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Tremor (Tremors)

Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of CEREBELLAR DISEASES, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of PARKINSON DISEASE.

Also Known As:

Tremors; Intention Tremor; Rest Tremor; Saturnine Tremor; Tremor, Muscle; Tremor, Action; Coarse Tremor; Continuous Tremor; Darkness Tremor; Fine Tremor; Intermittent Tremor; Involuntary Quiver; Massive Tremor; Passive Tremor; Persistent Tremor; Pill Rolling Tremor; Senile Tremor; Static Tremor; Tremor, Limb; Tremor, Neonatal; Tremor, Nerve; Tremor, Perioral; Tremor, Semirhythmic; Action Tremors; Coarse Tremors; Continuous Tremors; Darkness Tremors; Fine Tremors; Intention Tremors; Intermittent Tremors; Involuntary Quivers; Limb Tremor; Limb Tremors; Massive Tremors; Muscle Tremor; Muscle Tremors; Neonatal Tremor; Neonatal Tremors; Nerve Tremor; Nerve Tremors; Passive Tremors; Perioral Tremor; Perioral Tremors; Persistent Tremors; Pill Rolling Tremors; Quiver, Involuntary; Quivers, Involuntary; Rest Tremors; Resting Tremors; Rolling Tremor, Pill; Rolling Tremors, Pill; Saturnine Tremors; Semirhythmic Tremor; Semirhythmic Tremors; Senile Tremors; Static Tremors; Tremor, Coarse; Tremor, Continuous; Tremor, Darkness; Tremor, Fine; Tremor, Intention; Tremor, Intermittent; Tremor, Massive; Tremor, Passive; Tremor, Persistent; Tremor, Pill Rolling; Tremor, Rest; Tremor, Resting; Tremor, Saturnine; Tremor, Senile; Tremor, Static; Tremors, Action; Tremors, Coarse; Tremors, Continuous; Tremors, Darkness; Tremors, Fine; Tremors, Intention; Tremors, Intermittent; Tremors, Limb; Tremors, Massive; Tremors, Muscle; Tremors, Neonatal; Tremors, Nerve; Tremors, Passive; Tremors, Perioral; Tremors, Persistent; Tremors, Pill Rolling; Tremors, Rest; Tremors, Resting; Tremors, Saturnine; Tremors, Semirhythmic; Tremors, Senile; Tremors, Static; Action Tremor; Resting Tremor

Networked: 5178 relevant articles (453 outcomes, 403 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Parkinson Disease (Parkinson's Disease)
2.	Hypokinesia (Bradykinesia)
3.	Dyskinesias (Dyskinesia)
4.	Essential Tremor (Essential Tremors)
5.	Tremor (Tremors)

Experts

1.	Louis, Elan D: 29 articles (12/2015 - 03/2004)
2.	Okun, Michael S: 22 articles (05/2014 - 10/2003)
3.	Hagerman, Paul J: 19 articles (11/2014 - 05/2003)
4.	Deuschl, Günther: 18 articles (10/2015 - 01/2002)
5.	Hagerman, Randi J: 18 articles (11/2014 - 11/2005)
6.	Salamone, John D: 17 articles (02/2016 - 12/2004)
7.	Tassone, Flora: 17 articles (05/2014 - 05/2003)
8.	Foote, Kelly D: 16 articles (01/2014 - 04/2005)
9.	Pahwa, Rajesh: 15 articles (05/2014 - 03/2002)
10.	Deuschl, G: 14 articles (11/2011 - 01/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Tremor:

1.	Levodopa (L Dopa)FDA LinkGeneric 01/01/2015 - "Levodopa dramatically improved the tremor. " 09/01/2010 - "Levodopa remained effective in most patients in relieving motor symptoms including tremor. " 03/01/2007 - "In both cases, levodopa dramatically improved the tremor. " 08/01/1999 - "Two patients had resting and postural tremor, which showed a marked improvement with treatment with levodopa. " 11/01/2014 - "Similarly, harmonic oscillations were significantly greater in patients with subjective tremor reduction upon l-Dopa administration. "
2.	Propranolol (Inderal)FDA LinkGeneric 01/01/1976 - "Propranolol was most effective in older patients and in those with slow tremor frequencies." 11/01/1975 - "An improvement in tremor was observed in all patients who received propranolol and was most pronounced in the upper extremities. " 11/01/2008 - "ZNS was found to be more effective in the treatment of patients with isolated head tremor than propranolol. " 12/01/1992 - "The results suggest that the efficacy of sustained propranolol on isolated or prominent essential head tremor is less predictable and satisfactory than expected on the basis of the single-dose response, as compared with hand tremor." 05/01/1990 - "However, following 3-6 months of sustained treatment a proportion of patients required an increase in daily dosage of propranolol in order to maintain adequate symptomatic control of tremor, indicating a relative decrease in tremorolytic efficacy of the drug possibly due to long-term tolerance."
3.	Botulinum Toxins (Botulinum Toxin)IBA 08/01/1996 - "Needle-EMG recordings showed rhythmic, synchronous agonist/antagonist activity in both the splenius capitis and sternocleidomastoideus muscles at a frequency of 2-3 Hz. After administration of botulinum toxin A (DysportR), the tremor markedly improved and vanished completely after a booster. " 11/01/2013 - "When present in the jaw this rapid tremor has been successfully treated with botulinum toxin. " 07/03/2012 - "There was a significant improvement after botulinum toxin compared with that after placebo treatment in the Bain score for tremor severity at 6 weeks (p = 0.0005) and 12 weeks (p = 0.0001), writing at 6 weeks (p = 0.0001) and 12 weeks (p = 0.0003), and Archimedes spiral drawing at 6 weeks (p = 0.0006) and 12 weeks (p = 0.0002). " 03/01/2010 - "Botulinum toxin therapy is a safe and effective treatment of essential palatal tremor and seems to be especially useful in pediatric patients. " 07/01/2006 - "This would suggest that botulinum toxin is a safe and effective first line treatment for palatal tremor."
4.	Clonazepam (Rivotril)FDA LinkGeneric 01/01/1996 - "He was then treated with gradually increasing doses of clonazepam; when he received 8 mg/day of clonazepam, his tremor showed marked improvement. " 10/31/2007 - "Patients with fast tremor improved on clonazepam. " 02/01/2002 - "Clonazepam is the first-line treatment for orthostatic tremor. " 01/01/1998 - "Clonazepam was used in an open study in 11 MS patients to evaluate the sensitivity of TREMOR, compared to the clinical observations. " 07/01/2012 - "Clonazepam in the treatment of essential palatal tremors."
5.	Clozapine (Clozaril)FDA LinkGeneric 12/01/1997 - "A significant reduction of both resting (p < 0.05) and postural (p < 0.05) tremors was observed under clozapine from the first week of treatment through the entire period of the study. " 05/01/1999 - "A significant reduction of tremor was reported with chronic clozapine treatment (p <0.01) with no tolerance to drug antitremor effect, whereas sedation markedly decreased after 6-7 weeks of therapy. " 10/01/2000 - "Clozapine is an atypical neuroleptic agent, not on the market in Japan, and has been reported to decrease or ameliorate parkinsonian tremor through the studies of open label and double blind crossover as a new drug for parkinsonian tremor." 04/01/1994 - "Under these frequent blood monitoring conditions, in this study Clozapine produced a substantial alleviation of parkinsonian tremor in 17 of 23 patients (73%). " 01/01/1990 - "After preliminary observations on 5 psychotic and 7 nonpsychotic parkinsonian patients had shown unexpected impressive beneficial effects of the atypical neuroleptic clozapine on tremor, an open clinical study including 12 patients was started. "
6.	Primidone (Sertan)FDA LinkGeneric 02/01/2013 - "The decision to discontinue primidone after surgery resulted in a non-significant long-term improvement in tremor motor score (23 points versus 15 points, p = 0.19), and did not significantly influence the physical and mental composite quality of life scores (p = 0.81, 0.23, respectively). " 09/01/2012 - "The aim of our study was to determine the tolerability and efficacy of primidone in reducing severe cerebellar tremor in patients with MS. Ten patients with severe cerebellar tremor were enrolled in this study. " 01/01/1991 - "The tremor had not been helped by beta-blockers or primidone. " 09/01/2012 - "Our study showed that primidone is tolerable in MS patients and effectively reduces severe cerebellar tremor in such patients." 07/01/2013 - "The tDLB tremors were reduced by acute and chronic dopaminergic treatments (p < 0.01) but not by alcohol or primidone. "
7.	gabapentin (Neurontin)FDA LinkGeneric 07/01/2006 - "The findings confirm that gabapentin is an effective treatment for OT, reducing both tremor and postural instability and improving quality of life, and support its use as add-on or first-line therapy for OT." 09/01/1998 - "Effective treatment of orthostatic tremor with gabapentin." 02/15/2003 - "We evaluated the efficacy of gabapentin added to basal tremor treatment by means of a 16 month non randomized open study conducted at our Unit on treated and monitored patients. " 02/01/2003 - "A search of biomedical literature was completed through MEDLINE and EMBASE (1993-May 2002) to identify all clinical trials pertaining to the use of gabapentin for the treatment of tremor in humans. " 07/01/2006 - "Patients were then studied 7 days after drug withdrawal and again after two 2-week periods of treatment with either gabapentin or placebo, using force platform posturography to quantify postural sway and tremor. "
8.	LithiumIBA 01/01/2015 - "After lithium discontinuation, the patient had a rapid improvement in agitation and tremors. " 04/01/2001 - "Although the mean tremor activity subsided toward the end of treatment, tremor activity on the whole was still significantly greater after 6 weeks of combined lithium and antidepressant treatment than at the start of combination therapy. " 07/01/1981 - "Patients on lithium had a significantly lower peak frequency of tremor than control subjects (P less than 0.05) and significantly greater extrapyramidal symptoms (P less than 0.01), indicating that tremor appearing after chronic lithium therapy is likely to be an extrapyramidal symptom. " 07/01/1995 - "Studies show a wide range of incidence of lithium tremor--4% to 65%--due to differences in defining and reporting this side effect. " 01/01/1975 - "Frequency and amplitude of lithium-induced tremor till the ninth day of drug administration are discussed - and constitute only one aspect of a bigger, still going on, study."
9.	HarmalineIBA 01/01/1983 - "1. The alteration of the cortical cerebellar mechanisms resulting from the activation of the olivo-cerebellar pathway by Harmaline (H) administered at doses which were subthreshold for skeletomotor tremor (5 mg/kg, IM) yields, in the trained Baboon (Papio papio), a marked decrease of oculomotor system performance. " 05/01/2005 - "Depletion of 5HT produced a significant reduction in the intensity and duration of harmaline-induced tremor. " 05/01/2015 - "Only the highest dose of extracts (160 mg/kg) attenuated intensity of harmaline-induced tremors throughout the study. " 11/06/2013 - "The results of the present study seem to indicate that midbrain dopaminergic neurons influence glutamatergic transmission in the cerebellum which may be important for generation of the tremor induced by harmaline." 11/06/2013 - "The aim of the present study was to examine the influence of a partial lesion of both the substantia nigra pars compacta (SNC) and retrorubral field (RRF) on the glutamatergic transmission in the cerebellum and tremor induced by harmaline in rats. "
10.	pramipexol (pramipexole)FDA LinkGeneric 05/01/2000 - "In another study pramipexole has been shown to be significantly superior to placebo with an improvement in tremor score by 48% (vs. 13% in the placebo group). " 01/01/2015 - "Pramipexole has demonstrated the efficacy in the treatment of persistent tremor and depression in double-blind placebo-controlled trials. " 09/01/1999 - "The patients were drawn from a larger placebo-controlled, double-blind, randomized trial, which was not originally designed to investigate the effect of pramipexole on tremor. " 01/01/2006 - "The main reasons for switching to pramipexole (anti-tremor effect, anti-depressive/anti-anhedonic effect) as given by the physicians at baseline came up to expectations. " 05/01/2005 - "Patients with pronounced resting tremor derived a clear benefit from pramipexole treatment compared with placebo. "

Therapies and Procedures

1.	Deep Brain Stimulation 07/01/2014 - "Deep brain stimulation of globus pallidus internus, thalamus or subthalamic area led to a marked improvement of dystonic axial or appendicular tremors in most cases refractory to other treatments. " 05/01/2011 - "Deep brain stimulation is the most effective treatment for most tremors but is reserved for advanced cases." 08/01/2009 - "Fortunately, deep brain stimulation is effective for the most common and disabling tremor disorders. " 06/28/2005 - "Chronic deep brain stimulation (DBS) (Level C) and thalamotomy (Level C) are highly efficacious in reducing tremor. " 03/01/2015 - "Deep brain stimulation (DBS) has been proposed as an effective therapy for vocal tremor, but very few studies exist in the literature that comprehensively evaluate the efficacy of DBS for specifically addressing EVT. "
2.	Activities of Daily Living (ADL) 10/01/2003 - "The reduction in tremor scores and improvement in activities of daily living were highly significant compared with baseline and with the stimulation turned off. " 08/01/2002 - "Motor functioning, especially tremor, motor complications, depression, and activities of daily living improved highly significantly (P < 0.0005), including self-rating by the patients. " 11/01/2012 - "Worsening in PD-related tremor and rigidity was not observed, activities of daily living significantly improved and UKU subscales progressively decreased. " 07/01/2012 - "The TRS total, targeted tremor, and activities of daily living (ADL) scores were significantly improved compared with presurgical scores up to 12 years. " 10/01/2005 - "Activities of daily living and tremor significantly improved. "
3.	Injections 07/01/1994 - "In the present study, weekly injections of CPF (0, 15, 30 or 60 mg/kg s.c.) inhibited ChE activity in whole blood of rats by 60% to 90% after 5 weeks; the highest dose also induced tremor, working memory impairment and motor slowing in daily delayed matching-to-position/visual discrimination tests. " 01/01/2015 - "Effective Management of Upper Limb Parkinsonian Tremor by IncobotulinumtoxinA Injections Using Sensor-based Biomechanical Patterns." 10/01/2013 - "Thirteen patients had a vertical laryngeal tremor, and these patients underwent additional strap muscle injections. " 09/01/2012 - "Vocal fold (VF) injections of viscous materials are typically performed using hand-operated syringes or injection guns; however, these methods can be imprecise due to accumulation of pressure, effort-related tremor, and poor feedback regarding injection volume and rate. " 01/01/2011 - "Only one patient with severe vocal tremor wished to continue with injections. "
4.	Pallidotomy 01/01/2000 - "We here report that although all the motor signs were significantly improved 6 months after pallidotomy, the temporal sequence of tremor response was different from those of other symptoms." 06/01/2000 - "Contemporary combination of pallidotomy and thalamotomy is effective and safe in treating regular parkinsonian symptoms and intractable tremor." 08/01/1994 - "Ventroposterior pallidotomy has been shown to improve not only rigidity and tremor, but also akinesia. " 11/01/1997 - "Based on anatomic studies, surgical misadventures, and empirical observations, there was an abrupt shift regarding the favored target to treat parkinsonian tremor to the thalamus, and most neurosurgeons abandoned pallidotomy in the 1960s. " 04/01/1997 - "The goals of this study were to analyze the effect of pallidotomy on parkinsonian tremor and to ascertain whether an association exists between microrecording findings and tremor outcome. "
5.	Electrodes (Electrode) 01/01/2007 - "In the patient with MS tremor, we implanted bilateral ventralis intermedius (V.im.) and ventralis oralis anterior (V.o.a.) thalamic electrodes; this patient had significant tremor improvement with stimulation of either V.im. " 04/01/2005 - "A second rationalization was that the placement of a second electrode may affect somatotopy, and may, therefore, be beneficial for the treatment of more difficult to control tremor subtypes. " 04/01/2006 - "Previously, we reported the use of two DBS electrodes (one at the VIM/VOP border and one at the VOA/VOP border) as effective for the treatment of posttraumatic tremor in a single patient. " 11/01/2012 - "The effect on tremor was, in this small sample population, improved by implanting an electrode in the cZi. " 02/01/2003 - "We studied the efficacy of DBS at 2 years and 6-7 years after electrode implantations in the ventrointermediate nucleus of the thalamus in 39 patients (20 PD, 19 ET) with severe tremor. "