Essential Tremor: Different Brain Chemistry?

Essential tremor (ET) is a functional movement disorder that is often incorrectly diagnosed as Parkinson’s disease (PD). While it might be said that PD, which also causes tremors, has a higher “public profile” than ET, the fact is that nearly ten times as many people have ET. There is quite a financial discrepancy between PD and ET, too. According to the National Institutes of Health, government funding for PD research was $168,000,000, while neither ET nor movement disorders even show up on their list.i Compare this level of fiscal support with the reported $706,505 received as donations to the International Essential Tremor Foundation in 2014.ii

Undoubtedly, there is a great need to support research into as widespread a condition as ET that can dramatically affect a person’s physical, emotional and mental quality of life. Only by understanding the nature of the brain’s abnormal signals that result in tremors of the hands, head, voice or other parts of the body can new treatments be created and tested.

Measuring brain proteins

A 2014 research study from the Université Laval and their teaching hospital in Québec, Canada is an example of the kind of research needed. In this case, the research team were able to analyze the brain chemistry of human brains (from a brain bank) for levels of certain proteins. They suspected that levels in ET brains would be higher than those of control brains (without ET).iii In particular, they wanted to evaluate two proteins (LINGO1 and LINGO2) which other studies have associated with ET.

They were especially interested in the region of the brain called the cerebellum, since the dysfunctional transmissions that travel along what’s known as the tremor pathway appear to begin there. The team measured the cerebellum levels of these proteins in:

  • Essential tremor cases (9 brains)
  • Parkinson’s disease cases (10 brains)
  • Healthy cases (16 brains)

Results of analyzing brain chemistry

They found that LINGO1 levels were twice as high as those in the control brains, and even higher if ET had been present for more than 20 years. These differences did not show up in the PD brains. The problem with LINGO1 is its effect on what the brain normally does to refresh or repair itself, called neuroregeneration (neuro = brain, regeneration = rebuild or repair). LINGO1 interferes with the brain’s ability to regenerate by slowing it down.

The members of the team are hopeful that the results of their study could open the door to a new treatment approach. They recognize that, “The drugs currently prescribed to people suffering from this neurological condition were developed 30 years ago and their effectiveness is limited.”iv Theoretically, inhibiting the production and action of LINGO1 could have a positive outcome in ET cases.

Clearly, there is an enormous need for more research, and this cannot occur without financial support. The team’s lead researcher, Professor Frédéric Calon, observed, “Even though it’s not a lethal degenerative disease, essential tremor still poses a serious problem to sufferers, making it extremely difficult to perform basic everyday activities.”v

Hopefully, Calon’s team and many others around the globe will one day see the fruit of their efforts in the form of an innovative new therapy. While this process requires time, money and patience, those with uncontrollable tremors that don’t respond to medication have an excellent option. The Sperling Neurosurgery Associates now offers an outpatient procedure called MRI-guided Focused Ultrasound (MRgFUS) to control essential tremors. The noninvasive, incisionless treatment uses no surgery, radiation or drugs. It is safe and effective.

For more information contact Sperling Neurosurgery Associates

i https://report.nih.gov/categorical_spending.aspx
ii https://www.essentialtremor.org/wp-content/uploads/2014/10/IETF2014AnnualReport_WEB.pdf
iii Delay C, Tremblay C, Brochu E, Paris-Robidas S et al. Increased LINGO1 in the cerebellum of essential tremor patients. Mov Disord. 2014 Nov;29(13):1637-47.
iv “Protein Identified Linked to Most Common Movement Disorder, Essential Tremor.” Reported in Science Daily, Mar. 4, 2014. https://www.sciencedaily.com/releases/2014/03/140304113416.htm
v Ibid

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.

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