Abstract
The response of postural wrist tremors to supramaximal median nerve stimulation was examined in patients with hereditary essential tremor (n = 10) and Parkinson's disease (n = 9), and in normal subjects mimicking wrist tremor (n = 8). The average frequency of on-going tremor was the same in all three groups. Supramaximal peripheral nerve shocks inhibited and then synchronised the rhythmic electromyographic (EMG) activity of all types of tremor. The duration of inhibition ranged from 90 to 210ms, varying inversely with the frequency of on-going tremor. There was no significant difference in mean duration of inhibition or in the timing of the first peak after stimulation on the average rectified EMG records between the three groups. The degree to which supramaximal peripheral nerve shocks could modulate the timing of rhythmic EMG bursts in the forearm flexor muscles was also quantified by deriving a resetting index. No significant difference in mean resetting index of the three groups was found. These results suggest that such studies cannot be used to differentiate between the common causes of postural wrist tremors.
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- Bathien N., Rondot P., Toma S. Inhibition and synchronisation of tremor induced by a muscle twitch. J Neurol Neurosurg Psychiatry. 1980 Aug;43(8):713–718. doi: 10.1136/jnnp.43.8.713. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Britton T. C., Thompson P. D., Day B. L., Rothwell J. C., Findley L. J., Marsden C. D. "Resetting" of postural tremors at the wrist with mechanical stretches in Parkinson's disease, essential tremor, and normal subjects mimicking tremor. Ann Neurol. 1992 May;31(5):507–514. doi: 10.1002/ana.410310508. [DOI] [PubMed] [Google Scholar]
- Findley L. J., Gresty M. A., Halmagyi G. M. Tremor, the cogwheel phenomenon and clonus in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1981 Jun;44(6):534–546. doi: 10.1136/jnnp.44.6.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
- HUFSCHMIDT H. J. PROPRIOCEPTIVE ORIGIN OF PARKINSONIAN TREMOR. Nature. 1963 Oct 26;200:367–368. doi: 10.1038/200367a0. [DOI] [PubMed] [Google Scholar]
- Hömberg V., Hefter H., Reiners K., Freund H. J. Differential effects of changes in mechanical limb properties on physiological and pathological tremor. J Neurol Neurosurg Psychiatry. 1987 May;50(5):568–579. doi: 10.1136/jnnp.50.5.568. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee R. G., Stein R. B. Resetting of tremor by mechanical perturbations: a comparison of essential tremor and parkinsonian tremor. Ann Neurol. 1981 Dec;10(6):523–531. doi: 10.1002/ana.410100606. [DOI] [PubMed] [Google Scholar]
- Lippold O. C. Oscillation in the stretch reflex arc and the origin of the rhythmical, 8-12 C-S component of physiological tremor. J Physiol. 1970 Feb;206(2):359–382. doi: 10.1113/jphysiol.1970.sp009018. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MERTON P. A. The silent period in a muscle of the human hand. J Physiol. 1951 Jun;114(1-2):183–198. doi: 10.1113/jphysiol.1951.sp004610. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McLellan D. L. Levodopa in Parkinsonism: reduction in the electromyographic silent period and its relationship with tremor. J Neurol Neurosurg Psychiatry. 1972 Jun;35(3):373–378. doi: 10.1136/jnnp.35.3.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mones R. J., Weiss A. H. The response of the tremor of patients with Parkinsonism to peripheral nerve stimulation. J Neurol Neurosurg Psychiatry. 1969 Dec;32(6):512–518. doi: 10.1136/jnnp.32.6.512. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rack P. M., Ross H. F. The role of reflexes in the resting tremor of Parkinson's disease. Brain. 1986 Feb;109(Pt 1):115–141. doi: 10.1093/brain/109.1.115. [DOI] [PubMed] [Google Scholar]