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Evidence of central involvement in essential tremor: a detailed study of auditory pathway physiology

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Essential tremor (ET) is a common tremor disorder that is likely neurodegenerative. The pathophysiology of ET involves the cerebellum and its connections in the brainstem and thalamus. Hearing dysfunction has been shown to be a non-motor finding in ET patients. A limited number of studies have suggested that cochlear pathology is the cause, but studies have not evaluated the integrity of the primary auditory pathway in ET. The main aim of this study is to investigate the integrity of the auditory pathway via auditory brainstem response (ABR) and auditory middle latency response (AMLR), thereby allowing us to evaluate the auditory pathway from the 8th cranial nerve to the cerebral cortex. Sixteen ET patients and sixteen age- and gender-matched controls (64 ears) were evaluated. In the ABR study, we detected prolongation of wave V peak latencies (ms) in ET (p = 0.02). In the AMLR study, P0 (p = 0.03), Pa (p = 0.008), Na (p = 0.03), and Nb (p = 0.01) waves differed between the two groups. Eleven ET patients and four control subjects had abnormal electrophysiological findings (ABR or AMLR or both) (68.8% vs. 25%, p = 0.01). Tremor duration was greater in ET patients with abnormal electrophysiological findings (p = 0.01). Finally, we observed prolongation of latencies after the ABR III wave, indicating that abnormalities exist within the superior olivary complex. For the first time, our research provides evidence that ET-related pathology is present at the subcortical and cortical levels of the auditory pathway.

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Abbreviations

ABR:

Auditory brainstem response

AMLR:

Auditory middle latency response

ET:

Essential tremor

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Acknowledgements

We thank the study participants and control subjects for their contributions to this study and Tess Cersonsky and Keith Radler for their valuable contribution. Corresponding author thanks Turkish Neurological Society and Dr. Rumeyza Kazancıoglu for their support.

Funding

There is no funding source in this study.

Author information

Authors and Affiliations

  1. Department of Neurology, Faculty of Medicine, Bezmialem Foundation University, Fatih, Istanbul, Turkey

    Yildizhan Sengul

  2. Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA

    Yildizhan Sengul & Elan D. Louis

  3. Department of Audiology, Faculty of Medical Sciences, Bezmialem Foundation University, Fatih, Istanbul, Turkey

    Nilufer Bal

  4. Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA

    Elan D. Louis

  5. Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA

    Elan D. Louis

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  1. Yildizhan Sengul
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  2. Nilufer Bal
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Contributions

YS participated in the conception and design of the study, the acquisition of data, the analysis and interpretation of data, and drafting the manuscript or revising it critically for important intellectual content. NB participated in the conception and design of the study, the acquisition of data, the analysis and interpretation of data, and drafting the manuscript or revising it critically for important intellectual content. EL participated in the conception and design of the study, the analysis and interpretation of data, and drafting the manuscript or revising it critically for important intellectual content.

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Correspondence to Yildizhan Sengul.

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The study protocol was conducted in accordance with ethical principles stated in the ‘Declaration of Helsinki’ and approved by the Ethical Committee of Bezmialem Foundation University Hospital.

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Sengul, Y., Bal, N. & Louis, E.D. Evidence of central involvement in essential tremor: a detailed study of auditory pathway physiology. J Neural Transm 127, 1153–1159 (2020). https://doi.org/10.1007/s00702-020-02215-w

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  • DOI: https://doi.org/10.1007/s00702-020-02215-w

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