EMG-Based Essential Tremor Detection Using PSD Features With Recurrent Feedforward Back Propogation Neural Network

Essential tremors (ET) are slow progressive neurological disorder that reduces muscular movements and involuntary muscular contractions. The further complications of ET may lead to Parkinson’s disease and therefore it is very crucial to identify at the early onset. This research study deals with the identification of the presence of ET from the EMG of the patient by using power spectral density (PSD) features. Several PSD estimation methods such as Welch, Yule Walker, covariance, modified covariance, Eigen Vector based on Eigen value and MUSIC, and Thompson Multitaper are employed and are then classified using a recurrent feedback Elman neural network (RFBEN). It is observed from the experimental results that the MUSIC method of estimating the PSD of the EMG along with RFBEN classifier yields a classification accuracy of 99.81%. It can be concluded that the proposed approach demonstrates the possibility of developing automated computer aided diagnostic tool for early detection of Essential tremors.

EMG BASED ESSENTIAL TREMOR DETECTION USING PSD FEATURES WITH RECURRENT FEEDFORWARD BACKPROPOGATION NEURAL NETWORK

Essential tremors (ET) are slow progressive neurological disorder that reduces muscular movements and involuntary muscular contractions. The further complications of ET may lead to Parkinson’s disease and therefore it is very crucial to identify at the early onset. This research study deals with the identification of the presence of ET from the EMG of the patient by using power spectral density (PSD) features. Several PSD estimation methods such as Welch, Yule Walker, covariance, modified covariance, Eigen Vector based on Eigen value and MUSIC, and Thompson Multitaper are employed and are then classified using a recurrent feedback Elman neural network (RFBEN). It is observed from the experimental results that the MUSIC method of estimating the PSD of the EMG along with RFBEN classifier yields a classification accuracy of 99.81%. It can be concluded that the proposed approach demonstrates the possibility of developing automated computer aided diagnostic tool for early detection of Essential tremors.

A Case Report of Essential Tremors Treated with Yeokhan-san

Objective: This report describes the case of a patient with essential tremors of the mouth and hands, which were improved by Yeokhan-san treatment.Methods: To relieve the symptoms, Korean medicine treatments, including Yeokhan-san, Ohaeng-Hwa acupuncture, and electronic moxibustion, were performed. To evaluate the effects of the treatments, the visual analog scale and Fahn-Tolosa-Marin clinical rating scale for tremor were used.Results: After the treatment, the patient's clinical symptoms were improved. The visual analog scale score decreased from 10 to 2 for the hand tremor and from 10 to 1 for the mouth tremor. The Fahn-Tolosa-Marin tremor scores decreased from 3 to 1 for both the hand and mouth tremors.Conclusions: The present case suggests that Yeokhan-san and Ohaeng-Hwa acupuncture are effective for the treatment of essential tremor.

Essential Tremors: A Detailed Review

Essential tremor (ET) is the most prevalent movement disorder globally and is ten times more prevalent than Parkinson's. It is considered one of the most common movement disorders with various treatment options reported in clinical practice but uncertainty about the most robust one. The International Parkinson and Movement Disorder Society recently reviewed the clinical studies of essential tremors and updated the treatment guidelines. Mild to moderate tremor severity can sometimes be managed with occupational treatment such as speech therapy or adaptation. In contrast, the first-line pharmacological treatments include symptomatic treatment with propranolol, primidone, and topiramate. Botulinum toxin is preferred for selected cases, whereas invasive treatments should be considered a severe essential tremor treatment option. Focused ultrasound thalamotomy is attracting a lot of attention as a new therapy for essential tremors. Misdiagnosis among tremor syndromes is another point of concern and impacts both clinical care and research. A new neurophysiological measure, known as the tremor stability index, is introduced recently to attain diagnostic accuracy between Parkinson's disease tremor and essential tremor. Also, ET-Plus is a newly suggested term for the classification of tremor in the recent Consensus statement, which acknowledges the presence of additional neurological signs in patients with ET. This review includes in detail defining ET, hypothesis about ET, clinical features along with points to consider while differentiating between ET and Parkinson's Disease (PD), evaluation of ET based on laboratory findings, treatment procedures, measures to reduce misdiagnosis between ET and PD, and reality about the new term ET-Plus syndrome.

The Essential Tremors: Evolving Concepts of a Family of Diseases

The past 10 years has seen a remarkable advance in our understanding of the disease traditionally referred to as “essential tremor” (ET). First, the clinical phenotype of ET has been expanded from that of a bland, unidimensional, and monosymptomatic entity to one with a host of heterogeneous features. These features include a broader and more nuanced collection of tremors, non-tremor motor features (e.g., gait abnormalities) and a range of non-motor features, including cognitive, psychiatric, sleep, and other abnormalities. The natural history of these features, as well as their relationships with one another and with disease duration and severity, are better appreciated than they were previously. Studies of disease etiology have identified a number of candidate genes as well as explored several environmental determinants of disease. In addition, the decade has seen the beginnings and expansion of rigorous postmortem studies that have identified and described the postmortem changes in the brains of patients with ET. This emerging science has given rise to a new notion that the disease, in many cases, is one of cerebellar system degeneration. Across all of these studies (clinical, etiological, and pathophysiological) is the observation that there is heterogeneity across patients and that “essential tremor” is likely not a single disease but, rather, a family of diseases. The time has come to use the more appropriate terminology, “the essential tremors,” to fully describe and encapsulate what is now apparent. In this paper, the author will review the clinical, etiological, and pathophysiological findings, referred to above, and make the argument that the terminology should evolve to reflect advances in science and that “the essential tremors” is a more scientifically appropriate term.