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4 "Essential tremor"
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Original Article
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Polysomnographic Evaluation of Sleep Disorders in Essential Tremor and Essential Tremor Plus: A Comparison With Healthy Controls
Ravi Prakash Singh, Mythirayee S, Doniparthi Venkata Seshagiri, Gulshan Kumar, Rohan Mohale, Pramod Kumar Pal, Bindu M Kutty, Jitender Saini, Nitish L Kamble, Vikram Holla, Ravi Yadav
J Mov Disord. 2025;18(1):45-54.   Published online October 28, 2024
DOI: https://doi.org/10.14802/jmd.24191
  • 978 View
  • 77 Download
AbstractAbstract PDF
Objective
To explore sleep patterns in individuals with essential tremor (ET) and essential tremor plus (ET-Plus) compared with healthy controls and assess differences between ET and ET-Plus, given the lack of established polysomnography (PSG) data on these groups and the potential for sleep disturbances to serve as clinical markers.
Methods
We conducted a prospective cross-sectional study at National Institute of Mental Health and Neurosciences, Bengaluru, from November 2021 to August 2023 on 45 patients (26 ET, 19 ET-Plus) and 45 controls. Tremor severity was assessed using The Essential Tremor Rating Assessment Scale (TETRAS) and Fahn‐Tolosa‐Marin Clinical Rating Scale (FTMRS). Sleep symptoms were assessed via the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Mayo Sleep Questionnaire, restless legs syndrome questionnaire, Berlin questionnaire, Generalized Anxiety Disorder Scale 7, and Patient Health Questionnaire-9. All patients and controls underwent overnight video PSG. Sleep scoring was manually performed by a trained sleep research technician and the first author following the American Academy of Sleep Medicine (2017) guidelines, with data analyzed using R studio.
Results
Compared with ET-Plus patients, ET patients had a younger onset age (46.8±11.1 years versus 30.8±16.7 years, respectively). Compared with ET patients, ET-Plus patients had higher TETRAS and FTMRS scores (p<0.005). Compared with controls, both ET patients and ET-Plus patients presented poorer sleep quality, excessive daytime sleepiness, rapid eye movement (REM) sleep behavior disorder, and restless legs syndrome symptoms. PSG findings supported these clinical observations, showing an elevated apnea‒hypopnea index, reduced total sleep time, prolonged REM latency, decreased sleep efficiency, increased N1 stage duration, and reduced N2/N3 durations and percentages in patients versus controls.
Conclusion
The study highlights significant sleep architecture abnormalities in both ET and ET-Plus patients compared with healthy controls, with no differences between the ET groups.
Brief communication
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Phonatory Characteristics of Male Patients with Classic Essential Tremor
Preetie Shetty Akkunje, Belur Keshavaprasad Yamini, Ravi Yadav, Nagarajarao Shivashankar, Palash Kumar Malo, Kandavel Thennarasu, Shantala Hegde, Pramod Kumar Pal
J Mov Disord. 2021;14(3):226-230.   Published online August 18, 2021
DOI: https://doi.org/10.14802/jmd.21010
  • 4,776 View
  • 103 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Objective
Voice tremor (VT) is one of the characteristics of essential tremor (ET). This study was designed to describe the group and phonatory characteristics of classic ET patients with VT.
Methods
This retrospective case-control study compared classic ET patients with age and sex-matched controls. The ET population was subgrouped based on auditory perceptual voice analysis. Electroglottography and acoustic voice samples obtained from both groups were analyzed for contact quotient (CQ) and multidimensional voice program parameters, i.e., fundamental frequency (F0), perturbation, noise, and tremor parameters.
Results
The CQ, F0, perturbation, noise, and tremor characteristics significantly increased from the moderate VT group to the severe VT group.
Conclusion
The CQ, F0, and noise characteristics reflected the vocal folds’ functionality. The perturbation and tremor parameters variation were reasoned considering the tremor-related changes occurring in the laryngeal, vocal tract, and expiratory muscles in patients with ET. Thus, phonatory analysis may help in monitoring the progression of ET.

Citations

Citations to this article as recorded by  
  • Exploiting speech tremors: machine learning for early diagnosis of amyotrophic lateral sclerosis
    Ritu Chauhan, Urvashi Sharma
    Engineering Research Express.2024; 6(4): 045224.     CrossRef
  • Voice Analysis in Patients with Essential Tremor
    Hakan Silek, Muzeyyen Dogan
    Journal of Voice.2023;[Epub]     CrossRef
Case Report
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Giant Middle Fossa Epidermoid Presenting as Holmes’ Tremor Syndrome
Bindu Menon, P Sasikala, Amit Agrawal
J Mov Disord. 2014;7(1):22-24.   Published online April 30, 2014
DOI: https://doi.org/10.14802/jmd.14005
  • 10,560 View
  • 67 Download
  • 4 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Intracranial dermoids may gradually reach an enormous size before the onset of symptoms. Common clinical presentations of intracranial epidermoid include headache and seizures. We present a case of a 35-year female patient with giant middle fossa epidermoid that presented with Holmes’ tremor syndrome, and we review the relevant literature. To the best of our knowledge, such a presentation has not previously been described in the literature.

Citations

Citations to this article as recorded by  
  • Holmes tremor
    Gabriela B. Raina, Maria G. Cersosimo, Silvia S. Folgar, Juan C. Giugni, Cristian Calandra, Juan P. Paviolo, Veronica A. Tkachuk, Carlos Zuñiga Ramirez, Andrea L. Tschopp, Daniela S. Calvo, Luis A. Pellene, Marcela C. Uribe Roca, Miriam Velez, Rolando J.
    Neurology.2016; 86(10): 931.     CrossRef
  • Movement Disorders Following Cerebrovascular Lesions: Etiology, Treatment Options and Prognosis
    Do-Young Kwon
    Journal of Movement Disorders.2016; 9(2): 63.     CrossRef
Original Article
Lateralized Effects of Unilateral Thalamotomy and Thalamic Stimulation in Patients with Essential Tremor
Mi J. Kim, Sang R. Jeon, Sung R. Kim, Myoung C. Lee, Sun J. Chung
J Mov Disord. 2011;4(2):64-67.
DOI: https://doi.org/10.14802/jmd.11013
  • 16,914 View
  • 78 Download
  • 8 Crossref
AbstractAbstract PDF
Background and Purpose

Stereotactic thalamotomy has been an effective surgical procedure in the treatment of medically refractory essential tremor (ET), however, little is known about the bilateral effects of unilateral ventralis intermedius (Vim) thalamotomy and Vim deep brain stimulation (DBS). We studied the lateralized effects of unilateral Vim thalamotomy and Vim DBS in ET patients.

Methods

Vim thalamotomy was performed in 6 patients and Vim DBS in 6. Patients were evaluated preoperatively and at 3 and 6 months postoperatively using the Clinical Rating Scale for Tremor (CRST).

Results

The contralateral Part A (tremor localization/severity rating) and Part B (specific motor tasks/function rating) subscores, and axial subscores of CRST significantly improved after unilateral Vim thalamotomy or Vim DBS. On the side ipsilateral to surgery, ET patients demonstrated no significant improvements in the Part A and Part B subscores of CRST. The Part C (functional disabilities resulting from tremor) subscores and total scores of CRST were significantly improved after surgery.

Conclusions

Vim thalamotomy and DBS may be equally effective for the management of contralateral and axial tremor in ET patients, but both interventions may not improve tremor on the side ipsilateral to surgery.

Citations

Citations to this article as recorded by  
  • Outcomes of stereotactic thalamotomy in patients of essential tremor: A systematic review
    Sagun Ghimire, Bibechan Thapa, Durga Neupane, Pashupati Pokharel
    Journal of Clinical Neuroscience.2024; 126: 38.     CrossRef
  • Displaced center of pressure on the treated side in individuals with essential tremor after radiofrequency ablation: a longitudinal case–control study
    Atsuya Sato, Takaomi Taira, Kazuya Kitada, Toshiki Ando, Toyohiro Hamaguchi, Michiko Konno, Yoshinori Kitabatake, Toshiyuki Ishioka
    Frontiers in Neurology.2023;[Epub]     CrossRef
  • Commentary on: A Network Approach to Understanding the Effects of Focused Ultrasound for Essential Tremor: Insights into Pathophysiology, Treatment, and Imaging Biomarkers
    Prashin Unadkat, David Eidelberg
    Neurotherapeutics.2022; 19(6): 1883.     CrossRef
  • Deep Brain Stimulation for Tremor: Update on Long-Term Outcomes, Target Considerations and Future Directions
    Naomi I. Kremer, Rik W. J. Pauwels, Nicolò G. Pozzi, Florian Lange, Jonas Roothans, Jens Volkmann, Martin M. Reich
    Journal of Clinical Medicine.2021; 10(16): 3468.     CrossRef
  • Clinical improvement associated with targeted interruption of the cerebellothalamic tract following MR-guided focused ultrasound for essential tremor
    J. Levi Chazen, Harini Sarva, Philip E. Stieg, Robert J. Min, Douglas J. Ballon, Kane O. Pryor, Paul M. Riegelhaupt, Michael G. Kaplitt
    Journal of Neurosurgery.2018; 129(2): 315.     CrossRef
  • Innovations in Functional Neurosurgery and Anesthetic Implications
    Lauren K. Dunn, Marcel E. Durieux, W. Jeffrey Elias, Edward C. Nemergut, Bhiken I. Naik
    Journal of Neurosurgical Anesthesiology.2018; 30(1): 18.     CrossRef
  • Surgical treatments for essential tremor
    Rodger J. Elble, Ludy Shih, Jeffrey W. Cozzens
    Expert Review of Neurotherapeutics.2018; 18(4): 303.     CrossRef
  • The Current Status of Deep Brain Stimulation for the Treatment of Parkinson Disease in the Republic of Korea
    Jung-Il Lee
    Journal of Movement Disorders.2015; 8(3): 115.     CrossRef

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