Our primary objective is to identify the brain networks involved in tremor generation in homogeneous groups of ET patients. In addition we will investigate the differences on a behavioral level during goal-directed movements between ET subgroups and…
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Main outcome measures: changes in patterns of BOLD-signal, coupled to changes
in tremor intensity, extent of differentiated muscl use, and kinematic
parameters such as reaction time, velocity and acceleration and the presence of
'overshoot'. The different patient groups will be compared to each other and to
a healthy control group.
Secondary outcome
NA
Background summary
The most common motor disorder is pathological tremor. Several years of tremor
research have indicated that so-called central oscillators must underlie
different forms of pathological tremor. Yet, which brain structures and
networks host these oscillators, is still vigorously debated. Essential tremor
(ET) is the most common of the tremors characterized by an isolated postural
tremor of the upper extremities which can easily be manipulated, making it
eminently suitable to investigate tremor related brain areas. By concurrently
recording muscle and brain activity, EMG-fMRI is uniquely fitting to couple the
overt manifestation of tremor to its generators in the brain.
Study objective
Our primary objective is to identify the brain networks involved in tremor
generation in homogeneous groups of ET patients. In addition we will
investigate the differences on a behavioral level during goal-directed
movements between ET subgroups and healthy controls. In addition, we will
investigate the effect of medication on tremor and other kinematic parameters
by means of musclereflex measurements (only AMC). We hypothesize that specific
brain networks will be involved in tremor generation in the ET subgroups.
Study design
Observational. Patients with hereditary ET will be selected and divided into
groups based on medication response and presence/absence of an intention
component in the tremor. In addition healthy age-matched controls will be
investigated. Brain activity, muscle activity and movement will be compared
during movement tasks that evoke tremor. The whole study will be executed in a
multi-center setting (UMCG and AMC).
Study burden and risks
No risks, as long as the exclusion criteria are taken into account. Burden is
limited except for patients who are asked to withdraw from medication
temporarily. For details: see protocol.
Hanzeplein 1
Groningen 9713 GZ
NL
Hanzeplein 1
Groningen 9713 GZ
NL
Listed location countries
Age
Inclusion criteria
Healthy subjects:
- subjectively healthy, including vision (after correction)
- 18 years or older and as well as possible age-matched with patients
- informed consent
- righthanded according to the Annett Handedness scale
ET patients:
- ET according to the cirteria defined by the Tremor Investigation Group
- using propranolol or primidone effectively (determined subjectively) and willing to stop this medication temporarily, or intention to start medication use
- heriditary ET
- informed consent
- 18 years or older
- righthanded acoording to the Annett Handedness scale
- subjectively healthy (except for tremor), including vision (after correction)
Exclusion criteria
ET patients:
- absent (Tremor Rating Scale (TRS) Part A 2 UE < 2) or atypical tremor when off medication, as confirmed by polymyography (tremor recording)
- no measurable medication response
- no medication response after wash-in in de novo ET patients
General MR-related:
- presence of metal implants
- presence of electronic implants (eg heart pacemakers) en connections to electronic hardware (eg implanted electrodes)
- claustrophobia
- (possible) pregnancy
General other:
- MMSE < 27
- reumatoid disorder of the wrist, or other non-ET related disorders that can hamper fluent movement of the wrist
- use of medication/drugs that can influence taks performance
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL35788.042.11 |