title: Eyeblink conditioning is impaired in subjects with essential tremor.
abstract: Several lines of evidence point to an involvement of the olivo-cerebellar system in the pathogenesis of essential tremor (ET), with clinical signs of cerebellar dysfunction being present in some subjects in the advanced stage. Besides motor coordination, the cerebellum is critically involved in motor learning. Evidence of motor learning deficits would strengthen the hypothesis of olivo-cerebellar involvement in ET. Conditioning of the eyeblink reflex is a well-established paradigm to assess motor learning. Twenty-three ET subjects (13 males, 10 females; mean age 44.3 +/- 22.3 years, mean disease duration 17.4 +/- 17.3 years) and 23 age-matched healthy controls were studied on two consecutive days using a standard delay eyeblink conditioning protocol. Six ET subjects exhibited accompanying clinical signs of cerebellar dysfunction. Care was taken to examine subjects without medication affecting central nervous functioning. Seven ET subjects and three controls on low-dose beta-blocker treatments, which had no effect on eyeblink conditioning in animal studies, were allowed into the study. The ability to acquire conditioned eyeblink responses was significantly reduced in ET subjects compared with controls. Impairment of eyeblink conditioning was not due to low-dose beta-blocker medication. Additionally, acquisition of conditioned eyeblink response was reduced in ET subjects regardless of the presence of cerebellar signs in clinical examination. There were no differences in timing or extinction of conditioned responses between groups and conditioning deficits did not correlate with the degree of tremor or ataxia as rated by clinical scores. The findings of disordered eyeblink conditioning support the hypothesis that ET is caused by a functional disturbance of olivo-cerebellar circuits which may cause cerebellar dysfunction. In particular, results point to an involvement of the olivo-cerebellar system in early stages of ET.
authors.affiliation: Department of Neurology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Kronenbuerger
authors.forename: Marcus
authors.initials: M
authors.lastname: Gerwig
authors.forename: Beate
authors.initials: B
authors.lastname: Brol
authors.forename: Frank
authors.initials: F
authors.lastname: Block
authors.forename: Dagmar
authors.initials: D
authors.lastname: Timmann
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001767:Blinking; D002531:Cerebellum / Q000503:physiopathology; D003215:Conditioning, Eyelid / Q000187:drug effects; D004576:Electromyography / Q000379:methods; D020329:Essential Tremor / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D005108:Extinction, Psychological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology; D011597:Psychomotor Performance; D012720:Severity of Illness Index; D012815:Signal Processing, Computer-Assisted
chemical_list: D000319:Adrenergic beta-Antagonists