The movement disorder essential tremor can be treated with deep brain stimulation (DBS), where electric current is delivered to deep brain structures through permanently implanted electrodes. In this study, brain activity during working memory performance was measured with functional magnetic resonance imaging in thirteen essential tremor patients with DBS in caudal Zona incerta, a diencephalic nucleus. With active stimulation less exertion of certain working memory areas was required to achieve the same level of performance in a manipulation and a maintenance-type working memory task. At the same time, a relatively higher activation was reached for the more demanding manipulation task. These results indicate that DBS can make the brains of tremor patients more efficient in working memory tasks, in accordance with the “efficiency hypothesis” proposed by Nyberg et al. (2014). / Rörelsestörningen essentiell tremor kan behandlas med djup hjärnstimulering (DBS), vid vilken elektrisk ström tillförs djupa hjärnstrukturer genom permanent inopererade elektroder. I den här studien mättes hjärnaktivering under arbetsminnesbelastning med funktionell magnetresonans-tomografi hos tretton essentiell tremor-patienter med DBS i kaudala Zona incerta, en kärna i mellanhjärnan. Med stimuleringen påslagen krävdes en lägre hjärnaktivering i arbetsminnes-relaterade områden för att nå samma resultat i två arbetsminnesuppgifter där den enda krävde manipulation och den andra enbart kvarhållande av information. Samtidigt kunde en relativt sett högre aktiveringsnivå uppnås för den mer krävande manipulationsuppgiften. De här resultaten tyder på att DBS kan göra tremorpatienters hjärna mer effektiv i arbetsminnesuppgifter, i enlighet med den “effektivitetshypotes” som lagts fram av Nyberg m fl (2014).

京都大学 / 新制・課程博士 / 博士(理学) / 甲第23454号 / 理博第4748号 / 新制||理||1681(附属図書館) / 京都大学大学院理学研究科地球惑星科学専攻 / (主査)准教授 伊藤 喜宏, 准教授 宮澤 理稔, 教授 久家 慶子 / 学位規則第4条第1項該当 / Doctor of Science / Kyoto University / DGAM

Parkinson’s disease causes among other symptoms also writing disorder. Parkinson's dysgrafia is disease the writing of parkinsonics. The aim of the work is to show the importance of examinig the parametres of Parkinson's dysgrafia and to find writing parametres, which could distinguish healthy subjects from the pacient and also it could monitoring progress of pakinson's disease. Some of the parametrs showed marked differences and therefore could distinguish healthy people from those with Parkinson’s disease.

Essential Tremor (ET), a condition characterized by postural and kinetic tremor in the upper limbs, is one of the most prevalent movement disorders. While pharmaceutical and surgical treatment options exist, they are not ideal. Assistive devices have the potential to provide relief to patients but are largely unexplored for ET. Furthermore, prior characterizations of essential tremor have focused on endpoint tremor and provide insufficient detail for designing such a device. We propose and demonstrate a novel method for characterizing essential tremor in the 7 proximal degrees of freedom (DOF) of the upper limb in various postures. In addition, we provide a preliminary characterization in a small number of patients with mild ET. We collected data from 10 patients with ET. Subjects were instrumented with four electromagnetic sensors that recorded orientation of upper limb segments. After a calibration, each subject positioned his/her upper limb in 16 different postures for 15 seconds each. This procedure was repeated 4 times for each subject, with each repetition being considered a run. Sensor data were converted to angular kinematic data for each DOF using inverse kinematics, a practice unique to this study. These data were then analyzed in the frequency domain to calculate the power associated with the tremor in each DOF and posture. More specifically, we computed the area of the periodogram over the 4-12 Hz frequency band typically associated with ET [narrow-band area (NBA)] and over the wider frequency band from 2 Hz to the Nyquist frequency [wide-band area (WBA)]. If significant peaks were found in the 4-12 Hz band, their frequency and amplitude were reported. Mixed-model ANOVA tests were used to investigate effects of DOF, posture, run, gravity, and patient characteristics on reported measures. NBA and WBA varied significantly between DOF, being lowest in the wrist, intermediate in the shoulder, and greatest in the elbow and forearm (pronation-supination). NBA and WBA also varied significantly with posture. Only 5% of observations had significant peaks, with 49% of peaks occurring in wrist flexion-extension and 39% occurring in wrist radial-ulnar deviation. Peak frequency was quite stereotyped (5.7 Hz ± 1.3Hz). Run had no significant effects, indicating that tremor measures were consistent over the duration of the experiment. Effects of gravity and demographic factors on measures were mixed and did not present a discernible pattern. This preliminary characterization suggests that tremor may be focused in a subset of upper limb DOF, being greatest (in terms of power) in elbow flexion-extension and forearm pronation-supination, and most concentrated (with peaks at a stereotyped frequency) in wrist flexion-extension and radial-ulnar deviation. Our method of 7 DOF characterization through inverse kinematics, in conjunction with future research (isolation studies, EMG, and finger DOF) may allow for optimal tremor suppression by an orthosis.

Two subjects exhibiting drug-induced hand tremor received EMG feedback from electrode sites above the forearm extensor muscles . EMG feedback resulted in reductions in muscle potentials for both subjects. However, self-report measures of tremor severity showed only general improvement in Subject l and little or no improvement in Subject 2. Behavioral measures of hand steadiness taken immediately after each treatment session showed slight changes across treatment conditions for both subjects. As indicated by a rapid increase in EMG measures during reversal, treatment effects appear transitory.

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