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. 2019 Feb;25(2):156-164.
doi: 10.1017/S1355617718001054. Epub 2018 Dec 3.

Action Control Deficits in Patients With Essential Tremor

Shelby Hughes  1 , Daniel O Claassen  1 , Wery P M van den Wildenberg  2 , Fenna T Phibbs  1 , Elise B Bradley  1 , Scott A Wylie  3 , Nelleke C van Wouwe  1
Affiliations

Action Control Deficits in Patients With Essential Tremor

Shelby Hughes et al. J Int Neuropsychol Soc. 2019 Feb.

Abstract

Objectives: Essential tremor (ET) is a movement disorder characterized by action tremor which impacts motor execution. Given the disrupted cerebellar-thalamo-cortical networks in ET, we hypothesized that ET could interfere with the control mechanisms involved in regulating motor performance. The ability to inhibit or stop actions is critical for navigating many daily life situations such as driving or social interactions. The current study investigated the speed of action initiation and two forms of action control, response stopping and proactive slowing in ET.

Methods: Thirty-three ET patients and 25 healthy controls (HCs) completed a choice reaction task and a stop-signal task, and measures of going speed, proactive slowing and stop latencies were assessed.

Results: Going speed was significantly slower in ET patients (649 ms) compared to HCs (526 ms; F(1,56) = 42.37; p <.001; η 2 = .43), whereas proactive slowing did not differ between groups. ET patients exhibited slower stop signal reaction times (320 ms) compared to HCs (258 ms, F(1,56) = 15.3; p <.00; η 2 = .22) and more severe motor symptoms of ET were associated with longer stopping latencies in a subset of patients (Spearman rho = .48; p <.05).

Conclusions: In line with previous studies, ET patients showed slower action initiation. Additionally, inhibitory control was impaired whereas proactive slowing remained intact relative to HCs. More severe motor symptoms of ET were associated with slower stopping speed, and may reflect more progressive changes to the cerebellar-thalamo-cortical network. Future imaging studies should specify which structural and functional changes in ET can explain changes in inhibitory action control. (JINS, 2019, 25, 156-164).

Keywords: Cerebellum; Choice behavior; Inhibitory control; Movement disorders; Reaction time; Tremor.

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Conflict of interest statement

Disclosure statements

Dr. Phibbs has done consulting for Boston Scientific, Medtronic and Teva. There are no other conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Trial examples of a) the choice reaction task where participants manually respond to the direction of dark-gray arrows presented on the screen with a left or right button press, and b) the stop-signal task in which subjects were instructed to respond to the direction of the dark-gray arrow with a left or right button press and to stop their response when the arrow turned purple (30% of the trials).
Figure 2
Figure 2
a) Mean go RT for the choice reaction task and for the stop-signal task for ET patients and HC. b) Mean SSRT for ET patients and HC. Error bars represent standard errors.
Figure 3
Figure 3
a) Correlation of SSRT in ET patients and motor severity as measured by the Fahn-Tolosa-Marin (FTM) rating scale b). Correlation of SSRT and proactive slowing in both ET patients and HC. Note that for clarity and interpretation of the scales, the values represented in the graph are the original scales (not corrected for age).
See this image and copyright information in PMC

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