Cerebellar involvement in Parkinson’s disease resting tremor
Identifieur interne : 000417 ( Main/Exploration ); précédent : 000416; suivant : 000418Cerebellar involvement in Parkinson’s disease resting tremor
Auteurs : Shannon C. Lefaivre ; Matt J. N. Brown ; Quincy J. AlmeidaSource :
- Cerebellum & Ataxias [ 2053-8871 ] ; 2016.
Abstract
There exists a lack of consensus regarding how cerebellar over-activity might influence tremor in Parkinson’s disease (PD). Specifically, it is unclear whether resting or postural tremor are differentially affected by cerebellar dysfunction. It is important to note that previous studies have only evaluated the influence of inhibitory stimulation on the lateral cerebellum, and have not considered the medial cerebellum. The aim of the current study was to compare the effects of a low-frequency rTMS protocol applied to the medial versus lateral cerebellum to localize the effects of cerebellar over-activity.
Fifty PD participants were randomly assigned to receive stimulation over the medial cerebellum (
The main finding was that resting tremor severity was reduced in tremor-dominant individuals, regardless of whether stimulation was applied over the medial (
Given that the cerebellum is overactive in PD, the improvements in resting tremor following an inhibitory stimulation protocol suggest that over-activity in cerebellar nuclei may be involved in the generation of resting tremor in PD. Low-frequency rTMS over the medial or lateral cerebellum provides promise of an alternative treatment for tremor in PD, a symptom that is poorly responsive to dopaminergic replacement.
The online version of this article (doi:10.1186/s40673-016-0051-5) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s40673-016-0051-5
PubMed: 27280027
PubMed Central: 4897799
Affiliations:
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Brown</name><affiliation><nlm:aff id="Aff2">Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N2L 3G1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Almeida, Quincy J" sort="Almeida, Quincy J" uniqKey="Almeida Q" first="Quincy J." last="Almeida">Quincy J. Almeida</name><affiliation><nlm:aff id="Aff1">Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON N2L 3C5 Canada</nlm:aff><wicri:noCountry code="subfield">ON N2L 3C5 Canada</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27280027</idno><idno type="pmc">4897799</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897799</idno><idno type="RBID">PMC:4897799</idno><idno type="doi">10.1186/s40673-016-0051-5</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000245</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000245</idno><idno type="wicri:Area/Pmc/Curation">000245</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000245</idno><idno type="wicri:Area/Pmc/Checkpoint">000152</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000152</idno><idno type="wicri:Area/Ncbi/Merge">001F96</idno><idno type="wicri:Area/Ncbi/Curation">001F96</idno><idno type="wicri:Area/Ncbi/Checkpoint">001F96</idno><idno type="wicri:Area/Main/Merge">000418</idno><idno type="wicri:Area/Main/Curation">000417</idno><idno type="wicri:Area/Main/Exploration">000417</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cerebellar involvement in Parkinson’s disease resting tremor</title><author><name sortKey="Lefaivre, Shannon C" sort="Lefaivre, Shannon C" uniqKey="Lefaivre S" first="Shannon C." last="Lefaivre">Shannon C. Lefaivre</name><affiliation><nlm:aff id="Aff1">Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON N2L 3C5 Canada</nlm:aff><wicri:noCountry code="subfield">ON N2L 3C5 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Brown, Matt J N" sort="Brown, Matt J N" uniqKey="Brown M" first="Matt J. N." last="Brown">Matt J. N. Brown</name><affiliation><nlm:aff id="Aff2">Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N2L 3G1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Almeida, Quincy J" sort="Almeida, Quincy J" uniqKey="Almeida Q" first="Quincy J." last="Almeida">Quincy J. Almeida</name><affiliation><nlm:aff id="Aff1">Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON N2L 3C5 Canada</nlm:aff><wicri:noCountry code="subfield">ON N2L 3C5 Canada</wicri:noCountry></affiliation></author></analytic><series><title level="j">Cerebellum & Ataxias</title><idno type="eISSN">2053-8871</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>There exists a lack of consensus regarding how cerebellar over-activity might influence tremor in Parkinson’s disease (PD). Specifically, it is unclear whether resting or postural tremor are differentially affected by cerebellar dysfunction. It is important to note that previous studies have only evaluated the influence of inhibitory stimulation on the lateral cerebellum, and have not considered the medial cerebellum. The aim of the current study was to compare the effects of a low-frequency rTMS protocol applied to the medial versus lateral cerebellum to localize the effects of cerebellar over-activity.</p></sec><sec><title>Methods</title><p>Fifty PD participants were randomly assigned to receive stimulation over the medial cerebellum (<italic>n</italic> = 20), lateral cerebellum (<italic>n</italic> = 20) or sham stimulation (<italic>n</italic> = 10). 900 pulses were delivered at 1Hz at 120 % resting motor threshold of the first dorsal interosseous muscle. Tremor was assessed quantitatively (before and after stimulation) using the Kinesia Homeview system which utilizes a wireless finger accelerometer to record tremor.</p></sec><sec><title>Results</title><p>The main finding was that resting tremor severity was reduced in tremor-dominant individuals, regardless of whether stimulation was applied over the medial (<italic>p</italic> = 0.024) or lateral (<italic>p</italic> = 0.033) cerebellum, but not in the sham group.</p></sec><sec><title>Conclusion</title><p>Given that the cerebellum is overactive in PD, the improvements in resting tremor following an inhibitory stimulation protocol suggest that over-activity in cerebellar nuclei may be involved in the generation of resting tremor in PD. Low-frequency rTMS over the medial or lateral cerebellum provides promise of an alternative treatment for tremor in PD, a symptom that is poorly responsive to dopaminergic replacement.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s40673-016-0051-5) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wirdefeldt, K" uniqKey="Wirdefeldt K">K Wirdefeldt</name></author><author><name sortKey="Adami, H O" uniqKey="Adami H">H-O Adami</name></author><author><name sortKey="Cole, P" uniqKey="Cole P">P Cole</name></author><author><name sortKey="Trichopoulos, D" uniqKey="Trichopoulos D">D Trichopoulos</name></author><author><name sortKey="Mandel, J" uniqKey="Mandel J">J Mandel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wu, T" uniqKey="Wu T">T 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sort="Almeida, Quincy J" uniqKey="Almeida Q" first="Quincy J." last="Almeida">Quincy J. Almeida</name><name sortKey="Brown, Matt J N" sort="Brown, Matt J N" uniqKey="Brown M" first="Matt J. N." last="Brown">Matt J. N. Brown</name><name sortKey="Lefaivre, Shannon C" sort="Lefaivre, Shannon C" uniqKey="Lefaivre S" first="Shannon C." last="Lefaivre">Shannon C. Lefaivre</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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