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Query: UMLS:C0270736 (Essential tremor)
 404 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There has been debate as to whether essential tremor has a central origin and over the possible role of the inferior olivary nucleus in its genesis. We used positron emission tomography with radioactive water (H2(15)O) to detect abnormal patterns of cerebral activity associated with this condition, at rest, without tremor, and on posture when the tremor was present. At rest, cerebellar blood flow was significantly increased bilaterally in the group with essential tremor (30-40%) but no increased olivary activity was evident. Essential tremor during arm extension was associated with further abnormal increases in bilateral cerebellar and abnormal red nuclear activation. Again, no olivary overactivity was evident. Voluntary wrist oscillation in control subjects caused only ipsilateral cerebellar activation. We conclude that essential tremor is associated with abnormal bilateral overactivity of cerebellar and red nuclear connections but found no evidence of intrinsic overactivity of the inferior olivary nucleus, as evidenced by raised blood flow.
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PMID:Red nuclear and cerebellar but no olivary activation associated with essential tremor: a positron emission tomographic study. 794 96

Essential tremor (ET) is a common movement disorder that often becomes refractory to conventional pharmacologic management. Open-label studies suggest that gabapentin is efficacious for ET, but the results of controlled trials have been mixed. To determine the efficacy and tolerability of gabapentin in ET, we conducted a double-blind, placebo-controlled, cross-over trial evaluating two doses (1800 mg per day and 3600 mg per day; N = 25). Patients on other ET medications were maintained on their concurrent medications for 3 months prior to study initiation and throughout the study. Twenty patients (mean age, 69.9 +/- 6.1 yrs) completed the study. Overall, patient global assessments (p <0.05), observed tremor scores (p <0.005), water pouring scores (p <0.05), and activities of daily living scores (p <0.005) significantly improved. Accelerometry scores, spirographs, and investigator global impression scores did not improve. The results were similar for high and low doses. Statistical regression models did not demonstrate any significant predictors for response. Gabapentin may be effective in some cases of ET.
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PMID:Gabapentin for essential tremor: a multiple-dose, double-blind, placebo-controlled trial. 1092 78

Essential Tremor (ET) refers to involuntary movements of a part of the body. ET patients have serious difficulties in performing daily living activities. Our ultimate goal is to develop a system that can enable ET patients to perform daily living activities. We have been developing an exoskeleton robot for ET patients. We make use of the electromyogram (EMG) signal to control this robot. However, the EMG signal of ET patients contains not only signals from voluntary movements but also noise from involuntary tremors. In this paper, we focus on developing a signal processing method to suppress tremor noise present in the surface EMG signal. The proposed filter detected attenuation ratio by the correlation between the last EMG data and one period squared sine wave. The filtered EMG signals indicated that essential tremor noise of the elbow flexed posture while holding a water-filled bottle was suppressed. In addition, voluntary information was less affected by the filter. Welch's t-value test confirmed that ease of extraction of voluntary movement was increased by the proposed filter.
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PMID:Filtering essential tremor noise on surface EMG based on squared sine wave approximation. 2225 70

Essential tremor is a disorder that causes involuntary oscillations in patients while engaging in actions or while maintaining a posture. ET patients have serious difficulties in performing activities of daily living such as eating food, drinking water, and writing. We have thus been developing an EMG-controlled exoskeletal robot to suppress tremors. The EMG signal of ET patients involves a mix of voluntary movement and tremor signals. To control the exoskeletal robot accurately, tremor signals must be removed from the patient's EMG signal. To date, we have been developing a filter to remove tremor signals from the patient's EMG. The design of this filter was based on the hypothesis that the rectified tremor signals are able to be approximated by a powered sine wave. This filter was found to have a large effect on removing tremor signals. However, tremor signals are generated both while performing voluntary movement and while maintaining a posture, and the filter was attenuating both signals. To control this robot accurately, the signal generated while performing voluntary movement is expected not to be attenuated. To accomplish this, we try to use a parameter that reflects a state of the patient's movement, performing a voluntary movement or maintaining a posture, as a switch to activate the powered sine filter. This paper provides an analysis of the favorable parameters. We focus on two parameters: the peak-to-peak interval of the rectified EMG signal, and the interval of the flat and low amplitude area of the rectified EMG signal. Through evaluation, it is affirmed that both parameters change with the state of the patient's movement. However, the latter parameter is superior to the former in terms of variability, which indicates that the interval of the flat and low amplitude area of the rectified EMG signal is a more favorable parameter to promote control of the exoskeletal robot. As a future work, we will mount the parameter to the algorithm and evaluate the robotic system.
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PMID:Analysis of EMG signals of patients with essential tremor focusing on the change of tremor frequency. 2336 70