PD Mechanics: Cause of Resting Tremors

[PDConscience]

"Resting tremors are among the most noticeable features of Parkinson’s disease (PD). The tremors are believed to be caused by complex interactions between a number of factors. Alterations in the activity of several areas of the brain including the substantia nigra, the basal ganglia, and the thalamus, as well as changes in the level and action of the neurotransmitter dopamine, are all related to each other and to the production of the tremors.

"Research studies have identified a number of defects in the brain associated with the tremor of PD. The interactions between these structures are complex, and even though we have a great deal of information about the anatomical and biochemical causes of PD tremors, there are many unanswered questions.

"One of the fundamental causes of Parkinson’s disease is a decrease in dopamine, an important neurotransmitter, in the areas of the brain that support movements. The substantia nigra, a region of the brainstem that produces dopamine, does not function as it should in PD, resulting in low levels of active dopamine. Studies have shown that the fall in overall dopamine levels begins years before the onset of PD symptoms. This affects various aspects of movement:

Voluntary movement: The globus pallidus is the part of the basal ganglia that helps regulate voluntary movement, such as holding a cup of tea. It normally receives and responds to dopamine, and, when there is altered dopamine production due to PD, the globus pallidus does not function as it should.

Complex movement: The thalamus and the subthalamic nucleus in the brain are primarily involved in sensation. They receive information about your body's position from several regions in the brain, including the globus pallidus. The brain uses this sensory feedback from the thalamus and subthalamic nucleus to control complex movements, such as stirring sugar in that cup of tea. When the levels of dopamine reach a critically low level, the thalamus loses its normal regulatory input.

Coordinated movement: The cerebellum controls coordination, while the motor portion of your cerebral cortex controls voluntary movement. Both of these areas receive information about your body's position from the thalamus and then work together to carry out coordinated physical movements. These final steps are disrupted when the basal ganglia are at rest, which is why the tremor is prominent during rest and not during an action."

"When the brain cannot get accurate sensory feedback about how well movements are proceeding, it can no longer effectively adjust physical movements. In PD, the most complex movements of the body, which involve the fingers and hands, are the first and most severely affected..."

Full Article [Aug2019]: verywellhealth.com/causes-o...

[parkie13]

It says in the article it's usually begins as a pill rolling tremor. I have never had pill rolling tremor. Would anybody like to chime in and say if it started that way for them? The funny thing is, that before I was diagnosed, I went to my GP and he told me no you don't have Parkinson's, Parkinson's is a pill rolling, and he showed me the motion with his fingers.

[Despe in reply to parkie13]

Yes, Mary. My husband's is a "pill rolling" tremor. However, it didn't start like that, but a pinkie finger shaking/tremor. It took 4 years to develop to its current tremor.

[LuckyLuke in reply to parkie13]

Same as Despe 's husband. 3/4 years since diagnosis to develop 'pill rolling' tremor at the beginning was a 'simple' tremor in my index finger in the left hand. The finger was just doing a sort of slow up and down.

[pdpatient in reply to parkie13]

Parkie13. Exactly the same way i was initially diagnosed. I even have his clinical notes today.

[park_bear]

The brain contains a control system that tries to keep our limbs in the same position we left them when we are no longer paying attention. This involves an automatic feedback system of proprioception (sensing position) and attempting to correct deviations from that position. When we put sufficient delay into a feedback loop of this kind, the result is oscillation, which we experience as tremor. At least in my experience I can put a halt to resting tremor by paying attention - thereby transferring control to the system of conscious movement. This system involves the conscious mind, which has the ability to compensate for motor defects, such as slower than normal response.

[Despe in reply to park_bear]

PB

"At least in my experience I can put a halt to resting tremor by paying attention. . ." Same goes for my husband, he can stop the tremor although it's not constant but intermittent. It takes will power and everyone CAN DO IT!

[bdphillips in reply to Despe]

What exactly do you mean by paying attention?

[Despe in reply to bdphillips]

Ask Park_Bear. I believe he is trying to say that if you make a concerted effort to stop the tremor, YOU CAN! Takes concentration and use of conscious mind.

[Smittybear7 in reply to Despe]

My tremors are diagnosed as resting tremors. However the tremors sometimes involve the whole hand I also have a lesser tremor in my left hand any suggestions? Thanks

[Despe in reply to Smittybear7]

Unfortunately that means that your PD has progressed and your left side is affected, too. I am not a doctor and can't suggest what could stop your tremors. Based on my husband's experience, I can only suggest to try adding MP to your daily PD meds. Remember, every individual is unique and what works for one, it won't work for the other.

[Smittybear7 in reply to Despe]

What is MP?

[Despe in reply to Smittybear7]

Mucuna Pruriens.

[MarionP in reply to park_bear]

This also works for all sorts of freezes. For example, stepping/walking, reaching. When you freeze, think about and "will" yourself to step "THERE," and the freeze breaks.

[bdphillips in reply to park_bear]

Can you elaborate on what you mean by paying attention?

[park_bear in reply to bdphillips]

Directing conscious attention to the part of the body having the tremor.

[GymBag]

I believe that PD has an effect on involuntary muscles also. Constipation, lack of eyes blinking , the Parkinson's mask on our face, etc etc. but no one ever talks about involuntary muscles.

[kaypeeoh]

I never had pill-rolling as a symptom. But I found that conscious pill-rolling controlled tremor. I discovered that when having an MRI. While I was locked in the tube a nurse was constantly yelling at me to stop moving. Pill-rolling suppressed the tremor enough to shut the nurse up.

[Smittybear7]

Thanks for sharing