DBS in the Treatment of Intractable Movement Disorders
Parkinson DiseaseEssential Tremors and DystoniaThe aim of this study is to observe the efficacy of Deep Brain Stimulation in the treatment of Parkinson's disease,Essential Tremors and Dystonia in our locality.
Cyclic Deep Brain Stimulation in Essential Tremor
Essential TremorThe aim of the study is to prove the efficacy and safety of cyclical deep brain stimulation (DBS) in patients with essential tremor, and demonstrate non-inferiority of cyclical DBS on tremor control when compared to continuous stimulation.
Alternating Current Stimulation for Essential Tremor
Essential TremorMovement disorders are common neurological disorders, characterized by either excess or paucity of movements. Essential tremor (ET) is one of the most common of these disorders, defined as chronic, rhythmic involuntary movements (tremor) that occur primarily during action involving the upper extremities as prominent body site. ET occurs in between 0.4% and 4% of adults below age 60, its prevalence and related impairment of routine daily actions increasing dramatically with age. More than half of patients do not regain functional independence with medications. These patients are offered functional neurosurgical approaches that carry procedural risk or adverse effects secondary to deep electric stimulation of surgical lesioning. Hence, there is a substantial need for alternative, non-invasive therapeutic options for this disabling neurological disorder. Recently, non-invasive neuromodulation applied as transcranial alternating current stimulation (tACS), has emerged as promising for tremor control. In healthy subjects, tACS applied with a high definition (or focused) montage to the primary motor cortex (M1), was found to entrain physiological tremor; in patients with Parkinson's disease, tACS could decrease the amplitude of rest tremor when the stimulation was delivered in phase with, and at the same frequency of, the tremor. Tremor in ET could also be entrained applying ACS to the arm skin's peripheral nerves (transcutaneous ACS), but its effect on tremor amplitude is unknown. METHODS AND POTENTIAL CONTRIBUTION/IMPACT OF THE RESEARCH. The proposed project aims to explore the whole potential of tACS for the tremor suppression in ET. The investigators aim to test the following hypotheses: focused (or high definition, HD) tACS delivered over M1 at the same frequency of the tremor is effective in decreasing tremor amplitude in ET; this effect is strongest when the delivery of tACS is locked to the phase of the tremor expressed by the patient, i.e. administering tACS in a closed-loop modality; transcutaneous ACS in the upper extremities is as effective as tACS applied to the scalp around M1.
An Efficacy/Safety Study of Perampanel for Reducing Essential Tremor
Essential TremorObtain information on whether the medication Perampanel reduces tremor in people with essential tremor and is well-tolerated.
Transcranial Direct Current Stimulation of the Motor Cortex in Essential Tremor
Essential TremorTranscranial Direct Current StimulationThe current research is aimed at using Transcranial Direct Current Stimulation (tDCS) as complementary therapeutic tool in the treatment of essential tremor. Patients will be randomized into two groups (tDCS-cathode vs. tDCS-sham) according to detailed protocol. Main outcome will be measured by the change in tremor amplitude using an accelerometer pre and post cathodal tDCS of the motor cortex. A total of 40 patients ought to be enrolled as specified in methodology. Secondary outcomes will assess TRG essential tremor rating assessment scale (TETRAS) as well as clinical monitoring.
Continuous Tremor Assessment During Daily Activities
Essential TremorThe specific aim of this study is to evaluate if tremor severity and quality of life can be improved more using continuous home monitoring along with traditional assessments versus traditional assessments alone.
Motor-related Cortical Potential in Patients With Essential Tremor
Essential TremorMovement-related Cortical PotentialsIn this proposal, in addition to the conventional MRCP recording, the dipoles and sources of the different subcomponents of MRCP will also be analyzed with the brain electric source analysis (BESA) to evaluate the difference in the solutions and source strength underlying the MRCP between normal controls and patients with ET.
New Stereotactic Frame System for Neurosurgery
Parkinson DiseaseEssential Tremor3 moreThis study is designed to demonstrate an in-house developed re-attachable stereotactic system that can markedly reduce the overall deep brain stimulation (DBS) procedure time to greatly facilitate subject access to neurosurgical restorative therapies. Subjects will consist exclusively of individuals who have been approved to undergo deep brain stimulation surgery for the treatment of a neurological disorder at Mayo Clinic - Rochester MN. This study is a quantitative comparative, between-subject study enrolling approximately 10 subjects.
The Relationship of Muscle Strength With Functional Skills in Geriatric Individuals With Essential...
Essential TremorEssential tremor is one of the most common movement disorders in the world and is characterized by postural and/or kinetic tremor. Although the prevalence studies show differences due to the absence of a biological marker of the disease, it has been shown that the disease affects 4% of the population over 40 years of age and this rate may increase up to 14% in the population over 65 years of age. The annual incidence of Essential Tremor was found to be 616 per 100 thousand. The incidence of the disease increases with age. An incidence study shows that the disease increases progressively with age, with a sharp increase after age 49. In another study, it was stated that the age of onset of the disease showed a bimodal distribution, reaching the highest level in the second and sixth decades. It is stated that the severity and disability of tremor increase with age. The female-to-male ratio of the disease was found to be equal, but it was shown that more head tremor developed in females. Although the factors affecting essential tremor are aging, stress, family history, excessive caffeine consumption, smoking, muscle weakness, distal and proximal muscle strength differences were detected in young individuals with tremor. The aim of this study was to investigate the relationship between proximal and distal muscle strength and upper extremity functional skills in geriatric individuals with essential tremor.
Biomarkers in Neural Disorders
Parkinson's DiseaseAlzheimer's Disease7 moreThis study seeks to establish the sensitivity and specificity of what appears to be a unique brainstem biomarker of Parkinson's Disease (PD) - an electrically induced olygosynaptic nasotrigeminal reflex response - in differentiating early stage PD from normal controls and from patients with various other neurodegenerative diseases. This study will additionally compare the biomarker to olfactory testing.