Aisen M L, Adelstein B D, Romero J, Morris A, Rosen M
Department of Neurology, Cornell University Medical College, White Plains, NY 10605.
Arch Neurol. 1992 Jul;49(7):740-2. doi: 10.1001/archneur.1992.00530310088016.
The tremor of chronic alcoholism, although clinically similar to essential tremor, has been considered a distinct syndrome. Its underlying mechanism was analyzed in five patients (none in the acute stages of alcohol withdrawal) hospitalized in an alcohol detoxification program. All five patients performed tracking tasks in which they pursued a linearly moving "target" light with a response light that they controlled by flexion-extension activity of the wrist. Stationary and dynamic targets were used with both isometric and unconstrained wrist mechanical interfaces. Frequency, torque, and displacement tremor characteristics were examined under varying inertial loading or isometric voluntary torque conditions. Two simultaneous tremor components were present in all patients: a prominent 4- to 7-Hz low-frequency peak and a smaller-amplitude 9.4- to 9.6-Hz high-frequency peak. As the inertia of the hand was augmented during unconstrained tasks, the low-frequency peak decreased, while the high-frequency peak was unaffected. As required voluntary effort was increased during isometric testing, the amplitude of the low-frequency peak increased. These findings suggest that the low-frequency peak represents the significant pathologic component of the tremor of chronic alcoholism and that it has a biomechanical reflex mechanism similar to that of the lower-amplitude normal physiologic tremor.
慢性酒精中毒性震颤虽然在临床上与特发性震颤相似，但一直被视为一种独特的综合征。在一个酒精解毒项目住院的5名患者（均非酒精戒断急性期患者）中分析了其潜在机制。所有5名患者都执行了跟踪任务，在任务中他们用一个由手腕屈伸活动控制的反应光追踪一个线性移动的“目标”光。使用了固定和动态目标以及等长和无约束的手腕机械接口。在不同的惯性负载或等长自愿扭矩条件下检查频率、扭矩和位移震颤特征。所有患者均存在两种同时出现的震颤成分：一个突出的4至7赫兹低频峰值和一个较小幅度的9.4至9.6赫兹高频峰值。在无约束任务中，随着手部惯性增加，低频峰值降低，而高频峰值不受影响。在等长测试中，随着所需的自愿努力增加，低频峰值的幅度增大。这些发现表明，低频峰值代表慢性酒精中毒性震颤的重要病理成分，并且它具有与幅度较小的正常生理性震颤相似的生物力学反射机制。
