Hypothetical Mechanisms in Essential Tremor
Author Information
Author(s): Shaikh Aasef G, Miura Kenichiro, Optican Lance M, Ramat Stefano, Tripp Robert M, Zee David S
Primary Institution: The Johns Hopkins University
Hypothesis
Increased membrane excitability in motor circuits has a key role in the pathogenesis of essential tremor.
Conclusion
Simulations support the hypothesis that increased membrane excitability in potentially unstable, reciprocally innervated circuits can produce oscillations that resemble essential tremor.
Supporting Evidence
- Increasing Ih and/or IT further depolarized the membrane and increased excitability.
- The characteristics of the tremor from all ET patients were simulated when Ih was increased to ~10× the range of physiological values.
- Simulations showed a strong correlation between the frequency of simulated tremor and the corresponding postural tremor frequency in the ET patients.
Takeaway
Essential tremor might happen because the nerves controlling movement are too excited, causing them to shake. By changing how excited these nerves are, we can better understand and treat the tremor.
Methodology
Postural limb tremor was recorded in 22 ET patients and simulated with a conductance-based neuromimetic model.
Limitations
The model cannot pinpoint specific anatomical neural networks that produce essential tremor.
Participant Demographics
Patients had bilateral postural tremor of their hands and were recruited from a movement disorders clinic.
Statistical Information
Confidence Interval
0.5 ± 0.05 for frequency; -0.02 ± 0.10 for amplitude with respect to Ih; -3.9 ± 0.1 for frequency with respect to IT; 1.1 ± 0.01 for amplitude with respect to IT.
Digital Object Identifier (DOI)
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