This article reports a case of adult scoliosis with limb tremor treated with electroacupuncture. The patient presented with neck stiffness accompanied with limb tremor as the primary symptoms. The pattern was attributed to yang qi deficiency, and the treatment principle focused on unblocking the governor vessel, warming yang, and regulating qi. Acupuncture was applied to Dazhui (GV14), below the spinous processes of C₄-C₆ and bilateral C₄-C₆ Jiaji (EX-B2) points, Feishu (BL13), Xinshu (BL15), Pishu (BL20), Ganshu (BL18), Shenshu (BL23), Dachangshu (BL25). After achieving deqi sensation, bilateral C₄ Jiaji (EX-B2) and C₆ Jiaji (EX-B2) points were separately connected to an SDZ-Ⅴ electroacupuncture device, with continuous wave, 2 Hz of frequency, intensity should be within the tolerance of the patient, the needles were retained for 20 min. For the first 5 months, the treatment was 1-2 times a week, then reduced to 1-2 times a month thereafter. After 30 times of treatment, the patient's bilateral lower limb tremor resolved, the clinical rating scale for tremor (CRST) score was 13 points, the scoliosis showed improvement with about 10° reduction in Cobb angle. At 1-month follow-up, the condition remained stable without progression of scoliosis.
Adult ; Humans ; Acupuncture Points ; Electroacupuncture ; Scoliosis/physiopathology* ; Tremor/complications*

In order to characterize the characteristics of pathological tremor of human upper limb, a simulation system of pathological tremor of human arm was provided and its dynamic response was analyzed. Firstly, in this study, a two-degree-of-freedom human arm dynamic model was established and linearized according to the arbitrary initial angle of joints. After solving the analytical solutions of steady-state responses of the joints, the numerical solution was used to verify it. The results of theoretical analysis show that the two natural frequencies of the developed dynamic model are 2.9 Hz and 5.4 Hz, respectively, which meet the characteristic frequency range of pathological tremors. Then, combined with the measured parameters of human arm, a tremor simulation system was built, and the measured results of joint responses are in good agreement with the theoretical and simulation analysis results, which verifies the effectiveness of the theoretical model. The results show that the human arm pathological tremor simulation system designed in this paper can characterize the frequency and response amplitude of the human upper limb pathological tremor. Moreover, the relevant research lays a theoretical foundation and experimental conditions for the subsequent development of wearable tremor suppression devices.
Humans ; Tremor/physiopathology* ; Computer Simulation ; Arm/physiopathology* ; Joints/physiopathology* ; Biomechanical Phenomena ; Upper Extremity/physiopathology* ; Models, Biological

Pathological neural activity in subthalamic nucleus (STN) is closely related to the symptoms of Parkinson' s disease. Local field potentials (LFPs) recordings from subthalamic nucleus show that power spectral peaks exist at tremor, double tremor and tripble tremor frequencies, respectively. The interaction between these components in the multi-frequency tremor may be related to the generation of tremor. To study the linear and nonlinear relationship between those components, we analyzed STN LFPs from 9 Parkinson's disease patients using time frequency, cross correlation, Granger casuality and bi-spectral analysis. Results of the time-frequency analysis and cross-frequency correlation analysis demonstrated that the power density of those components significantly decreased as the alleviation of tremor and cross-correlation (0.18-0.50) exists during tremor period. Granger causality of the time-variant amplitude showed stronger contribution from tremor to double tremor components, and contributions from both tremor and double tremor components to triple tremor component. Quadratic phase couplings among these three components were detected by the bispectral approaches. The linear and nonlinear relationships existed among the multi-components and certainly confirmed that the dependence cross those frequencies and neurological mechanism of tremor involved complicate neural processes.
Action Potentials ; Electromyography ; Humans ; Parkinson Disease ; physiopathology ; Subthalamic Nucleus ; physiopathology ; Tremor ; physiopathology

An automatic control system was designed to suppress pathological tremor on wrist joint with two degrees of freedom (DoF) using functional electrical stimulation (FES). The tremor occurring in the wrist flexion-extension and adduction-abduction was expected to be suppressed. A musculoskeletal model of wrist joint was developed to serve as the control plant, which covered four main muscles (extensor carpi radialis longus, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris). A second-order mechanical impedance model was used to describe the wrist skeletal dynamics. The core work was to design the controller and a hybrid control strategy was proposed, which combined inverse model based on feed forward control and linear quadratic regulator (LQR) optimal control. Performance of the system was tested under different input conditions (step signal, sinusoidal signal, and real data of a patient)., The results indicated that the proposed hybrid controller could attenuate over 94% of the tremor amplitude on multi-DoF wrist joint.
Electric Stimulation ; Humans ; Muscle, Skeletal ; physiopathology ; Tremor ; prevention & control ; therapy ; Wrist ; Wrist Joint ; physiopathology

Adult ; Deep Brain Stimulation ; Essential Tremor ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Subthalamic Nucleus ; physiology

BACKGROUNDAlthough thalamotomy could dramatically improve both parkinsonian resting tremor and essential tremor (ET), the mechanisms are obviously different. This study aimed to investigate the neuronal activities in the ventrolateral thalamus of Parkinson's disease (PD) and ET.

METHODSThirty-six patients (PD: 20, ET: 16) were studied. Microelectrode recordings in the ventral oral posterior (Vop) and the ventral intermediate nucleus (Vim) of thalamus was performed on these patients who underwent thalamotomy. Electromyography (EMG) was recorded simultaneously on the contralateral limbs to surgery. Single unit analysis and the interspike intervals (ISIs) were measured for each neuronal type. ISI histogram and auto-correlograms were constructed to estimate the pattern of neuronal firing. Mann-Whitney test and Kruskal-Wallis (K-W) test were used to compare the mean spontaneous firing rate (MSFR) of neurons of PD and ET patients.

RESULTSThree hundred and twenty-three neurons were obtained from 20 PD trajectories, including 151 (46.7%) tremor related neuronal activity, 74 neurons (22.9%) with tonic firing, and 98 (30.4%) neurons with irregular discharge. One hundred and eighty-seven neurons were identified from 16 ET trajectories including 46 (24.6%) tremor-related neuronal activity, 77 (41.2%) neurons with tonic firing, and 64 neurons (34.2%) with irregular discharge. The analysis of MSFR of neurons with tonic firing was 26.7 (3.4 - 68.3) Hz (n = 74) and that of neurons with irregular discharge (n = 98) was 13.9 (3.0 - 58.1) Hz in PD; whereas MSFR of neurons with tonic firing (n = 77) was 48.8 (19.0 - 135.5) Hz and that of neurons with irregular discharge (n = 64) was 26.3 (8.7 - 84.7) Hz in ET. There were significant differences in the MSFR of two types of neuron for PD and ET (K-W test, both P < 0.05). Significant differences in the MSFR of neuron were also obtained from Vop and Vim of PD and ET (16.3 Hz vs. 34.8 Hz, 28.0 Hz vs. 49.9 Hz) (K-W test, both P < 0.05), respectively.

CONCLUSIONIn consistent with recent findings, the decreased MSFR of neurons observed in the Vop is likely to be involved in PD whereas the increased MSFR of neurons seen in the Vim may be a cause of ET.

Essential Tremor ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Neurons ; physiology ; Parkinson Disease ; physiopathology ; Retrospective Studies ; Ventral Thalamic Nuclei ; physiopathology

Aiming at three kinds of tremor, including essential tremor (ET), Parkinsonian disease (PD) tremor and physiological tremor (PT), which are subjected to frequent clinical misdiagnosis, a new method based on singular value decomposition (SVD) of empirical mode decomposition (EMD) and support vector machine (SVM) for the recognition of tremor is proposed in this paper. First, the hand acceleration signals of three different types of 40 tremor voluntary subjects were collected on the basis of informed consent, and the EMD method was used to decompose the signals into a number of stationary intrinsic mode functions (IMFs). Then the preceding four IMFs which could describe signals were selected, and the initial feature vector matrixes were formed. After the application of SVD technique to the initial feature vector matrixes, the singular values were obtained and used as the feature vectors of tremor types to be put in the support vector machine classifier as well as in the identification of tremor types. The results of experiment have shown that the proposed diagnosis method based on SVD of EMD and SVM can extract tremor features effectively and identify tremor types accurately. It also provides a new assistant approach for clinical diagnosis of tremor.
Algorithms ; Arm ; physiopathology ; Diagnosis, Computer-Assisted ; Diagnosis, Differential ; Electromyography ; methods ; Humans ; Muscle, Skeletal ; physiology ; Parkinson Disease ; diagnosis ; Signal Processing, Computer-Assisted ; Software ; Support Vector Machine ; Tremor ; diagnosis

OBJECTIVETo investigate the clinical heterogeneity of movement disorder in Parkinson's disease (PD).

METHODSNinety-eight PD patients (68 males and 30 females) were divided into tremor-dominant PD (n=23), mixed subtype PD (n=29) and postural instability and gait disorder (PIGD)-dominant PD (n=46) groups, and the clinical heterogeneity of the movement function of the patients was compared.

RESULTSThe initial symptom of tremor-predominant PD was tremor, but patients with PIGD-dominant PD had rigidity and gait disorder as the initial symptoms, commonly compromising the left limb. The amended Hoehn-Yahr stage of tremor-dominant PD was significantly lower than that of the PIGD-dominant PD, while the score of Mini-Mental State Examination (MMSE) was significantly higher in the former. No statistical differences were found in the gender, course of disease and family history between the patients with different subtypes of PD.

CONCLUSIONThere are significant differences in the initial and typical symptoms between tremor-dominant PD and PIGD-dominant PD.

Aged ; Female ; Gait Disorders, Neurologic ; classification ; pathology ; physiopathology ; Humans ; Male ; Middle Aged ; Movement Disorders ; classification ; pathology ; physiopathology ; Parkinson Disease ; classification ; pathology ; physiopathology ; Postural Balance ; Tremor ; pathology ; physiopathology

Tremor, a rhythmic and involuntary oscillatory movement of one or several body parts, is the movement resulting from the abnormal synchronization of motor neural units. Detecting and analyzing the ACC, EMG and EEG signals of tremor patients by signal processing methods are very important for clinical diagnosis, rating evaluation and detection of incipient illness. This paper introduces the applications of time domain,frequency domain, artificial neural network, high order accumulation, approximate entropy, fuzzy, chaos, discriminant analysis in the researches of tremor signals, and finally points out the application foreground of researches on tremor signals.
Electroencephalography ; methods ; Electromyography ; methods ; Humans ; Motor Cortex ; physiopathology ; Muscle, Skeletal ; physiopathology ; Signal Processing, Computer-Assisted ; Tremor ; physiopathology

OBJECTIVETo investigate the relationship between limb tremor and neuronal firing in thalamus (Vim) and retrospectively review the clinical effects and safety of the surgical treatment of essential tremor (ET).

METHODSForty-two ET patients received microelectrode-guided thalamotomy and 11 cases were quantitatively evaluated with FAHN rating scales pre- and post-operatively.

RESULTSThere were electrophysiological tremor-related neurons in ventrolateral part of thalamus. Lesioning of those neurons abolished contralateral limb tremor in all of the patients. No permanent contralateral weakness, dysarthria and hemorrhage were observed.

CONCLUSION"Tremor cell" in thalamus plays a key role in the symptom of ET patients. Destruction of those cells may completely and permanently abolish tremor symptom.

Adult ; Aged ; Aged, 80 and over ; Electrophysiology ; Essential Tremor ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neurons ; physiology ; Retrospective Studies ; Thalamus ; physiopathology ; surgery