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Synchronized brain network underlying postural tremor in Wilson's disease
Author(s) -
Südmeyer Martin,
Pollok Bettina,
Hefter Harald,
Gross Joachim,
Butz Markus,
Wojtecki Lars,
Timmermann Lars,
Schnitzler Alfons
Publication year - 2006
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21104
Subject(s) - supplementary motor area , thalamus , neuroscience , sma* , motor cortex , resting tremor , premotor cortex , electromyography , psychology , cerebellum , cortex (anatomy) , postural tremor , forearm , physical medicine and rehabilitation , primary motor cortex , medicine , essential tremor , functional magnetic resonance imaging , anatomy , mathematics , dopaminergic , dorsum , combinatorics , stimulation , dopamine
Common neurological manifestation of Wilson's disease (WD) is a postural tremor of the upper extremities. Recently, the primary sensorimotor cortex (S1/M1) has been shown to be involved in WD postural tremor generation. However, neuropathological changes in WD are mostly observed in subcortical structures. We therefore aimed to investigate whether S1/M1 may be functionally interconnected with other brain areas. In five WD patients, we used magnetoencephalography and surface electromyography (EMG) to record simultaneously cerebral neuronal activity and muscular activity during sustained posture of the right forearm. As demonstrated previously, the strongest coupling to tremor EMG was observed in the contralateral S1/M1. This area was taken as reference in order to identify and localize cerebro–cerebral coherence at tremor frequency and its first harmonic. The analysis revealed significant coherence within an oscillatory network including S1/M1, higher cortical motor areas (premotor cortex, PM; supplementary motor area, SMA), posterior parietal cortex (PPC) and thalamus contralateral as well as the cerebellum ipsilateral to the tremor forearm. Flow of information was mainly of bidirectional nature. Taken together, our results indicate that WD postural tremor is generated within a synchronized cerebello–thalamo–cortical network, comprising S1/M1, higher cortical motor areas (SMA, PM), and PPC. © 2006 Movement Disorder Society