Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore-560029, Karnataka, India.
Parkinsonism Relat Disord. 2010 Jan;16(1):36-41. doi: 10.1016/j.parkreldis.2009.07.008. Epub 2009 Aug 3.
Electrophysiological evaluation of tremor secondary to intracranial space occupying lesions (SOL) and cranial trauma may provide information regarding pathophysiology of tremors.
To compare the electrophysiological characteristics of tremor secondary to SOL and trauma and to correlate tremor characteristics with sites of lesion, and types of SOL.
Multi-channel tremor recording and MRI were performed in 18 patients with predominantly tremor secondary to SOL (F: M = 5:6; age +/- SD: 26.6 +/- 15.0 years) and following trauma (7 men; age: 27.3 +/- 11.0 years).
In both groups, there was a wide range in the frequency of tremor (2.5-7.5 Hz in the SOL group and 2-7.5 Hz in the post-trauma group) and a strong inverse correlation of the frequency with the duration of EMG bursts (SOL group: r = 0.8, p = 0.004; post-trauma group: r = 0.9, p = 0.02). While all the patients with SOL had regular EMG bursts (synchronous - 54.6%, alternating - 27.3%, mixed - 18.2%), 85.7% of post-trauma patients had irregular EMG bursts (synchronous - 42.9%, alternating - 14.3%, mixed - 42.9%). In SOL group, those with predominantly intrinsic destructive lesions of brainstem, thalamus, or basal ganglia (n = 7) had a statistically significant lower mean frequency of tremor than those (n = 4) with either extrinsic or intrinsic compressive lesions (3.5 +/- 0.9 Hz vs 6.7 +/- 0.6 Hz; p = 0.0001). In the post-trauma group, the patients with additional lesions in thalamus or striatum, apart from white and grey matter lesions had lower mean tremor frequency (3.7 +/- 1.0 Hz vs 6.1 +/- 1.5 Hz; p = 0.05).
The electrophysiological characteristics of tremor secondary to SOL and trauma differ and correlate with the nature and sites of lesions. This information, which need to be validated in larger cohort of patients, may be useful in understanding the pathogenesis of tremor.
颅内占位病变（SOL）和颅脑创伤继发震颤的电生理评估可为震颤的病理生理学提供信息。
比较 SOL 和创伤继发震颤的电生理特征，并将震颤特征与病变部位和 SOL 类型相关联。
对 18 例以震颤为主的 SOL 继发震颤患者（F：M=5：6；年龄±SD：26.6±15.0 岁）和创伤后患者（7 例男性；年龄：27.3±11.0 岁）进行多通道震颤记录和 MRI。
在两组中，震颤频率范围广泛（SOL 组为 2.5-7.5Hz，创伤后组为 2-7.5Hz），并且 EMG 爆发的频率与频率呈强负相关（SOL 组：r=0.8，p=0.004；创伤后组：r=0.9，p=0.02）。虽然所有 SOL 患者的 EMG 爆发均规则（同步-54.6%，交替-27.3%，混合-18.2%），但 85.7%的创伤后患者的 EMG 爆发不规则（同步-42.9%，交替-14.3%，混合-42.9%）。在 SOL 组中，以脑桥、丘脑或基底节为主的内在破坏性病变（n=7）患者的震颤频率明显低于以外在或内在压迫性病变为主的患者（n=4）（3.5±0.9Hz 比 6.7±0.6Hz；p=0.0001）。在创伤后组中，除白质和灰质病变外，丘脑或纹状体有附加病变的患者的平均震颤频率较低（3.7±1.0Hz 比 6.1±1.5Hz；p=0.05）。
SOL 和创伤继发震颤的电生理特征不同，并与病变的性质和部位相关。这些信息，需要在更大的患者队列中验证，可能有助于理解震颤的发病机制。
