The cerebral mechanisms underlying dystonic and essential tremor: a multimodal network approach

Completed

Conditions: 10028037
dystonia

Registration Number: NL-OMON45276

Lead Sponsor: Radboud Universitair Medisch Centrum

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 32

Inclusion Criteria

For essential tremor patients:
-Clinical diagnosis of essential tremor
-Postural tremor of both hands
-Onset of tremor before the age of 65 (to exclude pathophysiological heterogeneity caused by age-related tremor [15]);For dystonic tremor patients:
-Clinical diagnosis of dystonic tremor
-Primary focal / segmental dystonia
-Presence of postural tremor of at least one arm (which may or may not be the dystonic limb)

Exclusion Criteria

-Neurological co-morbidity
-Moderate to severe head tremor (to avoid artifacts caused by extensive head motion during scanning)
-Cognitive dysfunction (clinical diagnosis of mild cognitive impairment or dementia)
-MRI or TACS contraindications

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>We will use concurrent EMG-fMRI to localize and compare tremor-related activity<br /><br>between both groups (outcome #1) - an approach we have previously validated in<br /><br>Parkinson*s tremor. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>Given the hypothesized role of inhibitory GABA-ergic circuits in both tremor<br /><br>types, we will use 3T magnetic resonance spectroscopy to compare GABA<br /><br>concentrations in the internal globus pallidus, cerebellum, and motor cortex<br /><br>between both groups (outcome #2). Also, we use a non-invasive, adaptive and<br /><br>controlled brain stimulation approach (transcranial alternating current<br /><br>stimulation; TACS) to test for the effect of inhibiting the motor cortex and<br /><br>cerebellum on tremor intensity (accelerometry) and, for the cerebellum, on<br /><br>tremor-related activity (EMG-fMRI) and (outcome #3). Previous research has<br /><br>shown powerful modulatory influences of TACS on both Parkinson*s tremor and ET. </p><br>