Abstract
Objectives: This study aims to investigate if patients with inflammatory neuropathies and tremor have evidence of dysfunction in the cerebellum and interactions in sensorimotor cortex compared to nontremulous patients and healthy controls.
Methods: A prospective data collection study investigating patients with inflammatory neuropathy and tremor, patients with inflammatory neuropathy without tremor, and healthy controls on a test of cerebellar associative learning (eyeblink classical conditioning), a test of sensorimotor integration (short afferent inhibition), and a test of associative plasticity (paired associative stimulation). We also recorded tremor in the arms using accelerometry and surface EMG.
Results: We found impaired responses to eyeblink classical conditioning and paired associative stimulation in patients with neuropathy and tremor compared with neuropathy patients without tremor and healthy controls. Short afferent inhibition was normal in all groups.
Conclusions: Our data strongly suggest impairment of cerebellar function is linked to the production of tremor in patients with inflammatory neuropathy.
GLOSSARY
- ADM=
- abductor digiti minimi;
- ANOVA=
- analysis of variance;
- APB=
- abductor pollicis brevis;
- CIDP=
- chronic inflammatory demyelinating polyradiculoneuropathy;
- CR=
- conditioned blink responses;
- EBCC=
- eyeblink classical conditioning;
- FDI=
- first dorsal interossei;
- IgMPN=
- immunoglobulin M paraproteinaemic neuropathy;
- MEP=
- motor evoked potential;
- MMNCB=
- multifocal motor neuropathy with conduction block;
- MRC=
- Medical Research Council;
- ONLS=
- Overall Neuropathy Limitation Scale;
- PAS=
- paired associative stimulation;
- PF=
- peak tremor frequency;
- SAI=
- short afferent inhibition;
- TMS=
- transcranial magnetic stimulation;
- TP=
- total power of the spectra between 1 and 30 Hz used as surrogate measure of tremor amplitude;
- US=
- unconditioned stimulus;
- WE=
- wrist extensor muscles
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
Supplemental data at www.neurology.org
- Received September 25, 2012.
- Accepted in final form January 31, 2013.
- © 2013 American Academy of Neurology
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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