Movement preparation and cortical processing of afferent inputs in cortical tremor: an event-related (de)synchronization (ERD/ERS) study

Abstract

Objective: We sought to characterize cortical activity related to motor control in patients presenting with isolated cortical tremor, in order to determine whether or not myoclonus-related impairments are a source of event-related desynchronization/synchronization (ERD/ERS) disruption.

Methods: Nine patients presenting with isolated cortical tremor were compared with controls. Mu and beta ERD/ERS were computed over the scalp and brain surfaces using 128-channel electroencephalographic (EEG) recording during voluntary and passive finger extensions. We recorded somatosensory-evoked potentials following median nerve stimulation and performed myoclonic jerk-locked back-averaging of EEG activity.

Results: Back-averaging revealed a cortical premyoclonic spike in all patients. Five of the nine patients had exaggerated SEPs. The amplitude of mu ERD was greater in patients. Beta ERD/ERS did not differ from that seen in controls. Localizations of mu and beta ERD/ERS did not differ from controls and were identified in pre- and post-central sensorimotor cortical areas.

Conclusions: The present results suggest a hyperexcitability of the cortico-subcortical loops responsible for movement preparation and execution. Post-movement inhibition related to cortical processing of afferent input is unaffected in isolated cortical myoclonus.

Significance: Intracortical abnormalities can differ in patients suffering from cortical myoclonus, according to whether or not the individuals have associated epileptic symptoms.