Purpose:
Tremors are involuntary movements of a part or parts of the body that occur because of
alternating contraction and relaxation of muscles. The causes behind most tremors are
poorly understood.
Some studies suggest tremors could be caused by abnormalities in a particular area of the
brain called the olivary nucleus. Researchers believe that the cells making up the
olivary nucleus may be responsible for generating a central rhythm of the body and may
therefore also be responsible for the generation of tremors.
Consumption of alcohol has been known to reduce tremors in some patients. Researchers
believe that the alcohol may work directly on the cells of the olivary nucleus. As a
result, researchers would like to determine the effects of alcohol on three different kinds
of tremors (physiological, symptomatic palatal, and essential palatal).
Study summary:
The pathophysiology and anatomical basis of most tremors remains poorly understood. One
particular theory of essential tremor, the olivary hypothesis, has gained support from
various studies. These studies point to the olivary nucleus as possible central rhythm
generator. Cells in the olivary nucleus show spontaneous rhythmic discharges that can be
suppressed by alcohol. Since alcohol is known to suppress tremor in some patients with
essential tremor, one can theorize that it is through its effect on the olivary nucleus;
that is, the inferior olive is the generator of the tremor. Given this assumption, we
intend to study the effect of alcohol on three different kinds of tremor: the 8-12 Hz
component of physiological tremor, symptomatic palatal tremor and essential palatal tremor.
Our hypothesis is that the central generator of each of these types of tremor lies in the
inferior olive and that the ingestion of alcohol should reduce the amplitude of the tremor,
similar to the effect of alcohol seen in essential tremor.
Criteria:
INCLUSION CRITERIA:
A total of 20 subjects will be enrolled in the study. 10 normal subjects will be enrolled
in the study. All will have an 8-12 Hz component of physiologic tremor as determined by
neurophysiologic studies. Patients will have a prominent 8-12 Hz spike on accelerometry
recordings that is associated with an EMG spike at the same frequency.
5 patients with essential palatal tremor and 5 patients with symptomatic palatal tremor
will be included.
All participants must be a minimum of 21 years of age.
EXCLUSION CRITERIA:
The presence of any medical condition, such as liver disease, history or family history of
alcoholism, that can reasonably be expected to subject the patient to unwarranted risk or
compromise the value of the data.
Any patient with pathologic tremor, such as parkinsonian rest tremor, essential tremor, or
tremor secondary to medications or structural brain lesions.
Any clinically significant laboratory abnormalities.
Lack of effective contraception.
Patients who are pregnant.
Inability to understand the nature of the study or its procedures.
Persons under the age of 21, who are not of legal age to consume alcohol in Maryland.
Patients taking any psychoactive medications including certain cough or cold medicine
preparations.
No one will be excluded or discriminated against based on the grounds of race, creed,
gender, color, or national origin. Every attempt will be made to include women and
minorities in the study population.