System (ADS)

Lin, Y.; Hillers, G.; Ma, K.; Campillo, M.

2011-12-01

We study tectonic tremor activity in the Taichung area, Taiwan, analyzing continuous seismic records from 6 short-period sensors of the TCDP borehole array situated around 1 km depth. The low background noise level facilitates the detection of low-amplitude tectonic tremor and low-frequency earthquake (LFE) waveforms. We apply a hierarchical analysis to first detect transient amplitude increases, and to subsequently verify its tectonic origin, i.e. to associate it with tremor signals. The frequency content of tremor usually exceeds the background noise around 2-8 Hz; hence, in the first step, we use BHS1, BHS4 and BHS7 (top, center, bottom sensor) records to detect amplitude anomalies in this frequency range. We calculate the smoothed spectra of 30 second non-overlapping windows taken daily from 5 night time hours to avoid increased day time amplitudes associated with cultural activities. Amplitude detection is then performed on frequency dependent median values of 5 minute advancing, 10 minute long time windows, yielding a series of threshold dependent increased-energy spectra-envelopes, indicating teleseismic waveforms, potential tremor records, or other transients related to anthropogenic or natural sources. To verify the transients' tectonic origin, potential tremor waveforms detected by the amplitude method are manually picked in the time domain. We apply the Brown et al. (2008) LFE matched filter technique to three-component data from the 6 available sensors. Initial few-second templates are taken from the analyst-picked, minute-long segments, and correlated component-wise with 24-h data. Significantly increased similarity between templates and matched waveform segments is detected using the array-average 7-fold MAD measure. Harvested waveforms associated with this initial `weak' detection are stacked, and the thus created master templates are used in an iterative correlation procedure to arrive at robust LFE detections. The increased similarity of waveforms

30 CFR 57.7053 - Moving hand-held drills.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Moving hand-held drills. 57.7053 Section 57... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Drilling and Rotary Jet Piercing Drilling-Surface and Underground § 57.7053 Moving hand-held drills. Before hand-held...

30 CFR 57.7053 - Moving hand-held drills.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Moving hand-held drills. 57.7053 Section 57... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Drilling and Rotary Jet Piercing Drilling-Surface and Underground § 57.7053 Moving hand-held drills. Before hand-held...

30 CFR 57.7053 - Moving hand-held drills.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Moving hand-held drills. 57.7053 Section 57... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Drilling and Rotary Jet Piercing Drilling-Surface and Underground § 57.7053 Moving hand-held drills. Before hand-held...

30 CFR 57.7053 - Moving hand-held drills.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Moving hand-held drills. 57.7053 Section 57... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Drilling and Rotary Jet Piercing Drilling-Surface and Underground § 57.7053 Moving hand-held drills. Before hand-held...

30 CFR 57.7053 - Moving hand-held drills.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Moving hand-held drills. 57.7053 Section 57... MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Drilling and Rotary Jet Piercing Drilling-Surface and Underground § 57.7053 Moving hand-held drills. Before hand-held...

30 CFR 57.12033 - Hand-held electric tools.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Hand-held electric tools. 57.12033 Section 57.12033 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12033 Hand-held electric tools. Hand-held electric tools shall not be...

30 CFR 57.12033 - Hand-held electric tools.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Hand-held electric tools. 57.12033 Section 57.12033 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12033 Hand-held electric tools. Hand-held electric tools shall not be...

30 CFR 57.12033 - Hand-held electric tools.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Hand-held electric tools. 57.12033 Section 57.12033 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12033 Hand-held electric tools. Hand-held electric tools shall not be...

30 CFR 57.12033 - Hand-held electric tools.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Hand-held electric tools. 57.12033 Section 57.12033 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12033 Hand-held electric tools. Hand-held electric tools shall not be...

30 CFR 57.12033 - Hand-held electric tools.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Hand-held electric tools. 57.12033 Section 57.12033 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Surface and Underground § 57.12033 Hand-held electric tools. Hand-held electric tools shall not be...

Impaired eye blink classical conditioning distinguishes dystonic patients with and without tremor.

PubMed

Antelmi, E; Di Stasio, F; Rocchi, L; Erro, R; Liguori, R; Ganos, C; Brugger, F; Teo, J; Berardelli, A; Rothwell, J; Bhatia, K P

2016-10-01

Tremor is frequently associated with dystonia, but its pathophysiology is still unclear. Dysfunctions of cerebellar circuits are known to play a role in the pathophysiology of action-induced tremors, and cerebellar impairment has frequently been associated to dystonia. However, a link between dystonic tremor and cerebellar abnormalities has not been demonstrated so far. Twenty-five patients with idiopathic isolated cervical dystonia, with and without tremor, were enrolled. We studied the excitability of inhibitory circuits in the brainstem by measuring the R2 blink reflex recovery cycle (BRC) and implicit learning mediated by the cerebellum by means of eyeblink classical conditioning (EBCC). Results were compared with those obtained in a group of age-matched healthy subjects (HS). Statistical analysis did not disclose any significant clinical differences among dystonic patients with and without tremor. Patients with dystonia (regardless of the presence of tremor) showed decreased inhibition of R2 blink reflex by conditioning pulses compared with HS. Patients with dystonic tremor showed a decreased number of conditioned responses in the EBCC paradigm compared to HS and dystonic patients without tremor. The present data show that cerebellar impairment segregates with the presence of tremor in patients with dystonia, suggesting that the cerebellum might have a role in the occurrence of dystonic tremor. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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.

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

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Focal mechanisms and tidal modulation for tectonic tremors in Taiwan

NASA Astrophysics Data System (ADS)

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.

Space-Time Variations in Tidal Stress and Cascadia Tremor Amplitude

NASA Astrophysics Data System (ADS)

Klaus, A. J.; Creager, K. C.; Sweet, J.; Wech, A.

2011-12-01

We present a new analysis of the influence of tidal stresses on the amplitude of non-volcanic tremor in Washington State. Tremor counts (Thomas et al., 2009), tremor amplitude (Rubinstein et al., 2008), and strain (Hawthorne and Rubin, 2010) are modulated by tidal stresses in Cascadia as well as in California. However, tremor amplitudes have not yet been extensively studied in Cascadia. Furthermore, Hawthorne and Rubin's Cascadia-wide tidal stress model (2010) allows us to look at the tremor-tide relationship in more detail than ever before. The ability to look at the tidal modulation of tremor amplitude in space as well as time will increase our understanding of this phenomenon and may provide information about the frictional properties of the plate interface. We focus on the August 2010 episodic tremor and slip (ETS) event recorded by the Array of Arrays, a seismic experiment on the Olympic Peninsula. The instrument response is deconvolved, seismograms band-pass filtered at 1.5-5.5 Hz and envelopes are made in 5-minute windows. An inverse problem compensates for site corrections and source-receiver distances to produce, for any given time, a single amplitude measurement at the source. Source locations are determined using an envelope waveform cross-correlation method. Then, we compare the amplitudes, catalog of tremor locations, and the tidal stress at the desired location and time. Amplitudes during the August 2010 ETS event are clearly modulated by tidal stresses. Viewed in the frequency domain, there are clear peaks in the tremor amplitude spectrum at several tidal periods, most prominently the 12.4 and 24 hour periods. Comparison with Hawthorne and Rubin's tidal stress model shows that higher amplitudes are associated with positive shear stress in the downdip direction and, less strongly, with more compressional normal stress.

Tremor in X-linked recessive spinal and bulbar muscular atrophy (Kennedy's disease)

PubMed Central