Limb Cooling in Essential Tremor
Limb Cooling in Essential Tremor
Essential Tremor (ET) is characterized by tremors affecting the arms. The investigators will
 examine the effects of non-pharmacological limb cooling on clinical and physiological
 characteristics in patients presenting with ET at three different temperatures; and will
 measure changes in tremor amplitude after cooling of the upper limb.
Once the subject has agreed to participate in the study the following assessments will be
 performed.

 Three non-pharmacological assessments will be performed at different temperature to the upper
 limbs. The first will be a baseline assessment with upper limbs maintaining a normal body
 temperature (96-98°F). The second assessment will be performed with upper limbs at a
 temperature of 59°F and the third will be performed at a temperature of 80°F for a period of
 10 minutes. At the end of 10 minutes, tremor measurements will be 15, 40, and 60 minutes.

 1. Assessments will include the Tremor Rating Scale (TRS), Handwriting Assessment Battery
 (HAB) and the Functional Dexterity Test (FDT).

 2. The Bagnoli and Trigno EMG systems will record surface EMG signals from muscles and
 accelerometer readings.
Inclusion Criteria:

 -  Age range 18 to 95 years,

 -  Clinical diagnosis of essential tremor for at least a year,

 -  A +2 or worse action or kinetic tremor of one or both upper limbs involving at least
 the forearm and/or hand

 Exclusion Criteria:

 -  Dermatologic lesions in upper limbs (e.g. skin cancer, eczema, fresh or healing
 wounds, abrasions, acne, pustules, abscesses, or skin rash),

 -  Sensory loss in the upper limbs,

 -  Known history of sensitivity to cold (i.e., cold urticaria),

 -  Known peripheral vascular disease,

 -  Raynaud's phenomenon,

 -  Scleroderma

 Healthy normal controls will be enrolled through advertisements. All controls will be
 examined to ensure that they are neurologically healthy.

 The exclusion criteria for controls will remain same as those for patient subjects.