Ming-Kuei Lu1, Shang-Ming Chiou2, Ulf Ziemann3, Hui-Chun Huang4, Yu-Wan Yang4, Chon-Haw Tsai5. 1. Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, Medical College, China Medical University, Taichung, Taiwan; Graduate Institute of Neural and Cognitive Science, China Medical University, Taichung, Taiwan. Electronic address: d4297@mail.cmuh.org.tw. 2. School of Medicine, Medical College, China Medical University, Taichung, Taiwan; Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan. 3. Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, Eberhard-Karls-University, Tübingen, Germany. 4. Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, Medical College, China Medical University, Taichung, Taiwan. 5. Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, Medical College, China Medical University, Taichung, Taiwan; Graduate Institute of Neural and Cognitive Science, China Medical University, Taichung, Taiwan. Electronic address: windymovement@yahoo.com.tw.
Abstract
OBJECTIVE: The pathogenesis of tremor in Parkinson's disease (PD) and essential tremor (ET) is not fully understood. This study tested the role of primary motor cortex (M1), supplementary motor area (SMA) and cerebellar cortex on PD and ET tremor by single- and paired-pulse transcranial magnetic stimulation (TMS). METHODS: Ten PD patients with resting tremor, six of them also with postural tremor, and ten ET patients with postural tremor were studied. Randomized single- and paired-pulse TMS with an interstimulus interval of 100 ms were delivered over M1, SMA and cerebellum. TMS effects were evaluated by calculating a tremor-resetting index (RI). RESULTS: Single- vs. paired-pulse TMS showed no difference. M1-TMS and SMA-TMS but not by cerebellar TMS induced a significant RI in PD and ET. M1-TMS resulted in a significantly higher RI in PD than ET. Furthermore, M1-TMS in PD but not in ET resulted in a significantly higher RI than SMA-TMS. CONCLUSIONS: Findings suggest a stronger involvement of M1 in resting and postural tremor in PD than postural tremor in ET. SIGNIFICANCE: RI provides a useful marker to explore the differential functional role of M1, SMA and cerebellum in PD vs. ET tremor.
OBJECTIVE: The pathogenesis of tremor in Parkinson's disease (PD) and essential tremor (ET) is not fully understood. This study tested the role of primary motor cortex (M1), supplementary motor area (SMA) and cerebellar cortex on PD and ET tremor by single- and paired-pulse transcranial magnetic stimulation (TMS). METHODS: Ten PDpatients with resting tremor, six of them also with postural tremor, and ten ET patients with postural tremor were studied. Randomized single- and paired-pulse TMS with an interstimulus interval of 100 ms were delivered over M1, SMA and cerebellum. TMS effects were evaluated by calculating a tremor-resetting index (RI). RESULTS: Single- vs. paired-pulse TMS showed no difference. M1-TMS and SMA-TMS but not by cerebellar TMS induced a significant RI in PD and ET. M1-TMS resulted in a significantly higher RI in PD than ET. Furthermore, M1-TMS in PD but not in ET resulted in a significantly higher RI than SMA-TMS. CONCLUSIONS: Findings suggest a stronger involvement of M1 in resting and postural tremor in PD than postural tremor in ET. SIGNIFICANCE: RI provides a useful marker to explore the differential functional role of M1, SMA and cerebellum in PD vs. ET tremor.
Authors: David J Pedrosa; Christian Nelles; Peter Brown; Lukas J Volz; Esther A Pelzer; Marc Tittgemeyer; John-Stuart Brittain; Lars Timmermann Journal: Exp Neurol Date: 2017-07-25 Impact factor: 5.330
Authors: Giorgio Leodori; Daniele Belvisi; Maria I De Bartolo; Andrea Fabbrini; Matteo Costanzo; Felipe Vial; Antonella Conte; Mark Hallett; Alfredo Berardelli Journal: Mov Disord Date: 2020-03-16 Impact factor: 9.698