Re-emergent Tremor in Parkinson’s Disease: The Role of the Motor Cortex

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dc.contributor.authorLeodori, Giorgio
dc.contributor.authorBelvisi, Daniele
dc.contributor.authorDe Bartolo, Maria I.
dc.contributor.authorFabbrini, Andrea
dc.contributor.authorCostanzo, Matteo
dc.contributor.authorVial Undurraga, Felipe
dc.contributor.authorConte, Antonella
dc.contributor.authorHallett, Mark
dc.contributor.authorBerardelli, Alfredo
dc.date.accessioned2021-10-27T02:26:51Z
dc.date.available2021-10-27T02:26:51Z
dc.date.issued2020
dc.description.abstractBackground: Parkinson’s disease patients may show a tremor that appears after a variable delay while the arms are kept outstretched (re-emergent tremor). The objectives of this study were to investigate re-emergent tremor pathophysiology by studying the role of the primary motor cortex in this tremor and making a comparison with rest tremor. Methods: We enrolled 10 Parkinson’s disease patients with both re-emergent and rest tremor. Tremor was assessed by spectral analysis, corticomuscular coherence and tremor-resetting produced by transcranial magnetic stimulation over the primary motor cortex. We also recorded transcranial magnetic stimulation-evoked potentials generated by motor cortex stimulation during rest tremor, tremor suppression during wrist extension, and re-emergent tremor. Spectral analysis, corticomuscular coherence, and tremor resetting were compared between re-emergent tremor and rest tremor. Results: Re-emergent tremor showed significant corticomuscular coherence, causal relation between motor cortex activity and tremor muscle and tremor resetting. The P60 component of transcranial magnetic stimulation-evoked potentials reduced in amplitude during tremor suppression, recovered before re-emergent tremor, was facilitated at re-emergent tremor onset, and returned to values similar to those of rest tremor during re-emergent tremor. Compared with rest tremor, re-emergent tremor showed similar corticomuscular coherence and tremor resetting, but slightly higher frequency. Conclusions: Re-emergent tremor is causally related with the activity of the primary motor cortex, which is likely a convergence node in the network that generates re-emergent tremor. Re-emergent tremor and rest tremor share common pathophysiological mechanisms in which the motor cortex plays a crucial role.es
dc.identifier.citationMovement Disorders, Vol. 35, No. 6, 2020es
dc.identifier.urihttps://doi.org/10.1002/mds.2802es
dc.identifier.urihttp://hdl.handle.net/11447/4942
dc.language.isoenes
dc.subjectClinical neurophysiologyes
dc.subjectMotor cortexes
dc.subjectParkinson’s diseasees
dc.subjectTMS-EEGes
dc.subjectTremores
dc.titleRe-emergent Tremor in Parkinson’s Disease: The Role of the Motor Cortexes
dc.typeArticlees

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