Tremors: Essential Tremor and Beyond

Miskin, Chandrabhaga; Carvalho, Karen S.

doi:10.1016/j.spen.2018.02.002

Cited by 8 publications

(10 citation statements)

References 65 publications

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“…65 In the brain, two networks are commonly implicated in tremor disorders: the cortico-striatal-thalamo-cortical loop and components of Mollaret's triangle (red nucleus, inferior olivary nucleus, and dentate nucleus). 66 The first loop integrates different muscle groups to produce a coordinated movement and to ensure that any ongoing movement will not be terminated or altered by minor or inconsequential external stimuli. The latter loop is involved in fine tuning precision movements.…”

Section: Tremor Pathophysiologymentioning

confidence: 99%

“…The latter loop is involved in fine tuning precision movements. 66 In addition to these long ranging pathways, central nuclei with inherent rhythmicity may develop aberrancies in ion channels (calcium channels), leading to changes in repetitive depolarizations followed by hyperpolarizations, causing tremor. 65 Also, inherent properties of objects such as weight and stiffness can contribute to variable oscillatory nature and tremor.…”

Section: Tremor Pathophysiologymentioning

confidence: 99%

“…65 ET pathophysiology is incompletely understood but likely involves structures along the cerebello-thalamo-cortical network, with some studies suggesting causative roles for aberrantly firing pacemaker cells in the cerebellum and thalamus and cerebellar degeneration such as loss of Purkinje fibers. 66,67 Recent murine experiments suggest reduced glutamate Rd2 protein levels causing deficits in pruning of climbing fiber synapses on Purkinje cells, and these synaptic surpluses create cerebellar oscillations correlating with tremor severity. 68 A functional MRI study of the effect of visual inputs on ET patients 69 demonstrated that a widespread network involving the cerebellum, motor cortex, extrastriate visual cortex, and parietal cortex is all associated with tremor severity in ET, expanding the responsible network.…”

Section: Tremor Pathophysiologymentioning

confidence: 99%

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Approach to Tremor Disorders

Lee

Sarva

2021

Semin Neurol

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Tremor disorders are diverse and complex. Historical clues and examination features play a major role in diagnosing these disorders, but diagnosis can be challenging due to phenotypic overlap. Ancillary testing, such as neuroimaging or laboratory testing, is driven by the history and examination, and should be performed particularly when there are other neurological or systemic manifestations. The pathophysiology of tremor is not entirely understood, but likely involves multiple networks along with the cerebello-thalamo-cortical pathways. Treatment options include medications, botulinum toxin, surgery, and nonpharmacologic interventions utilizing physical and occupational therapies and assistive devices. Further work is needed in developing accurate diagnostic tests and better treatment options for tremor disorders.

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Section: Tremor Pathophysiologymentioning

confidence: 99%

Section: Tremor Pathophysiologymentioning

confidence: 99%

Section: Tremor Pathophysiologymentioning

confidence: 99%

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Approach to Tremor Disorders

Lee

Sarva

2021

Semin Neurol

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“…A tremor is one of the most common involuntary movements seen in neurological disorders. It is characterized as a rhythmic, involuntary oscillation of a body part by muscle innervations that imply repetitive contractions [ 1 , 2 , 3 , 4 ]. Various types of tremors occur, depending on their causes.…”

Section: Introductionmentioning

confidence: 99%

“…Both ET and CD patients have several common features, such as increased tremor when mentally stressed and restricted fine movements. In clinical practice, clinicians try to distinguish these two tremors, ET and CD , by neurological examinations such as FNF (finger–nose–finger) test [ 1 , 6 , 7 ]. However, it is not easy to detect subtle irregularities of finger movement and observe where the finger tremor becomes stronger during the FNF test by usual observation.…”

Section: Introductionmentioning

confidence: 99%

Imaging Tremor Quantification for Neurological Disease Diagnosis

Mitsui

Zin

Ishii

et al. 2020

Sensors

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In this paper, we introduce a simple method based on image analysis and deep learning that can be used in the objective assessment and measurement of tremors. A tremor is a neurological disorder that causes involuntary and rhythmic movements in a human body part or parts. There are many types of tremors, depending on their amplitude and frequency type. Appropriate treatment is only possible when there is an accurate diagnosis. Thus, a need exists for a technique to analyze tremors. In this paper, we propose a hybrid approach using imaging technology and machine learning techniques for quantification and extraction of the parameters associated with tremors. These extracted parameters are used to classify the tremor for subsequent identification of the disease. In particular, we focus on essential tremor and cerebellar disorders by monitoring the finger–nose–finger test. First of all, test results obtained from both patients and healthy individuals are analyzed using image processing techniques. Next, data were grouped in order to determine classes of typical responses. A machine learning method using a support vector machine is used to perform an unsupervised clustering. Experimental results showed the highest internal evaluation for distribution into three clusters, which could be used to differentiate the responses of healthy subjects, patients with essential tremor and patients with cerebellar disorders.

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