Plasmeijer, D.B. (Danieke) (2019) The influence of muscle weakness on tremor after solid organ transplantation. thesis, Medicine.
Full text available on request.Abstract
Background: Tremor is a common complication after solid organ transplantation and is associated with a high impact on quality of life. Muscle weakness resulting in an enhanced physiological tremor is a possible explanation for this increase in incidence of tremor. Objectives: The aim of this study, therefore, is to explore the influence of muscle weakness on tremor. Patients and methods: In this cross-sectional study 238 organ transplant recipients and 104 healthy kidney donors were examined at the University Medical Center Groningen, as part of the TransplantLines Biobank and Cohort study. We performed measurements of the amplitude and frequency of tremor of the hands using triaxial accelerometers in multiple conditions, categorized in three groups, i.e. rest, postural conditions and weighted conditions. In addition, functional disability was assessed, blood levels of tacrolimus were obtained and muscle strength of the hands, fingers and arms was measured using dynamometers. Results: Tremor amplitude in rest, postural and weighted conditions was significantly higher in recipients than healthy subjects (p=0.033, p<0.001 and p<0.001). The median amplitude of tremor was significantly correlated with functional disability scores in rest, postural and weighted conditions (p=0.008, p<0.001 and p<0.001 respectively). Muscle strength of the fingers and biceps were significantly lower in transplant recipients than healthy subjects (p=0.013 and p=0.002 respectively). However, it was not correlated with tremor amplitude. Muscle weakness of the hands was significantly correlated with the inversely transformed tremor amplitude in weighted conditions in men (β=0.179, p=0.039) and postural and weighted conditions in women (β=0.298, p=0.002 and β=0.274, p=0.005 respectively). Blood levels of tacrolimus were significantly correlated with the inversely transformed tremor amplitude in rest, postural and weighted conditions (β=-0.247, p=0.003, β=-0.372, p<0.001 and β=-0.365, p<0.001 respectively). Multiple regression analyses on the inverse transformation of tremor amplitude showed significant contributions of blood levels of tacrolimus, functional disability scores, handgrip strength, sex and age in rest, postural and weighted conditions (Adj. R2=0.129, p=0.001, Adj. R2=0.231, p<0.001 and Adj. R2=0.249, p<0.001 respectively). Conclusion: Muscle strength of the hands is mildly correlated with tremor amplitude. Tremor amplitude is significantly higher in transplant recipients than in healthy subjects and is correlated with functional disability scores. Muscle strength of the hands, fingers and arms is also lower in recipients. Compared to muscle strength, blood levels of tacrolimus show a much stronger correlation with tremor amplitude. This suggests that dosage reduction tacrolimus is a promising target point for tremor treatment in these patients. However, we expect that other yet unidentified factors are involved in the aetiology of tremor as well
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Drost, Dr. G. neurologist and University Medical Center Groningen (UMCG) Department of Neu |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:55 |
| Last Modified: | 25 Jun 2020 10:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1579 |
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