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Postural tremor in Wilson's disease: A magnetoencephalographic study

✍ Scribed by Martin Südmeyer; Bettina Pollok; Harald Hefter; Joachim Gross; Lars Wojtecki; Markus Butz; Lars Timmermann; Alfons Schnitzler

Publisher
John Wiley and Sons
Year
2004
Tongue
English
Weight
596 KB
Volume
19
Category
Article
ISSN
0885-3185

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✦ Synopsis

Abstract

The following study included 5 Wilson's disease (WD) patients showing a right‐sided postural forearm tremor (4–6 Hz) and addressed the question of whether the primary motor cortex (M1) is involved in tremor generation. Using a 122‐channel whole‐head neuromagnetometer and surface electromyogram (EMG), we investigated cerebromuscular coupling. Postural tremor was observed in a sustained 45‐degree posture of the right‐sided forearm. Data were analyzed using dynamic imaging of coherent sources (DICS), revealing cerebromuscular coupling between EMG and cerebral activity. Coherent sources were superimposed on individual high‐resolution T1‐weighted magnetic resonance images (MRI). Phase lags between EMG and cerebral areas showing strongest coherence were determined by means of a Hilbert transform of both signals. In all patients, postural tremor was associated with strong coherence between tremor EMG and activity in contralateral primary sensorimotor cortex (S1/M1) at tremor or double tremor frequency. Phase lag values between S1/M1 activity and EMG revealed efferent and afferent components in the corticomuscular coupling. Taken together, our results indicate that postural tremor in WD is mediated through a pathological oscillatory drive from the primary motor cortex. © 2004 Movement Disorder Society

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