Influence of Proprioceptive Input on Parkinsonian Tremor

Spiegel, Jörg; Fuss, Gerhard; Krick, Christoph; Schimrigk, К.; Dillmann, Ulrich

doi:10.1097/00004691-200201000-00012

Cited by 18 publications

(25 citation statements)

References 19 publications

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“…In a few cases, this view was corroborated by coherence observations between such cerebral rhythms and tremor ( Zirh et al, 1998 ; Hurtado et al, 1999 ; Timmermann et al, 2003 ). Other investigations, however, obtained results strongly suggesting the involvement of proprioceptive input and peripheral loops or spinal motor systems in tremor generation ( Rack and Ross, 1986 ; Burne, 1987 ; Spiegel et al, 2002 ; Rivlin-Etzion et al, 2008 ). Although hypotheses assuming their supra-spinal origin are far more popular, the neural basis of PD tremor remains unclear.…”

Section: Introductionmentioning

confidence: 93%

Characteristics of Rest and Postural Tremors in Parkinson’s Disease: An Analysis of Motor Unit Firing Synchrony and Patterns

Agapaki

Christakos

Anastasopoulos

2018

Front. Hum. Neurosci.

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The neural mechanisms responsible for resting and postural tremor in Parkinson’s disease (PD) have been the object of considerable study, much of it focusing on supraspinal sites. Here, we adopted an alternative approach that emphasizes motor unit (MU) firing synchrony and patterns of discharge. To explore if these could account for known features of PD tremor, we recorded the instantaneous acceleration of the upper limb of 23 PD patients at rest or while they tried to hold a stable posture together with surface EMG and single MU discharges of upper limb muscles. Spectral, coherence and cross-correlation analyses of the recorded signals demonstrated alternating epoch-I and epoch-II intervals in PD patients both at rest and while they held a stable posture. Epoch-II intervals are characterized by the presence of 4–8 Hz overt tremor, enhanced MU synchrony and spike-doublets or triplets bearing a one-to-one relation to each tremor cycle. Epoch-I resembled physiological tremor in that it was characterized by 6–10 Hz non-overt tremor, lower MU synchrony and rhythmical MU firing at the intrinsic rate of the unit. The frequency of overt and non-overt tremor remained the same whether the patient was at rest or held a stable posture and the same was true of the remaining characteristics of epoch-I and epoch-II. The mean interval between spikes of a doublet/triplet varied between 30 and 50 ms and, for any given patient, remained roughly constant throughout measurements. This is the first time that enhanced MU synchrony and spike doublets/triplets characterized by relatively stable interspike intervals, are shown to accompany the overt tremor of PD patients. To account for our findings we propose that a two-state oscillatory spinal stretch reflex loop generates overt parkinsonian tremor in response to intermittent, descending, relatively high frequency oscillatory signals.

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Section: Introductionmentioning

confidence: 93%

Characteristics of Rest and Postural Tremors in Parkinson’s Disease: An Analysis of Motor Unit Firing Synchrony and Patterns

Agapaki

Christakos

Anastasopoulos

2018

Front. Hum. Neurosci.

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“…Among the review articles, ten studies reported the effects of peripheral electrical stimulation results on patients with ET [18][19][20][21][22][23][24][25][26][27] while ten studies reported on patients with PD [28][29][30][31][32][33][34][35][36][37] and seven studies included both patients with ET and patients with PD [16,17,[38][39][40][41][42]. In order to compare electrical stimulation strategies, some studies also included healthy volunteers that either mimicked tremorgenic activity during experimentation or were subject to artificially induced tremors for experimentation [31,38,41].…”

Section: Target Populationsmentioning

confidence: 99%

Peripheral electrical stimulation to reduce pathological tremor: a review

Pascual-Valdunciel

Hoo

Avrillon

et al. 2021

J NeuroEngineering Rehabil

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Interventions to reduce tremor in essential tremor (ET) and Parkinson’s disease (PD) clinical populations often utilize pharmacological or surgical therapies. However, there can be significant side effects, decline in effectiveness over time, or clinical contraindications for these interventions. Therefore, alternative approaches must be considered and developed. Some non-pharmacological strategies include assistive devices, orthoses and mechanical loading of the tremorgenic limb, while others propose peripheral electrical stimulation. Specifically, peripheral electrical stimulation encompasses strategies that activate motor and sensory pathways to evoke muscle contractions and impact sensorimotor function. Numerous studies report the efficacy of peripheral electrical stimulation to alter tremor generation, thereby opening new perspectives for both short- and long-term tremor reduction. Therefore, it is timely to explore this promising modality in a comprehensive review. In this review, we analyzed 27 studies that reported the use of peripheral electrical stimulation to reduce tremor and discuss various considerations regarding peripheral electrical stimulation: the stimulation strategies and parameters, electrodes, experimental designs, results, and mechanisms hypothesized to reduce tremor. From our review, we identified a high degree of disparity across studies with regard to stimulation patterns, experimental designs and methods of assessing tremor. Having standardized experimental methodology is a critical step in the field and is needed in order to accurately compare results across studies. With this review, we explore peripheral electrical stimulation as an intervention for tremor reduction, identify the limitations and benefits of the current state-of-the-art studies, and provide ideas to guide the development of novel approaches based on the neural circuitries and mechanical properties implied in tremor generation.

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“…These include the basal ganglia (Bergman & Deuschl, 2002; Liu et al 2002; Brown, 2003) and the thalamus (Lenz et al 1988). Other findings argue for the participation of proprioceptive input in this process (Rack & Ross, 1986; Spiegel et al 2002). There also exist observations suggesting the involvement of peripheral loops (Burne, 1987) and spinal motor systems (Rivlin‐Etzion et al 2008) in tremor generation.…”

Section: Introductionmentioning

confidence: 99%

Tremor‐related motor unit firing in Parkinson's disease: implications for tremor genesis

Christakos

Erimaki

Anagnostou

et al. 2009

The Journal of Physiology

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Muscle tremors reflect rhythmical motor unit (MU) activities. Therefore, the MU firing patterns and synchrony determine the properties of the parkinsonian force tremor (FT) and the neurogenic components of associated limb tremors. They may also be indicative of the neural mechanisms of tremor genesis which to date remain uncertain. We examined these MU behaviours during isometric contractions of a finger muscle in 19 parkinsonian subjects. Our results reveal that the parkinsonian FT is abnormally large. Like the physiological FT, it is accompanied by in-phase rhythms in all MU activities. However, there exist two important differences. Firstly, the synchrony during the parkinsonian FT is stronger than the normal one and therefore contributes to the FT enhancement. Secondly, the synchronous MU components partly represent rhythmical sequences of spike doublets and triplets whose incidences directly reflect the differences of the MU firing rates to the FT frequency. According to our analyses, the latter frequency coincides with the MU recruitment rate. Consequently, the numerous mediumand small-sized active MUs contribute rhythmical twitch doublets and triplets, i.e. large force pulses, to the parkinsonian FT. The impact of this effect on the FT amplitude is found to predominate over the impact of the augmented synchrony. Importantly, apart from the rule governing the occurrence of doublets/triplets, the mean interspike intervals within such spike events are fairly fixed around 50 ms. Such regularities in MU activities may reflect properties of the neural input underlying the FT, and thus represent a basis for more focused studies of the generator(s) of parkinsonian tremors.

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Influence of Proprioceptive Input on Parkinsonian Tremor

Cited by 18 publications

References 19 publications

Characteristics of Rest and Postural Tremors in Parkinson’s Disease: An Analysis of Motor Unit Firing Synchrony and Patterns

Characteristics of Rest and Postural Tremors in Parkinson’s Disease: An Analysis of Motor Unit Firing Synchrony and Patterns

Peripheral electrical stimulation to reduce pathological tremor: a review

Tremor‐related motor unit firing in Parkinson's disease: implications for tremor genesis

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