Tremor is attenuated during walking in essential tremor with resting tremor but not parkinsonian tremor

Background and objectives: tremor is an unintentional and rhythmic movement of any part of the body that is a typical symptom of Essential Tremor (ET). ET impairs the quality of life of patients and is treated with pharmacotherapy. We investigated the tremor reduction efficacy of an innovative vibrational medical device (IMD) in ET patients. Materials and Methods: we conducted a prospective, single-center, single-arm, pragmatic study in ET patients with an extended safety study to evaluate the efficacy and safety of the Vilim Ball—a local hand-arm vibration device that produces vibrations in the frequency range of 8–18 Hz and amplitude from 0 to 2 mm. The primary endpoint was the decrease in the power spectrum after device use. The secondary endpoints were safety outcomes. Results: In total, 17 patients with ET were included in the main study, and no patients withdrew from the main study. The tremor power spectrum (m2/s3 Hz) was lower after the device use, represented as the mean (standard deviation): 0.106 (0.221); median (Md) 0.009 with the interquartile range; IQR, 0.087 vs. 0.042 (0.078); Md = 0.009 with the IQR 0.012; Wilcoxon signed-rank test V = 123; and p = 0.027. Seven patients reported that vibrational therapy was not effective. Two patients reported an increase in tremor after using the device. In the extended safety study, we included 51 patients: 31 patients with ET and 20 with Parkinsonian tremor, where 48 patients reported an improvement in tremor symptoms and 49 in function. No serious adverse events were reported, while two patients in the Parkinsonian tremor group reported a lack of efficacy of the proposed medical device. Conclusions: the device reduces essential tremor in some patients and is safe to use in ET.

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Ritanserin: has no effect on patients with essential tremor, but improves resting tremor in patients with Parkinson's disease

InPharma ◽

10.1007/bf03305993 ◽

1987 ◽

Vol 588 (1) ◽

pp. 6-6

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Essential Tremor ◽

Resting Tremor

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Clinical and Electromyographic Examinations of Patients with Essential Tremor

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100052008 ◽

2000 ◽

Vol 27 (1) ◽

pp. 65-70 ◽

Cited By ~ 8

Author(s):

Ivan Milanov

Keyword(s):

Essential Tremor ◽

Neurological Examination ◽

Lower Limbs ◽

Electromyographic Activity ◽

Parkinsonian Tremor ◽

Historical Aspects ◽

Rest Tremor ◽

Different Types ◽

Antagonistic Muscles ◽

Alt Activity

ABSTRACT:Background:It is believed that no clinical differences exist among essential, familial and senile tremor, or between the tremor with synchronous or alternating electromyographic activity. The aim of this study was to evaluate the clinical and electromyographic findings in a large group of patients with different types of essential tremor.Methods:Two hundred and twenty patients with sporadic, familial or senile variants of essential tremor were examined. According to the electromyographic activity recorded from the antagonistic muscles, the patients were subdivided into a group with synchronous (SYN) and a group with alternating (ALT) activity. The historical aspects of the disease were noted, and a detailed neurological examination was performed.Results:A widespread tremor involving upper and lower limbs and 3-4 different anatomical regions was typical for familial tremor. It also had higher amplitude than the sporadic and senile tremor. ALT tremor had a higher amplitude and longer burst duration than SYN and more often involved lower limbs. Rest tremor was common in the ALT group. Overall, ALT tremor was more common than previously supposed.Conclusion:The familial and ALT tremors are more disabling than other types of essential tremor. Since electromyographic ALT activity is common in essential tremor, its presence does not reliably distinguish essential and Parkinsonian tremor.

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

Journal of Neurology ◽

10.1007/s00415-014-7626-y ◽

2015 ◽

Vol 262 (3) ◽

pp. 719-728 ◽

Cited By ~ 19

Author(s):

Valentina Nicoletti ◽

Paolo Cecchi ◽

Daniela Frosini ◽

Ilaria Pesaresi ◽

Serena Fabbri ◽

...

Keyword(s):

Essential Tremor ◽

Functional Mri ◽

Resting Tremor ◽

Mri Changes

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Significance of Parkinsonian Manifestations in Essential Tremor

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s031716710004765x ◽

1993 ◽

Vol 20 (2) ◽

pp. 114-117 ◽

Cited By ~ 76

Author(s):

A.H. Rajput ◽

B. Rozdilsky ◽

L. Ang ◽

Alex Rajput

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

General Population ◽

Essential Tremor ◽

Natural Evolution ◽

Resting Tremor ◽

Age Related

ABSTRACT:Parkinsonian features, notably resting tremor may be seen in some essential tremor patients but the significance of those is unknown. The reported risk of parkinsonism in essential tremor patients varies from being unchanged to 35 times higher than expected. We studied 9 patients with essential tremor who had autopsies. In 6 of the 9 (66%) resting tremor was noted and in 3 (33%) cases fully developed parkinsonism was noted. The parkinsonism was consequent to neuroleptic usage in 2 and to basal ganglia status lacunaris and cribrosus in one case but no consistent abnormalities were noted in 3 essential tremor only and 3 essential tremor plus resting tremor cases. We conclude that resting tremor is an age-related natural evolution in some essential tremor patients. We recommend that the additional diagnosis of parkinsonism in the essential tremor be made only when resting tremor, bradykinesia and rigidity are all evident. The risk of ideopathic Parkinson's disease in essential tremor cases is similar to the general population.

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Patterns of intrinsic brain activity in essential tremor with resting tremor and tremor-dominant Parkinson’s disease

Brain Imaging and Behavior ◽

10.1007/s11682-019-00214-4 ◽

2020 ◽

Vol 14 (6) ◽

pp. 2606-2617

Author(s):

Jun-ying Li ◽

Zhong-jiao Lu ◽

Xue-ling Suo ◽

Nan-nan Li ◽

Du Lei ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Essential Tremor ◽

Brain Activity ◽

Resting Tremor ◽

Intrinsic Brain Activity

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Tremors

10.2310/im.6352 ◽

2016 ◽

Author(s):

Alfonso Fasano ◽

Günther Deuschl

Keyword(s):

Movement Disorder ◽

Essential Tremor ◽

Involuntary Movement ◽

The Body ◽

Drug Induced ◽

Parkinsonian Tremor ◽

Dystonic Tremor ◽

Physiologic Tremor ◽

Disease Definition ◽

Holmes Tremor

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

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