Clinical, neurophysiological and neuroimaging study of tremor in multiple sclerosis

Khabirov F.A.

Kazanskaia gosudarstvennaia meditsinskaia akademiia Minzdravsotsrazvitiia Rossii;
Respublikanskiĭ kliniko-diagnosticheskiĭ tsentr po demieliniziruiushchim zabolevaniiam Ministerstva zdravookhraneniia Respubliki Tatarstan, Kazan'

Aver'ianova L.A.

Babicheva N.N.

Granatov E.V.

Khaĭbullin T.I.

Clinical, neurophysiological and neuroimaging study of tremor in multiple sclerosis

Authors:

Khabirov F.A., Aver'ianova L.A., Babicheva N.N., Granatov E.V., Khaĭbullin T.I.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2015;115(2‑2): 21‑30

DOI: 10.17116/jnevro20151152221-30

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To cite this article:

Khabirov FA, Aver'ianova LA, Babicheva NN, Granatov EV, Khaĭbullin TI. Clinical, neurophysiological and neuroimaging study of tremor in multiple sclerosis. S.S. Korsakov Journal of Neurology and Psychiatry. 2015;115(2‑2):21‑30. (In Russ.)
https://doi.org/10.17116/jnevro20151152221-30

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Objective. To identify clinical types of tremor in multiple sclerosis (MS) and clarify their pathophysiological mechanisms. Material and methods. We examined 124 patients with MS, including 58 patients with tremor, using clinical (digital spiralography), neurophysiological (tremor electromyography, visual and sensory evoked potentials, transcranial magnetic stimulation with tremor resetting, long latency reflexes, electroencephalography) and neuroimaging (MRI, morphometry) methods. Results and conclusion. Five main variants of tremor were identified: distal postural and postural-intention (variant 1), distal intention (variant 2), proximal and distal intention and postural-intention (variant 3), Holmes (variant 4), axial (variant 5). Postural tremor (variants 1, 3) and rest tremor (variant 4) are caused by the central oscillators. Intention tremor (variants 2, 3), postural-intention tremor (variant 4), axial (variant 5) are caused by the pathology of cerebellar feedback loops. Clarification of mechanisms for the development of tremor in MS allowed to develop a scheme of differential treatment.

Keywords:

multiple sclerosis

tremor

oscillators

feedback loops

digital spiralography

long latency reflexes

tremor resetting

morphometry

treatment