Action tremor and weakness in Parkinson's disease: a study of the elbow extensors.
Identifieur interne : 004512 ( PubMed/Checkpoint ); précédent : 004511; suivant : 004513Action tremor and weakness in Parkinson's disease: a study of the elbow extensors.
Auteurs : P. Brown [Royaume-Uni] ; D M Corcos ; J C RothwellSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1998.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (pharmacology), Case-Control Studies, Elbow Joint (drug effects), Elbow Joint (physiology), Electromyography, Female, Humans, Intervention Studies, Longitudinal Studies, Male, Middle Aged, Muscle Contraction (drug effects), Muscle Contraction (physiology), Muscle Weakness (drug therapy), Muscle Weakness (physiopathology), Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Torque, Tremor (drug therapy), Tremor (physiopathology).
- MESH :
- chemical , pharmacology : Antiparkinson Agents.
- drug effects : Elbow Joint, Muscle Contraction.
- drug therapy : Muscle Weakness, Parkinson Disease, Tremor.
- physiology : Elbow Joint, Muscle Contraction.
- physiopathology : Muscle Weakness, Parkinson Disease, Tremor.
- Aged, Case-Control Studies, Electromyography, Female, Humans, Intervention Studies, Longitudinal Studies, Male, Middle Aged, Torque.
Abstract
We have previously shown that action tremor persists during maximal wrist extension in patients with Parkinson's disease, and that this contributes to weakness at this joint by preventing the fully fused contraction of the forearm extensor muscles. Antiparkinsonian medication reduces the action tremor in torque and electromyographic (EMG) records, thereby improving strength at the wrist. In the present experiments, peak torque and action tremor were recorded during maximal extension of the elbow in nine patients with Parkinson's disease while they were on and off antiparkinsonian medication, and in eight age- and sex-matched healthy subjects. Peak torque and mean rectified EMG levels were reduced by 34% and 36%, respectively, during maximal elbow extension when patients off medication were compared to those in the treated state. Action tremor was visible in torque records and had a frequency of approximately 10 Hz both in parkinsonian patients and in normal controls. Activity of a similar frequency was often detected in EMG records, especially in patients off therapy. The absolute amplitude of action tremor in torque (A[torque]) and EMG (A[EMG]) records from the elbow was unaffected by therapy and was little different from that recorded in healthy controls. The relative action tremor in torque ([A(torque)/peak torque] x 100) and EMG ([A(EMG)/mean rectified EMG] x 100) was reduced by treatment, but this was the result of the increase in peak torque and mean rectified EMG. Thus, in contrast to the results at the wrist, antiparkinsonian medication has little effect on the 10-Hz action tremor at the elbow. Increased strength is produced by a different mechanism which allows recruitment of triceps motor units outside of this synchronizing influence.
DOI: 10.1002/mds.870130114
PubMed: 9452327
Affiliations:
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Brown</name><affiliation wicri:level="3"><nlm:affiliation>MRC Human Movement and Balance Unit, Institute of Neurology, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Human Movement and Balance Unit, Institute of Neurology, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Corcos, D M" sort="Corcos, D M" uniqKey="Corcos D" first="D M" last="Corcos">D M Corcos</name></author><author><name sortKey="Rothwell, J C" sort="Rothwell, J C" uniqKey="Rothwell J" first="J C" last="Rothwell">J C Rothwell</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1998">1998</date><idno type="RBID">pubmed:9452327</idno><idno type="pmid">9452327</idno><idno type="doi">10.1002/mds.870130114</idno><idno type="wicri:Area/PubMed/Corpus">004516</idno><idno type="wicri:Area/PubMed/Curation">004516</idno><idno type="wicri:Area/PubMed/Checkpoint">004512</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Action tremor and weakness in Parkinson's disease: a study of the elbow extensors.</title><author><name sortKey="Brown, P" sort="Brown, P" uniqKey="Brown P" first="P" last="Brown">P. Brown</name><affiliation wicri:level="3"><nlm:affiliation>MRC Human Movement and Balance Unit, Institute of Neurology, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Human Movement and Balance Unit, Institute of Neurology, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Corcos, D M" sort="Corcos, D M" uniqKey="Corcos D" first="D M" last="Corcos">D M Corcos</name></author><author><name sortKey="Rothwell, J C" sort="Rothwell, J C" uniqKey="Rothwell J" first="J C" last="Rothwell">J C Rothwell</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="1998" type="published">1998</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (pharmacology)</term><term>Case-Control Studies</term><term>Elbow Joint (drug effects)</term><term>Elbow Joint (physiology)</term><term>Electromyography</term><term>Female</term><term>Humans</term><term>Intervention Studies</term><term>Longitudinal Studies</term><term>Male</term><term>Middle Aged</term><term>Muscle Contraction (drug effects)</term><term>Muscle Contraction (physiology)</term><term>Muscle Weakness (drug therapy)</term><term>Muscle Weakness (physiopathology)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Torque</term><term>Tremor (drug therapy)</term><term>Tremor (physiopathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Elbow Joint</term><term>Muscle Contraction</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Muscle Weakness</term><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Elbow Joint</term><term>Muscle Contraction</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Muscle Weakness</term><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Case-Control Studies</term><term>Electromyography</term><term>Female</term><term>Humans</term><term>Intervention Studies</term><term>Longitudinal Studies</term><term>Male</term><term>Middle Aged</term><term>Torque</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We have previously shown that action tremor persists during maximal wrist extension in patients with Parkinson's disease, and that this contributes to weakness at this joint by preventing the fully fused contraction of the forearm extensor muscles. Antiparkinsonian medication reduces the action tremor in torque and electromyographic (EMG) records, thereby improving strength at the wrist. In the present experiments, peak torque and action tremor were recorded during maximal extension of the elbow in nine patients with Parkinson's disease while they were on and off antiparkinsonian medication, and in eight age- and sex-matched healthy subjects. Peak torque and mean rectified EMG levels were reduced by 34% and 36%, respectively, during maximal elbow extension when patients off medication were compared to those in the treated state. Action tremor was visible in torque records and had a frequency of approximately 10 Hz both in parkinsonian patients and in normal controls. Activity of a similar frequency was often detected in EMG records, especially in patients off therapy. The absolute amplitude of action tremor in torque (A[torque]) and EMG (A[EMG]) records from the elbow was unaffected by therapy and was little different from that recorded in healthy controls. The relative action tremor in torque ([A(torque)/peak torque] x 100) and EMG ([A(EMG)/mean rectified EMG] x 100) was reduced by treatment, but this was the result of the increase in peak torque and mean rectified EMG. Thus, in contrast to the results at the wrist, antiparkinsonian medication has little effect on the 10-Hz action tremor at the elbow. Increased strength is produced by a different mechanism which allows recruitment of triceps motor units outside of this synchronizing influence.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">9452327</PMID><DateCreated><Year>1998</Year><Month>03</Month><Day>26</Day></DateCreated><DateCompleted><Year>1998</Year><Month>03</Month><Day>26</Day></DateCompleted><DateRevised><Year>2007</Year><Month>11</Month><Day>14</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>13</Volume><Issue>1</Issue><PubDate><Year>1998</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. 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Peak torque and mean rectified EMG levels were reduced by 34% and 36%, respectively, during maximal elbow extension when patients off medication were compared to those in the treated state. Action tremor was visible in torque records and had a frequency of approximately 10 Hz both in parkinsonian patients and in normal controls. Activity of a similar frequency was often detected in EMG records, especially in patients off therapy. The absolute amplitude of action tremor in torque (A[torque]) and EMG (A[EMG]) records from the elbow was unaffected by therapy and was little different from that recorded in healthy controls. The relative action tremor in torque ([A(torque)/peak torque] x 100) and EMG ([A(EMG)/mean rectified EMG] x 100) was reduced by treatment, but this was the result of the increase in peak torque and mean rectified EMG. Thus, in contrast to the results at the wrist, antiparkinsonian medication has little effect on the 10-Hz action tremor at the elbow. Increased strength is produced by a different mechanism which allows recruitment of triceps motor units outside of this synchronizing influence.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Brown</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>MRC Human Movement and Balance Unit, Institute of Neurology, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Corcos</LastName><ForeName>D M</ForeName><Initials>DM</Initials></Author><Author ValidYN="Y"><LastName>Rothwell</LastName><ForeName>J C</ForeName><Initials>JC</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>K04-NS01508</GrantID><Acronym>NS</Acronym><Agency>NINDS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01-AR33189</GrantID><Acronym>AR</Acronym><Agency>NIAMS NIH HHS</Agency><Country>United 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UI="D019415">Torque</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D014202">Tremor</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000188">drug therapy</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000503">physiopathology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1998</Year><Month>2</Month><Day>6</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1998</Year><Month>2</Month><Day>6</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1998</Year><Month>2</Month><Day>6</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">9452327</ArticleId><ArticleId IdType="doi">10.1002/mds.870130114</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Corcos, D M" sort="Corcos, D M" uniqKey="Corcos D" first="D M" last="Corcos">D M Corcos</name><name sortKey="Rothwell, J C" sort="Rothwell, J C" uniqKey="Rothwell J" first="J C" last="Rothwell">J C Rothwell</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Brown, P" sort="Brown, P" uniqKey="Brown P" first="P" last="Brown">P. 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