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Summary of Dr. Sabine Meunier’s report.
Sabine Meunier, MD, PhD, a neurologist and senior researcher at the Movement Disorders Clinic, Pitié-Salpêtrié Hospital, Paris, along with Drs. Cecile Gallea and Marie Vidailhet, conducted a pilot study to see whether artificial stimulation of the cerebellum could improve primary orthostatic tremor (POT).
Conclusions: Localized cerebellar atrophy and hypertrophy of the SMA (supplementary motor area) were found in POT patients in the present study and in patients with essential tremor in a previous study (Gallea et al 2015). This pattern could represent a “generic” signature of tremor. Hypertrophy of the cerebellar vermis is specific to the POT patients and likely represents a compensatory response, opposing the postural instability caused by the lower limb tremor.
Five days of stimulation in nine POT patients (and nine non-POT volunteers) are able to induce functional changes (a decrease in the amplitude of the tremor as measured by electrodes) but not strong enough to translate into clinical improvement (the patients did not feel any change in their ability to stand). “We could try longer stimulation duration or target another brain area like the SMA (supplementary motor area),” in future studies, according to Dr. Meunier ,who would like to conduct a detailed MRI mapping of the resting state networks of the cerebellum in POT patients AND investigate the cognitive cerebellum resting state network, correlating it putative impairment with the performance of various cognitive tasks.
Respectfully submitted, March 4, 2016