• Journal of Biomedical Engineering Research
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• v.36 no.4
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• pp.103-108
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• 2015

Discrimination of Parkinson's disease (PD) from Essential tremor (ET) is often misdiagnosed in clinical practice. Since tremor is time-varying signal, and dominant and harmonic frequencies are shown in tremor only with moderate or severe symptom, there are some limitations to use frequency related features. Moreover, patients with PD or ET can suffer from both resting tremor and postural tremor. In this study, 28 patients with PD and 17 patients with ET were enrolled. Tremor was measured with accelerations on the more affected hand during resting and postural conditions. The ratio of root mean square (RMS) of resting tremor to RMS of postural tremor, the mean coefficients of autocorrelation function (ACF), and the mean of differences of two adjacent coefficients of ACF at resting and postural were calculated and compared between PD and ET. The performance showed 98% accuracy with support vector machine and leave-one-out cross validation. In addition, the method accurately differentiated the patients with tremor-dominant PD from patients with ET, with 100% accuracy. Therefore, the developed algorithm can assist clinicians in diagnosing and categorizing patients with tremor, especially, patients with mild symptom or the early stage of a disease, for proper treatment.

• Annals of Clinical Neurophysiology
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• v.3 no.2
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• pp.168-171
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• 2001

It has been said that variable anatomical structures and neural circuits are related to the generation of tremor. There are cerebral cortex, thalamus, basal ganglia, inferior olivary nucleus, midbrain tegmentum, stretch reflex, and musculoskeletal structures. The stretch reflex is related with the physiologic tremor and various peripherally originated tremors. We experienced a case with the post-stroke resting tremor which was induced and aggravated by mechanical stretching stimulation. In the present case, stretch reflex has a major role in the generation and exacerbation of tremor. It is presumed that the development of tremor is attributed to the increased rhythmicity of ventral intermedius nucleus of thalamus. The enhancement of thalamic rhythmicity may be due to the increasement of long latency reflex by post-stroke rigidity. This case suggests that stretch reflex may have a major role in the pathophysiologic mechanisms of a certain centrally originated tremor.

• The Journal of Internal Korean Medicine
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• v.27 no.3
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• pp.776-783
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• 2006

Tremor is a rhythmic and involuntary muscular contraction characterized by oscillations of a part of the body. The most common of all involuntary movements, tremor can affect various body parts such as hands, head, facial structures, vocal cords, trunk, and legs; most tremors, however, occur in the hands. Clinically, tremor is classified into postural tremor, resting tremor, action tremor, and other kinds of tremor, and treated according to the causes. The author reports the improvement of the patient, hospitalized at Dong Seo Medical Center, whose tremor was not classified specifically in western medicine but was diagnosed as Ganhyeolbujok (肝血不足) by Korean medicine.

• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.421-431
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• 2023

Objectives: The purpose of this study was to report the effect of complex Korean medicine treatments on Essential Tremor Plus (ET plus) patient aggravated by a traffic accident. Methods: We treated an ET plus patient with complex Korean medicine. The patient's resting tremor and kinetic tremor in both hands intensified after experiencing a traffic accident, with tremor in the left hand being worse than that in the right hand. Effect of complex Korean medicine treatment was evaluated using Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS), Numerical Rating Scale (NRS), and Beck Anxiety Inventory (BAI). Results: After 26 weeks of treatments (acupuncture, pharmacupuncture, cupping, Iigyeungbyunqi-therapy, and herbal medicine), the FTMTRS decreased from 38 to 15. NRS of Lt. upper limb pain decreased from NRS 9 to 0. BAI score also decreased from 31 to 17. Conclusions: Complex Korean medicine could be used to treat patients with ET plus aggravated by a traffic accident.

• Journal of Biomedical Engineering Research
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• v.35 no.4
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• pp.81-86
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• 2014

One of the methods for Parkinson's disease(PD) tremor evaluation is the Clinical Tremor Rating Scale(CTRS). However, the method has some limitations that clinician ratings can vary because the scores are subjectively rated. In addition, most researches usually collected data measured on the more affected arm. In this study, we developed a portable wearable system(SNUMAP system) for measuring PD tremor. The SNUMAP system captures 3-dimensional motion using tri-accelerometer and tri-gyroscope on finger and wrist. 40 PD patients participated in resting tremor and postural tremor tasks, while wearing the system on both hands simultaneously. Estimated tremor scores from Leave-One-Out Cross Validation for regression were highly correlated to the average clinician CTRS scores for rest tremor($r^2$ = 0.87, RMSE = 0.48) and postural tremor($r^2$ = 0.82, RMSE = 0.48). Therefore, the quantitative assessment model can improve treatment of PD patients.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1360-1364
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• 2000

This 26-year-old man gradually developed a disabling midbrain tremor involving both distal and proximal part of left upper arm. On neurologic examination, oculomotor palsy, and ataxia of the left arm were noted. Radiologic examination revealed a mass lesion on midbrain tegmentum. He was tentatively diagnosed as brain tumor (presumably germinoma) without stereotactic biopsy. Conventional radiation therapy was given for this lesion. Although there was improvement in the radiologic imaging, his midbrain tremor worsened and became untolerable. The authors performed MR-guided stereotactic Vim-thalamotomy. With macroelectrode stimulation and radiofequency lesioning, his resting, postural and action tremors were almost completely abolished in both distal and proximal part of left upper extremity. Authors consider that Vim thalamotomy is still an effective means of controlling midbrain tremor involving proximal upper limb.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.165-180
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• 2007

Parkinson's disease is a common neurodegenerative disorder charaterized by distal resting tremor, rigidity, and bradykinesia, and asymmetric onset. The patient was 38-year-old man who had Parkinson's disease diagnosed and complained resting and postural tremor, rigidity, bradykinesia and so on. He was treated by oriental medicine with acupuncture, herb medication, physical therapy, kinesitherapy and Korean psychotherapy; Eejeong-byunki, Jiun-goron. After treatment the symptoms of Parkinson' disease was reduced, but the patient was deconditioned through several seizures. This result suggested that the oriental medical therapy is recommanded for Parkinson's disease. But, the relation of Parkinson's disease and seizure should be studied.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.71-73
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• 2007

Tricyclic antidepressant (TCA) is a useful drug for treating neuropathic pain. However, tremors are one of the relatively frequent side effects of TCA. A female patient, who was suffering from postherpetic neuralgia, was treated with amitriptyline starting with 10 mg/day. She developed resting tremors on the second day after increasing the dose to 30 mg/day. This case highlights the need for the careful use of amitriptyline in the treatment of neuropathic pain in elderly patients.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.904-911
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• 2005

Tremor is a rhythmic and involuntary muscular contraction characterized by oscillations of body parts. Clinically, tremor is classified into postural tremor, resting tremor, action tremor, and other kinds of tremor, and treated according to the causes. In oriental medicine, Bangpungtongsung-San has been used to treat tremor when diagnosed as wind-heat. Bangpungtongsung-San-gamibang was administered to patients, with tremor from chromic alcoholic derogation and diagnosed as wind-heat and damp-heat. Both patients, treated with Bangpungtongsung-San-gamibang improved in symptoms, so it is here reported for the better treatment.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.929-936
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• 2007

Tremor is a rhythmic, involuntary muscular contraction characterized by oscillations of a part of the body and is the most common movement disorder. Clinically, tremor isclassified into postural tremor, resting tremor, action tremor, or other kinds of tremor, and treated according to the causes. The appropriate treatment of tremor depends on accurate diagnosis of its cause. We have recently examined a number of tremor-patients diagnosed as cerebellar infarction. Based on traditional Korean medicine curative way, we diagnosed this patient as deficiency of Qi and blood(氣血兩虛). On this account, suitable treatment had been provided. Our results show the clinical symptoms had improved through treatment with herbal medicine (Palmultang-gamibang) and acupuncture, so we report it for better treatment.