Changes in cortical inhibition during task-specific contractions in primary writing tremor patients

Milos Ljubisavljevic, Aleksandra Kacar, Sladjan Milanovic, Marina Svetel, Vladimir S. Kostic

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Primary writing tremor (PWT) is a rare disease of unknown pathophysiology. We studied changes in silent period (SP) duration, after transcranial magnetic stimulation (TMS), set at 20% above the motor threshold in 6 PWT patients and 7 healthy control subjects. SP duration was tested during a task-specific act, i.e., writing that induced tremor in all patients in the affected hand (Wr); nonspecific voluntary contraction of intensity, matching that developed during writing (VCWr); and during near maximal voluntary contraction (VCNmax). There were no differences in SP duration during Wr and VCWr contraction on the right affected side or between sides in both PWT patients and control subjects, nor between the groups. However, during VCNmax, SP significantly shortened on both sides in PWT patients, whereas there were no changes in control subjects. Although it appears that inhibitory mechanism are not directly involved in the generation of the tremulous activity, the shortening of SP indicates that central inhibitory mechanisms are affected in PWT patients. Therefore, whereas the underlying pathophysiological mechanisms in PWT and writer's cramp may share common features, the results indicate that PWT is not a variant of focal task-specific dystonia but rather a separate nosological entity.

Original languageEnglish
Pages (from-to)855-859
Number of pages5
JournalMovement Disorders
Issue number6
Publication statusPublished - Jun 2006


  • Cortical inhibition
  • Primary writing tremor
  • Silent period
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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