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Reference Values of the Forearm Tremor Power Spectra for Youth Athletes. J Hum Kinet 2023; 86:133-143. [PMID: 37181254 PMCID: PMC10170535 DOI: 10.5114/jhk/159644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The aim of the study was to determine reference graphs of power spectral density functions of forearm physiological tremor and to compare their parameters in the male and female population of young athletes from various sports. One hundred fifty-nine (159) female (15.7 ± 2.1 years, 59.8 ± 8.1 kg, 169.1 ± 7.5 cm) and 276 male (16.4 ± 1.9 years 72.7 ± 10.3 kg and 180.9 ± 8.7 cm) youth athletes participated in the study. Forearm tremor was measured accelerometrically in a sitting position. Power spectrum density (PSD) function was calculated for each individual tremor waveform. Because of right skewness of power distribution, the PSD functions were subjected to logarithmic transformation. Average log-powers in low (2–4 Hz) and high (8–14 Hz) frequency ranges and mean frequencies in those ranges were analyzed. Tremor log-powers for male were greater than for female athletes (p < 0.001), while frequencies of spectrum maxima did not differ from each other. Frequencies of spectrum maxima correlated (p < 0.001) with age (r = 0.277 and 0.326 for males and females, respectively). The obtained reference functions may be utilized in order to quantify and assess tremor size and its changes evoked by stress and fatigue, which can be applied for selection and training monitoring in sports, but also in medicine for detection and diagnosis of pathologic tremor in young individuals.
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Hu Y, Wu Y, Su H, Tu J, Zeng L, Lei J, Xia L. Exploring the relationship between brain white matter change and higher degree of invisible hand tremor with computer technology. Technol Health Care 2022; 31:921-931. [PMID: 36442160 DOI: 10.3233/thc-220361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: At present, the clinical diagnosis of white matter change (WMC) patients depends on cranial magnetic resonance imaging (MRI) technology. This diagnostic method is costly and does not allow for large-scale screening, leading to delays in the patient’s condition due to inability to receive timely diagnosis. OBJECTIVE: To evaluate whether the burden of WMC is associated with the degree of invisible hand tremor in humans. METHODS: Previous studies have shown that tremor is associated with WMC, however, tremor does not always have imaging of WMC. Therefore, to confirm that the appearance of WMC causes tremor, which are sometimes invisible to the naked eye, we achieved an optical-based computer-aided diagnostic device by detecting the invisible hand tremor, and we proposed a calculation method of WMC volume by using the characteristics of MRI images. RESULTS: Statistical analysis results further clarified the relationship between WMC and tremor, and our devices are validated for the detection of tremors with WMC. CONCLUSIONS: The burden of WMC volume is positive factor for degree of invisible hand tremor in the participants without visible hand tremor. Detection technology provides a more convenient and low-cost evaluating method before MRI for tremor diseases.
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Affiliation(s)
- Yang Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Yanqing Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Hai Su
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Jianglong Tu
- Department of Nephrology Medicine, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Luchuan Zeng
- School of Software, Nanchang University, Nanchang, Jiangxi, China
| | - Jie Lei
- School of Software, Nanchang University, Nanchang, Jiangxi, China
| | - Linglin Xia
- School of Software, Nanchang University, Nanchang, Jiangxi, China
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Riboldi GM, Frucht SJ. Is essential tremor a family of diseases or a syndrome? A family of diseases. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 163:7-29. [PMID: 35750371 DOI: 10.1016/bs.irn.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
It is now well-established that essential tremor (ET) can manifest with different clinical presentations and progressions (i.e., upper limb tremor, head tremor, voice tremor, lower limb tremor, task- or position-specific tremor, or a combination of those). Common traits and overlaps are identifiable across these different subtypes of ET, including a slow rate of progression, a response to alcohol and a positive family history. At the same time, each of these manifestations are associated with specific demographic, clinical and treatment-response characteristics suggesting a family of diseases rather than a spectrum of a syndrome. Here we summarize the most important clinical, demographic, neuropathological and imagingfeatures of ET and of its subtypes to support ET as a family of identifiable conditions. This classification has relevance for counseling of patients with regard to disease progression and treatment response, as well as for the design of therapeutic clinical trials.
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Affiliation(s)
- Giulietta M Riboldi
- The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, New York University Langone Health, New York, NY, United States
| | - Steven J Frucht
- The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, New York University Langone Health, New York, NY, United States.
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Ferrer M, Eliasen EH, Petersen MS, Jiang W, Zheng W, Louis ED. Meat Consumption and Meat Cooking Practices in Essential Tremor: A Population-Based Study in the Faroe Islands. Tremor Other Hyperkinet Mov (N Y) 2020; 10:30. [PMID: 32864189 PMCID: PMC7427676 DOI: 10.5334/tohm.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/17/2020] [Indexed: 11/20/2022] Open
Abstract
Background Elevated tissue levels of the tremor-producing neurotoxin, harmane, have been detected in patients with essential tremor (ET) in the USA and Spain. Recently, a study in the Faroe Islands similarly noted an elevation in blood harmane concentrations in probable and definite ET cases. The underlying mechanism is not understood. Possible mechanisms include increased dietary consumption (esp. through cooked meats), impaired metabolism, or increased endogenous production of harmane. To investigate this issue further, we conducted a population-based study in the Faroe Islands to examine meat consumption and meat cooking practices in ET cases and controls. Methods 1,328 Faroese adults were screened for tremor and 27 ET cases were identified. Meat consumption and meat cooking practices were compared to 200 controls. Detailed data were collected via questionnaires regarding current meat consumption for 14 meat types and meat cooking doneness for 8 meat types. Data were also available on blood harmane concentrations. Results Current meat consumption was similar in ET cases and controls in 12 out of 14 meat types, with no differences observed after a Bonferroni correction in any meat type; no difference was observed when stratified by gender. No difference was observed in meat doneness between ET cases and controls. Blood harmane concentrations were not correlated with dietary data. Discussion This is the first population-based study of harmane-linked dietary factors in ET. The study suggests the observed difference in blood harmane in ET is not driven by dietary differences and is likely due to other mechanisms (e.g., impaired metabolism).
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Affiliation(s)
- Monica Ferrer
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, US
| | - Eina H. Eliasen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, FO
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, FO
- Centre for Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, FO
| | - Wendy Jiang
- Purdue University School of Health Sciences, West Lafayette, IN, US
| | - Wei Zheng
- Purdue University School of Health Sciences, West Lafayette, IN, US
| | - Elan D. Louis
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern, Dallas, TX, US
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Hennekam RCM. The external phenotype of aging. Eur J Med Genet 2020; 63:103995. [PMID: 32726674 DOI: 10.1016/j.ejmg.2020.103995] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/27/2020] [Accepted: 06/26/2020] [Indexed: 12/17/2022]
Abstract
Aging is widely studied as a physiological process. Segmental aging can also occur prematurely in Mendelian disorders, and these can act this way as excellent sources of information, specifically for the underlying mechanisms. Adequate recognition of such aging characteristics in Mendelian disorders needs a well-defined phenotype of aging. Here the external phenotype of aging is described that can be recognized in the consulting room without major additional studies. Existing definitions of the signs and symptoms in Elements of Morphology or Human Phenotype Ontology are added or a new definition is suggested if none is available.
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Affiliation(s)
- Raoul C M Hennekam
- Department of Paediatrics, Room H7-236, Amsterdam UMC - location AMC, Meibergdreef 9, 1105AZ, Amsterdam, the Netherlands.
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Petersen MS. Assessing the Prevalence of Undetected Possible Dementia in Faroese Nursing Homes. Dement Geriatr Cogn Disord 2020; 48:30-38. [PMID: 31319414 DOI: 10.1159/000501607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION To assess the prevalence of possible dementia among nursing home residents in the Faroe Islands. METHOD This cross-sectional study, undertaken in 2017, included all nursing homes in the Faroe Islands (n = 30), housing 591 residents. All residents were invited to participate, except those with an existing clinical diagnosis of dementia or living in dementia units (n = 207). A total of 232 residents participated, while 39 declined and 113 were unable to give consent, had died, or were not permanent residents at the time of examination. Cognitive screening was carried out using the Mini-Mental State Examination (MMSE) and the Informant Questionnaire on Cognitive Decline (IQCODE). RESULTS Possible dementia was found in 49% to 78% of the participants depending on the method used. According to both MMSE and IQCODE (AND rule), possible dementia was present in 105 participants (49%). According only to IQCODE, 119 participants (55%) scored above the cut-off (≥3.6), according to MMSE alone, 162 participants (72%) scored below the cut-off (≤24 on MMSE), while 175 participants (78%) screened positive according to either MMSE or IQCODE (OR rule). A rough estimate of the prevalence of possible dementia in the entire nursing home population (n = 591) including residents with known dementia and those with possible dementia from this study was between 61% and 73%. CONCLUSION A high percentage (49-78%) of the participating nursing home residents without a pre-dementia diagnosis were assessed to have possible dementia based on screening with standardized tools, indicating a high degree of dementia underdiagnoses in Faroese nursing homes. This high prevalence of dementia is of significance for the clinical practice, running, and planning of nursing homes and pinpoints a need to act upon this, not only in the Faroes but also worldwide.
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Affiliation(s)
- Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faeroe Islands, .,Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faeroe Islands,
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Louis ED, Eliasen EH, Ferrer M, Iglesias Hernandez D, Gaini S, Jiang W, Zheng W, Nielsen F, Petersen MS. Blood Harmane (1-Methyl-9H-Pyrido[3,4-b]indole) and Mercury in Essential Tremor: A Population-Based, Environmental Epidemiology Study in the Faroe Islands. Neuroepidemiology 2020; 54:272-280. [PMID: 32007995 PMCID: PMC7210050 DOI: 10.1159/000505874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Essential tremor (ET) is among the most prevalent neurological diseases. Its environmental determinants are poorly understood. Harmane (1-methyl-9H-pyrido[3, 4-b]indole), a dietary tremor-producing neurotoxin, has been linked to ET in a few studies in New York and Madrid. Mercury, also a tremor-producing neurotoxin, has not been studied in ET. The Faroe Islands have been the focus of epidemiological investigations of numerous neurological disorders. OBJECTIVE In this population-based, case-control study, we directly measured blood harmane concentrations (HA) and blood mercury concentrations (Hg) in ET cases and controls. METHODS In total, 1,328 Faroese adults were screened; 26 ET cases were identified whose (HA) and (Hg) were compared to 197 controls. RESULTS Although there were no statistically significant differences between diagnostic groups, median (HA) was 2.7× higher in definite ET (4.13 g-10/mL) and 1.5× higher in probable ET (2.28 g-10/mL) than controls (1.53 g-10/mL). Small sample size was a limitation. For definite ET versus controls, p = 0.126. (Hg) were similar between groups. CONCLUSIONS We demonstrated marginally elevated (HA) in definite and probable ET. These data are similar to those previously published and possibly extend etiological links between this neurotoxin and ET to a third locale. The study did not support a link between mercury and ET.
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Affiliation(s)
- Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA,
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, USA,
- Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, Connecticut, USA,
| | - Eina H Eliasen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faeroe Islands
| | - Monica Ferrer
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | | | - Shahin Gaini
- Centre for Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faeroe Islands
- Infectious Diseases Division, National Hospital Faroe Islands, Tórshavn, Faeroe Islands
- Department of Infectious Diseases, Odense University Hospital/University of Southern Denmark, Odense, Denmark
| | - Wendy Jiang
- Purdue University School of Health Sciences, West Lafayette, Indiana, USA
| | - Wei Zheng
- Purdue University School of Health Sciences, West Lafayette, Indiana, USA
| | - Flemming Nielsen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faeroe Islands
- Centre for Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faeroe Islands
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Essential tremor pathology: neurodegeneration and reorganization of neuronal connections. Nat Rev Neurol 2020; 16:69-83. [PMID: 31959938 DOI: 10.1038/s41582-019-0302-1] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 01/26/2023]
Abstract
Essential tremor (ET) is the most common tremor disorder globally and is characterized by kinetic tremor of the upper limbs, although other clinical features can also occur. Postmortem studies are a particularly important avenue for advancing our understanding of the pathogenesis of ET; however, until recently, the number of such studies has been limited. Several recent postmortem studies have made important contributions to our understanding of the pathological changes that take place in ET. These studies identified abnormalities in the cerebellum, which primarily affected Purkinje cells (PCs), basket cells and climbing fibres, in individuals with ET. We suggest that some of these pathological changes (for example, focal PC axonal swellings, swellings in and regression of the PC dendritic arbor and PC death) are likely to be primary and degenerative. By contrast, other changes, such as an increase in PC recurrent axonal collateral formation and hypertrophy of GABAergic basket cell axonal processes, could be compensatory responses to restore cerebellar GABAergic tone and cerebellar cortical inhibitory efficacy. Such compensatory responses are likely to be insufficient, enabling the disease to progress. Here, we review the results of recent postmortem studies of ET and attempt to place these findings into an anatomical-physiological disease model.
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Louis ED, Eliasen EH, Kim CY, Ferrer M, Gaini S, Petersen MS. High Prevalence of Dystonia in the Faroe Islands: A Population-Based Study. Neuroepidemiology 2019; 53:220-224. [PMID: 31430749 DOI: 10.1159/000502455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/27/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND There are fewer than 5 population-based studies of dystonia worldwide. Only one utilized a movement disorders neurologist. Given the potential for founder effects, and the highly genetic nature of dystonia, the Faroe Islands provide a particularly interesting setting to study the prevalence of dystonia. OBJECTIVE To estimate the prevalence of dystonia. METHODS We used a 2-phase, population-based design, screening 1,334 randomly selected Faroese individuals aged ≥40 years from which a subsample of 227 participated in an in-person clinical evaluation. Dystonia was assessed by 2 movement disorder neurologists using videotaped examinations. RESULTS Two of 227 (0.88%, 95% CI -0.33 to 2.09%) were diagnosed with cervical or segmental dystonia. An unusual form of thumb flexion dystonia was noted in 75 more, yielding a combined prevalence of 33.92% (95% CI 27.73-40.11%). CONCLUSIONS The prevalence of cervical or segmental dystonia was as high as in one prior population-based study using similar methods. Furthermore, an unusual form of thumb flexion dystonia was uncovered, which yielded an extraordinarily high prevalence of dystonia in this population. Although our methods likely contributed to more complete capture of subtle dystonia, founder effects are highly likely to have been an additional major contributor to these findings.
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Affiliation(s)
- Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA, .,Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, USA, .,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, Connecticut, USA,
| | - Eina H Eliasen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faeroe Islands
| | - Christine Y Kim
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Monica Ferrer
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Shahin Gaini
- Centre for Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faeroe Islands.,Division of Infectious Diseases, National Hospital Faroe Islands, Tórshavn, Faeroe Islands.,Department of Infectious Diseases, Odense University Hospital/University of Southern Denmark, Odense, Denmark
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faeroe Islands.,Centre for Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faeroe Islands
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Kim CY, Petersen MS, Eliasen EH, Defazio G, Greene P, Jinnah HA, Tijssen MAJ, Louis ED. Involuntary Thumb Flexion on Neurological Examination: An Unusual Form of Upper Limb Dystonia in the Faroe Islands. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2019; 9:tre-09-686. [PMID: 31440418 PMCID: PMC6702791 DOI: 10.7916/tohm.v0.686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/23/2019] [Indexed: 12/25/2022]
Abstract
Background The prevalence of dystonia varies worldwide. A prior report suggested a high prevalence of focal dystonia in the Faroese population, possibly reflecting a founder effect. During standardized neurological examination as part of an ongoing neuroepidemiologic study in the Faroe Islands, we noted an unusual phenomenon of thumb flexion during repetitive hand movements in a subset of subjects and sought to define its phenomenology. Methods We requested commentary from a panel of dystonia experts regarding the phenomenology of the movements. These experts reviewed the videotaped neurological examination. Results Among the experts, dystonia was the leading diagnosis. Alternate causes were considered, but deemed less likely. Discussion Diagnosis of dystonia requires careful clinical assessment and consideration of associated features. We report a novel form of dystonia, not previously described to our knowledge, in this isolated population. Further studies of dystonia prevalence in the Faroe Islands are merited to characterize its burden in this population and its specific clinical characteristics.
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Affiliation(s)
- Christine Y Kim
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, FO.,Centre for Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, FO
| | - Eina H Eliasen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, FO
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, Neurology Unit, University of Cagliari, Cagliari, IT
| | - Paul Greene
- Mount Sinai School of Medicine, Movement Disorders Division, New York, NY, USA
| | - Hyder A Jinnah
- Departments of Neurology, Human Genetics and Pediatrics, Emory University, Atlanta, GA, USA
| | - Marina A J Tijssen
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, NL
| | - Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.,Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA
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Neuropathology and pathogenesis of extrapyramidal movement disorders: a critical update. II. Hyperkinetic disorders. J Neural Transm (Vienna) 2019; 126:997-1027. [DOI: 10.1007/s00702-019-02030-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/14/2019] [Indexed: 12/14/2022]
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