title: Tremor frequency patterns in mercury vapor exposure, compared with early Parkinson's disease and essential tremor.
abstract: A new portable tremometer allows determination of tremor intensities at different tremor frequencies. Based on past studies, two tremor frequency windows of similar size were chosen at 3.0-6.5 Hz and 6.6-10.0 Hz to reflect major tremor intensities in Parkinson's disease and mercury vapor poisoning, respectively. In 81 healthy controls, total tremor intensity was higher for the preferred hand and depended on age. Ten patients treated for Parkinson's disease showed substantially increased tremor intensity, especially within the low-frequency window. This pattern was also apparent in 14 patients with de novo Parkinson's disease whose overall tremor intensity was only mildly elevated. In contrast, ten patients with essential tremor had peak frequencies in both windows, and some patients had increased tremor on one side only. Sixty-three Brazilian gold traders exposed to mercury vapor showed increased tremor predominantly in the high-frequency window. Three of the gold traders had a narrower tremor peak at frequencies of 7-8 Hz. While the urine-mercury concentration was significantly associated with the current number of burning sessions per week, it did not correlate with tremor intensities. However, eight traders had a urinary mercury excretion level above 50 microg and at the same time a greatly increased average tremor intensity within the high-frequency window. These patterns were statistically significant for relative tremor intensities, but were less clear when total intensities were used. These observations suggest that the relative distribution of tremor intensities in specific frequency bands may be a valuable supplement to current diagnostic methods for subjects with mercury vapor exposure.
authors.affiliation: Department of Environmental Medicine, Odense University, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Biernat
authors.forename: S A
authors.initials: SA
authors.lastname: Ellias
authors.forename: L
authors.initials: L
authors.lastname: Wermuth
authors.forename: D
authors.initials: D
authors.lastname: Cleary
authors.forename: E C
authors.initials: EC
authors.lastname: de Oliveira Santos
authors.forename: P J
authors.initials: PJ
authors.lastname: Jørgensen
authors.forename: R G
authors.initials: RG
authors.lastname: Feldman
authors.forename: P
authors.initials: P
authors.lastname: Grandjean
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008628:Mercury / Q000652:urine*; D008630:Mercury Poisoning / Q000209:etiology*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010300:Parkinson Disease / Q000473:pathology*; D013997:Time Factors; D014202:Tremor / Q000139:chemically induced / Q000473:pathology; D014481:United States
chemical_list: D008628:Mercury