IETF Funded Research 2009

Holly Shill, MD, Director, Thomas H. Christopher Center for Parkinson’s Research, Sun City, AZ, has been awarded $36,000 for the study Brain Catecholamine System in Essential Tremor.

The object of this study is to determine and compare levels of three proteins in the brains of ET subjects, confirmed Lewy Body disease subjects and a control group. Lewy Bodies have been found in the brains of persons who had neurodegenerative diseases such as Parkinson’s disease.

Preliminary findings of this study determined striatal tyrosine hydroxylase (TH) levels in patients with ET in comparison with age-matched control subjects (people without ET) to find neurochemical evidence that ET is or is not pre-clinical Parkinson’s disease (PD).

Subjects in this study were assessed with a general neurological examination, a movement disorder evaluation and europsychological testing. Subjects were diagnosed with ET if they had previously been diagnosed by an outside physician and the examination was consistent with it, or if they had grade 2 action tremor (Fahn scale) of the hands/forearms without other cause, or had action tremor of the arms/forearms for at least three years.

For the TH analysis, frozen sections of the putamen, a part of the basal ganglion in the brain, were dissected and analyzed. 23 ET cases were compared with 37 controls. Ages at death were on average 86.2 years for ET cases and 85.6 years for controls.

All TH level differences between the groups were not significant, leading to the conclusion that “this study provides eurochemical support that ET does not appear to be pre-clinical PD.”

Final study findings to come later in 2009.

MRI Study Update

Fatta Nahab, MD, assistant professor of neurology, Department of Neurology, University of Miami, Miami, FL has been awarded $25,000 for the study, Identification of the Neural Generator(s) in Essential Tremor using Functional Magnetic Resonance Imaging.

The objectives of this research are to locate, through the use of MRI, a region of the brain with similar oscillatory features (tremor) as the subject’s observed symptomatic tremor; compare and contrast how tremor changes during various activities and at rest; and, assess the impact of alcohol on these selected areas of the brain and on the subject’s tremor.

At this juncture in the project, Nahab and colleagues are proceeding only slightly beyond their anticipated schedule. They received Institutional Review Board (IRB) approval on October 16, 2008. The IRB is a committee that formally designated to approve, monitor, and review biomedical and behavioral research involving humans in the US with the aim to protect the rights and welfare of research subjects.

During the ensuing period, they have been optimizing scan parameters on the Siemens MRI. Additionally, the equipment pledged by the department of neurology to the investigator for this project was fully installed and operational in late February 2009. This equipment includes fully MRI-compatible accelerometry and EMG recording devices that will allow for monitoring tremor frequency and power during the MRI scan.

Eight subjects have been recruited and are ready to begin, pending completion of the development phase of the project.

Project completion is projected by July 1, 2009. The data will then be analyzed as a whole before being reported.

Study Update:
Investigators are using various advanced MRI techniques to compare both the structure and function of ET brains to those without ET. This will help provide answers that may help explain why people have different tremor types or severities, why people have different responses to particular medications, and what role genetics has on the brain.

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