4.4 Article

Hyperventilation Increases the Randomness of Ocular Palatal Tremor Waveforms

Journal

CEREBELLUM
Volume 20, Issue 5, Pages 780-787

Publisher

SPRINGER
DOI: 10.1007/s12311-020-01171-1

Keywords

Cerebellum; Calcium channels; Inferior olive; Brain stem; Purkinje neurons

Categories

Funding

  1. American Academy of Neurology Career Award
  2. American Parkinson's Disease Association George C Cotzias Memorial Fellowship
  3. Dystonia Medical Research Foundation
  4. philanthropic funds to the Department of Neurology at University Hospitals (The AllanWoll Fund)

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The study found that hyperventilation has an instantaneous effect on the randomness of oscillatory waveforms, but has less substantial effects on oscillation intensity, and these deficits reverse immediately at the end of hyperventilation.
Hyperventilation changes the extracellular pH modulating many central pathologies, such as tremor. The questions that remain unanswered are the following: (1) Hyperventilation modulates which aspects of the oscillations? (2) Whether the effects of hyperventilation are instantaneous and the recovery is rapid and complete? Here we study the effects of hyperventilation on eye oscillations in the syndrome of oculopalatal tremor (OPT), a disease model affecting the inferior olive and cerebellar system. These regions are commonly involved in the pathogenesis of many movement disorders. The focus on the ocular motor system also allows access to the well-known physiology and precise measurement techniques. We found that hyperventilation causes modest but insignificant changes in the intensity of oscillation displacement (i.e., how large the eye excursions are) and velocity (i.e., how fast do the eyes move during oscillations). We found the robust increase in the randomness of the oscillatory waveform during hyperventilation and it instantaneously reverts to the baseline after hyperventilation. The subsequent analysis classified the oscillations according to their waveform shape and randomness into different clusters. The hyperventilation substantially changed the cluster type in 60% of the subjects, but it reverted to the pre-hyperventilation cluster at the conclusion of the hyperventilation. In summary, hyperventilation instantaneously affects the randomness of the oscillatory waveforms but there are less substantial effects on the intensity. The deficits reverse immediately at the end of the hyperventilation.

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