Cortical excitability in patients with essential tremor
Corresponding Author
Stefano Romeo MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, ItalySearch for more papers by this authorAlfredo Berardelli MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Istituto Mediterraneo di Neuroscienze “Neuromed,” Pozzilli, Italy
Search for more papers by this authorFrancesca Pedace MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Search for more papers by this authorMaurizio Inghilleri MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Search for more papers by this authorMorena Giovannelli MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Search for more papers by this authorMario Manfredi MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Istituto Mediterraneo di Neuroscienze “Neuromed,” Pozzilli, Italy
Search for more papers by this authorCorresponding Author
Stefano Romeo MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, ItalySearch for more papers by this authorAlfredo Berardelli MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Istituto Mediterraneo di Neuroscienze “Neuromed,” Pozzilli, Italy
Search for more papers by this authorFrancesca Pedace MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Search for more papers by this authorMaurizio Inghilleri MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Search for more papers by this authorMorena Giovannelli MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Search for more papers by this authorMario Manfredi MD
Dipartimento di Scienze Neurologiche, Università degli studi di Roma “La Sapienza,” Rome, Italy
Istituto Mediterraneo di Neuroscienze “Neuromed,” Pozzilli, Italy
Search for more papers by this authorAbstract
We used transcranial magnetic stimulation in 10 patients with essential tremor and 8 matched healthy subjects. A round stimulating coil was placed over the vertex and electromyographic activity was recorded from the first dorsal interosseous muscle. Paired transcranial stimuli were delivered at interstimulus intervals of 3, 5, 20, 100, 150, and 200 ms. The intensity of the conditioning stimulus was 80% of motor threshold at short and 150% at long interstimulus intervals (ISIs). We also measured the silent period obtained after a single magnetic pulse delivered at 150% of motor threshold during a submaximal muscle contraction. Patients and controls had similar motor threshold and similar latencies. Paired magnetic stimuli given at short and long ISIs at rest, and during a voluntary muscle contraction, elicited similar responses in both groups. The silent period evoked by transcranial magnetic stimulation had a similar duration in patients with ET and controls. In conclusion, these findings suggest that patients with essential tremor have normal cortical motor area excitability. © 1998 John Wiley & Sons, Inc. Muscle Nerve 21:1304–1308, 1998.
References
- 1 Bain PG, Britton TC, Ienkins IH, Thompson PD, Rothwell JC, Thomas PK, Brooks DJ, Marsden CD: Tremor associated with benign IgM paraproteinaemic neuropathy. Brain 1996; 119: 789–799.
- 2 Benabid AL, Pollak P, Gervason C, Hoffman D, Gao DM, Hommel M, Peret JE, de Rougemont J: Long term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 1991; 337: 403–406.
- 3 Berardelli A, Rona S, Inghilleri M, Manfredi M: Cortical inhibition in Parkinson' disease. A study with paired magnetic stimulation. Brain 1996; 119: 71–77.
- 4 Britton TC, Thompson PD, Day BL, Rothwell JC, Findley L, Marsden CD: Modulation of postural wrist tremors by magnetic stimulation of the motor cortex in patients with Parkinson's disease or essential tremor and in normal subjects mimicking tremor. Ann Neurol 1993; 33: 473–479.
- 5 Britton TC, Thompson PD, Day BL, Rothwell JC, Findley L, Marsden CD: Resetting of postural tremor at the wrist with mechanical stretches in Parkinson's disease, essential tremor, and in normal subjects mimicking tremor. Ann Neurol 1992; 31: 507–514.
- 6 Cantello R, Gianelli M, Bettucci D, Civardi C, De Angelis MS, Mutani R: Parkinson's disease rigidity: magnetic motor evoked potentials in a small hand muscle. Neurology 1991; 41: 1449–1456.
- 7 Claus D, Weis M, Janhnke U, Plewe A, Brunholzl C: Corticospinal conduction studied with magnetic double stimulation in the intact human. J Neurol Sci 1992; 111: 180–188.
- 8 Davey NJ, Dick JPR, Ellaway PH, Maskill DW: Raised motor cortical threshold associated with bradykinesia as revealed by transcranial magnetic stimulation in normal man and Parkinson's disease [abstract]. J Physiol (Lond) 1991; 438: 35P.
- 9 Deuschl G, Lucking CH, Schenck E: Essential tremor: electrophysiological and pharmacological evidence for a subdivision. J Neurol Neurosurg Psychiatry 1987; 50: 1435–1441.
- 10 Dupuis MJM, Delwaide PJ, Boucquey D, Gonsette RE: Homolateral disappearance of essential tremor after cerebellar stroke. Mov Disord 1989; 4: 180–187.
- 11 Elble RJ: Physiologic and essential tremor. Neurology 1986; 36: 225–231.
- 12 Elble RJ: Mechanism of physiological tremor and relationship to essential tremor, in LJ Findley, WCI Koller (eds): Handbook of Tremor Disorders. New York, Marcel Dekker, 1995, pp 51–62.
- 13 Hallett M, Dubinsky RM: Glucose metabolism in the brain of patients with essential tremor. J Neurol Sci 1993; 114: 45–48.
- 14 Hirai T, Miyazaki M, Nakajima H, Shibazaki T, Ohye C: The correlation between tremor characteristics and volume of effective lesions in stereotactic nucleus thalamotomy. Brain 1983; 106: 1001–1018.
- 15 Inghilleri M, Berardelli A, Cruccu G, Manfredi M: Silent period evoked by transcranial stimulation of the human cortex and cervicomedullary junction. J Physiol (Lond) 1993; 466: 521–534.
- 16 Jenkins IH, Bain PG, Colebatch JG, Thompson PD, Findley L, Frackoviack RSJ, Marsden CD: A positron emission tomography study of essential tremor: evidence for overactivity of cerebellar connections. Ann Neurol 1993; 34: 82–90.
- 17 Kujirai T, Caramia MD, Rothwell JC, Day BL, Thompson PD, Ferbert A: Corticocortical inhibition in human motor cortex. J Physiol (Lond) 1993; 471: 501–519.
- 18 Lee RG, Stein RB: Resetting of tremor by mechanical perturbations: a comparison of essential tremor and parkinsonian tremor. Ann Neurol 1981; 10: 523–531.
- 19 Narabyashi H: Stereotaxic Vim thalamotomy for treatment of tremor. Eur Neurol 1989; 112: 681–697.
- 20 Pascual Leone A, Valls-Sole J, Toro C, Wasserman EM, Hallett M: Resetting of essential tremor and postural tremor in Parkinson' disease with transcranial magnetic stimulation. Muscle Nerve 1994; 17: 800–807.
- 21 Priori A, Berardelli A, Inghilleri M, Polidori L, Manfredi M: Electromyographic silent period after transcranial brain stimulation in Huntington' disease. Mov Disord 1994; 9: 178–182.
- 22 Priori A, Berardelli A, Inghilleri M, Accornero N, Manfredi M: Motor cortical inhibition and dopaminergic system: pharmacological changes in the silent period after transcranial brain stimulation in normal subjects, patients with Parkinson's disease and drug-induced parkinsonism. Brain 1994; 117: 317–324.
- 23 Ridding MC, Taylor JL, Rothwell JC: The effect of voluntary contraction on cortico-cortical inhibition in human motor cortex. J Physiol 1995; 487: 541–548.
- 24 Ridding MC, Inzelberg R, Rothwell JC: Changes in excitability of motor cortical circuitry in patients with Parkinson's disease. Ann Neurol 1995; 37: 181–188.
- 25 Ridding MC, Sheen G, Rothwell JC, Inzelberg R, Kujirai T: Changes in the balance between motor cortical excitation and inhibition in focal, task specific dystonia. J Neurol Neurosurg Psychiatry 1995; 59: 493–498.
- 26 Smith IS: Tremor in peripheral neuropathy, in LJ Findley, WC Koller (eds): Handbook of Tremor Disorders. New York, Marcel Dekker, 1995, pp 443–454.
- 27 Thompson PD, Dick JPR, Day BL, Rothwell JC, Berardelli A, Kachi T, Marsden CD: Electrophysiology of the corticomoto-neurone pathways in patients with movement disorders. Mov Disord 1986; 2: 113–117.
- 28 Wills AJ, Jenkins IH, Thompson PD, Findley LJ, Brooks DJ: Red nuclear and cerebellar but no olivary activation associated with essential tremor: a positron emission tomographic study. Ann Neurol 1994; 36: 636–642.