Dystonia and Tremor: A Cross-Sectional Study of the Dystonia Coalition Cohort.

OBJECTIVE: To assess the clinical manifestations and predictors of different types of tremors in individuals with different types of isolated dystonia. METHODS: Clinical manifestations of tremor were assessed in a multicenter, international cross-sectional, cohort study of 2,362 individuals with all types of isolated dystonia (focal, segmental, multifocal, and generalized) recruited through the Dystonia Coalition. RESULTS: Methodical and standardized assessments of all participants in this cohort revealed the overall prevalence of any type of tremor was 53.3%. The prevalence of dystonic tremor varied from 36.9% to 48.4%, depending on criteria used to define it. To identify the factors associated with tremors in dystonia, the data were analyzed by generalized linear modeling and cluster analyses. Generalized linear modeling indicated 2 of the strongest factors associated with tremor included body region affected by dystonia and recruitment center. Tremor was also associated with severity of dystonia and duration of dystonia, but not with sex or race. The cluster analysis distinguished 8 subgroups within the whole cohort; defined largely by body region with dystonia, and secondarily by other clinical characteristics. CONCLUSION: The large number of cases evaluated by an international team of movement disorder experts facilitated the dissection of several important factors that influence the apparent prevalence and phenomenology of tremor in dystonia. These results are valuable for understanding the many differences reported in prior studies, and for guiding future studies of the nosology of tremor and dystonia.

A surface EMG multi-electrode technique for characterizing muscle activation patterns in mice during treadmill locomotion.

In mice a new method for 2x4-channel surface electromyography (EMG) recordings of the vastus lateralis and biceps femoris muscles during locomotion on a treadmill with varying speed is presented. The approach involves high-speed-videography (sampling interval 2.5 ms) in concert with the application of chronically implanted surface EMG multi-electrodes (EMG sampling rate 4000 Hz, frequency range 10-700 Hz). The recordings are started 2 days after surgery and finished 2 weeks after surgery. During the whole investigation period EMG recordings of both muscles have been possible. The monopolar EMG activities recorded by the electrode-arrays and the bipolar EMG signals derived from the monopolar activities permit an evaluation of the extent of myo-electrical activation in larger regions of both muscles and co-ordination between the flexor and extensor muscles. Bipolar EMG signals indicate propagation of activities along the muscle fibers and a slight effect of non-propagating signal components. Thus, the cross talk between these muscles is small and does not influence the evaluation of the EMG results. The resolution of the simultaneously recorded synchronized data allows a precise temporal correlation of kinematic and EMG parameters.