Application of Tremor Analysis in Parkinson's Disease and Its Related Diseases
Condition: Parkinson Disease
MeSH terms: Parkinson Disease
Study type: Observational

Summary: 
      This is a longitudinal study to evaluate the brainstem of patients at different stages
      through VEMP neck, masticatory muscle and eye tests on patients with early and
      middle-advanced PD (20 cases each) and healthy controls (40 cases) The function of various
      parts is affected. At the same time, combining the patient's neurological function score and
      non-motor symptom score to find evidence of early involvement and early intervention.
    

Detailed description: 
      [Background] Tremor is an important symptom of extrapyramidal diseases, and it is also an
      early symptom of a variety of complex diseases. The classification of tremor has not been
      completely unified, mainly including essential tremor, Parkinson's disease tremor, etc., each
      form of tremor has Crossover and connection make clinical differential diagnosis difficult.
      At the same time, many diseases related to tremor lack pathological, serological and imaging
      characteristic changes. Therefore, it is particularly important to find accurate and
      objective evaluation indicators for tremor.

      By recording a pair of antagonist muscles (active muscles and passive muscles),
      electromyography can objectively record the type, degree, amplitude, burst pattern (whether
      the burst activity of the antagonistic muscles are synchronized or alternate), and
      weight-bearing The effect of drugs on tremor is very valuable for the diagnosis and
      differential diagnosis of tremor; especially for patients with Parkinson's disease, it can be
      several years or even decades before they develop motor symptoms, that is, tremor, rigidity,
      slowness of movement, and postural instability. There are a wide range of non-motor symptoms,
      such as smell, mood, sleep, mental behavior and many other aspects. Compared with dyskinesia,
      non-motor symptoms are both a precursor to the onset and an indication of disease
      progression. Fully understanding and exploring the law of the occurrence and development of
      these non-motor symptoms can provide clues for our early diagnosis and provide us with
      opportunities for early implementation of neuroprotective treatment.

      The early clinical symptoms of Parkinson's disease (Pakinson's disease, PD) are often
      atypical, and it is difficult to diagnose it only based on the history and clinical
      manifestations. However, when the diagnosis is made when the clinical symptoms are obvious,
      the patient's substantia nigra dopamine neurons have been reduced by 60-70%, and the
      opportunity for early treatment is lost. A Berg study also showed that treatment when most
      neurons in the pre-exercise period have not undergone degeneration can better protect the
      nerves and may delay the clinical progress of PD. Therefore, early diagnosis and early
      treatment of PD patients are particularly important.

      The clinical manifestations of Parkinson's disease include motor symptoms and non-motor
      symptoms (NMS), the latter of which is often ignored by clinicians. It includes common
      neuropsychiatric symptoms: such as depression, anxiety, apathy, lack of affect, distraction,
      and even hallucinations, delusions, delusions, dementia, obsessive-compulsive symptoms, panic
      attacks; sleep disorders: periodic limb movement disorders, excessive sleep during the day
      and so on. Some of these symptoms can appear before the movement disorder of Parkinson's
      disease, some are accompanied by the movement disorder, and some appear in the middle and
      late stages of Parkinson's disease, and aggravate with the aggravation of the movement
      symptoms. And its NMS is closely related to the severity of the entire disease of PD.

      [Objective] To explore the significance of tremor analysis in judging the early diagnosis of
      Parkinson's disease.

      Discuss the significance of tremor analysis for the prognosis of the disease. To explore the
      diagnostic significance of tremor analysis in patients with Parkinson's disease and benign
      tremor.

      [Design] This is a longitudinal study to evaluate the brainstem of patients at different
      stages through VEMP neck, masticatory muscle and eye tests on patients with early and
      middle-advanced PD (20 cases each) and healthy controls (40 cases) The function of various
      parts is affected. At the same time, combining the patient's neurological function score and
      non-motor symptom score to find evidence of early involvement and early intervention.
    

Intervention name(s): Transcranial parenchymal color Doppler ultrasound (TCS); Electromyography (EMG) tremor analysis
Intervention type(s): Other; Other
Intervention description(s): tracing the nigrostriatal echogenic area; observed 1, frequency 2, amplitude (amplitude) 3, correlation between the two sides 4, load and post-drug test differences
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Parkinson's disease, the second most common neurodegenerative disease, affects 1 to 2
        percent of patients over 65 years of age. China currently has nearly 2 million patients
        with Parkinson's disease, and the number is expected to grow exponentially in the coming
        years. The clinical manifestations of Parkinson's disease include tremor, rigidity,
        bradykinesia, postural instability and other motor symptoms. The static tremor is caused by
        cerebellum and basal ganglia circuits, which has nothing to do with the number of dopamine
        neurons. Treatment with Mdopa can reduce the tremor amplitude of patients, but generally
        does not change the tremor frequency.