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Analysis of parkinsonian tremor and rigidity relying on peripheral and central intensifying mechanisms through thalamic activities
Author(s) -
Narabayashi Yohsuke,
Oshima Tomokazu
Publication year - 2014
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.77
Subject(s) - rigidity (electromagnetism) , muscle tone , resting tremor , medicine , postural tremor , stimulus (psychology) , thalamotomy , neuroscience , physical medicine and rehabilitation , thalamus , movement disorders , parkinson's disease , essential tremor , psychology , disease , deep brain stimulation , physics , pathology , quantum mechanics , psychotherapist
Background and Aim Passive and active muscle manipulations modify parkinsonian tremor and rigidity. We hypothesized that these outer maneuvers provoke thalamic 3 to 7‐Hz (τ‐range) and 13 to 27‐Hz (β‐band) activities, which in turn act to develop and maintain the symptoms. To test the hypothesis, we examined the temporal and quantitative relationships of the thalamic activities with the symptoms in conditions under the outer maneuvers. Methods In thalamotomy for 20 patients with P arkinson's disease, we monitored thalamic local field potentials and multiple unit spikes with surface electromyograms of neck and limb muscles. Results Tremor is intensified in postural and kinetic modes with higher amplitude and faster frequency than the resting state, and in tremor rhythms on the cogwheel rigidity with accelerated muscle tone. Exaggerated thalamic τ‐range activities always led to tremor of those intensified modes. The τ‐range activities developed and maintained tremor in keeping a quantitative relationship in amplitude. Both the passive and active muscle manipulations transiently abolished the β‐band activities, and then made them relapse to lead to rigidity in a waning and waxing fashion. Because of these changes of β‐band activities, the patient's active effort to move or hold postures caused a state in conflict between voluntary and involuntary contractions. Conclusion Together, the results suggest that passively activated peripheral kinesthetic afferents, and actively triggered central motor initiatives act to develop and maintain tremor and rigidity through the thalamic motor nuclei as the crucial relay stations.