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Neuroimaging in tremor and functional motor disorders

PhD ceremony:Ms M. (Marja) Broersma
When:November 01, 2017
Supervisors:prof. dr. ir. N.M. (Natasha) Maurits, prof. dr. M.A.J. (Marina) de Koning-Tijssen
Co-supervisor:dr. M. van Beilen
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Neuroimaging in tremor and functional motor disorders

This thesis is about two disorders with motor symptoms, with different origins and manifestations. What all disorders with motor symptoms have in common is that there is a deficit in the movement system, often caused by altered brain functioning.

Essential tremor (ET) is a common type of movement disorder in the category of too much movement and is characterized by a bilateral action tremor, occurring during posture and movement. By recording electromyography (EMG) and functional magnetic resonance imaging (fMRI) simultaneously, we were able to link tremor activity directly to brain activity.  With the use of this innovative technique, we identified brain activations specifically associated with variations in tremor intensity in essential tremor patients in the cerebellum.

In the second part of this thesis we studied functional neurological paresis (FNP), a functional motor disorder in the category of lack of movement. FNP is a functional neurological symptom disorder with loss of muscle strength as its core symptom. We examined the potential value of repetitive transcranial magnetic stimulation rTMS as a therapeutic tool in FNP and the effect of rTMS on neural activity with fMRI. We established that rTMS can be a potential therapeutic application for patients with FNP. The patients with FNP showed large variability in neural activation patterns after treatment with rTMS, illustrating that understanding the mechanisms involved remains difficult.