Adhd shaking hands

Attention Deficit: Hand Movements Could Be Sign of Severity

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Measuring how well children with attention deficit hyperactivity disorder (ADHD) can control their hand movements could help to gauge the severity of their disorder, a new study suggests.

Children with ADHD were twice as likely to have a hard time keeping their right hand completely still while tapping the fingers of their left hand, compared with kids without the disorder, said study researcher Dr. Donald L. Gilbert, of Cincinnati Children's Hospital Medical Center.

Moving one side of the body to match the actions of the other side of the body is called a mirror movement, Gilbert said. As children mature past toddlerhood and improve their motor control, mirror movements generally decrease, but researchers have long known that mirror movements go away more slowly in kids with ADHD, he said.

Measuring the extent to which kids with ADHD have outgrown these automatic mirror movements provides a "reliable, quantitative, brain-based tool, so that scientists can know what's going on in the brain to identify new and better treatments," Gilbert told MyHealthNewsDaily.

The study will be published tomorrow (Feb. 15) in the journal Neurology.

Mirrors and brain activity

In the first mirroring study, researchers examined the mirror movements of 25 right-handed boys and girls, ages 8 to 15, with ADHD , and 25 right-handed boys and girls without the disorder. Researchers attached a device that measures movement to the children's left hands.

When the children were asked to tap the fingers of their left hand while keeping their right hand still, the kids with ADHD were more than twice as likely to also move their right hand as the children without ADHD, the study said.

The effect was most pronounced in boys with ADHD they were almost four times more likely to move their right hand along with their left than boys without ADHD, the study said.

In a second, related study, the scientists measured the brain activity of 49 children with ADHD and 49 children without the disorder to see if there were any differences in the motor control areas of their brains.

They found that the activity of the brain's braking mechanism that would normally put a stop to mirror movements was reduced by 40 percent in the kids with ADHD, compared with the kids without the disorder, the study said. And the reduction in activity correlated to the severity of ADHD symptoms reported by the kids' parents.

The researchers also measured the kids' coordination, rhythm, manual dexterity and balance using motor development tests. They found that kids with ADHD scored 60 percent worse than the kids without ADHD.

Applying the findings

By objectively measuring the behavior of kids with ADHD, it's possible to quantify the severity of the disorder, said study researcher Dr. Stewart Mostofsky, director of the Laboratory for Neurocognitive and Imaging Research at the Kennedy Krieger Institute in Baltimore, Md.

The tests "may prove helpful in improving diagnosis and guiding effective therapies," Mostofsky told MyHealthNewsDaily.

But the tests likely won't be used for diagnosing ADHD, simply because these deficits in the ability to control hand mirroring can't be observed until the child is older, Gilbert said.

Current methods of assessing ADHD severity are "still somewhat crude," said Dr. Jonathan Mink, a neurology professor at the University of Rochester Medical Center in New York, who was not involved with the study. Rating scales assess the number of symptoms and how often they are present, but they don't look at the underlying neurobiology, he said.

The hand-mirroring test "provides important clues as to why many kids with ADHD have clumsy movements or bad handwriting," Mink told MyHealthNewsDaily.

The mirroring test could be useful for determining which kids are at highest risk of having motor difficulties and may lead to earlier intervention for these difficulties, he said.

Pass it on: Measuring hand movements and motor region brain activity in kids with ADHD can help to quantify the severity of their disorder.

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Follow MyHealthNewsDaily staff writer Amanda Chan on Twitter @AmandaLChan.

Amanda Chan was a staff writer for Live Science Health. She holds a bachelor's degree in journalism and mass communication from the Walter Cronkite School of Journalism and Mass Communication at Arizona State University, and a master's degree in journalism from Columbia University.

What's causing your shaky hands?

Tremors may be nothing to worry about or something more serious. But don't let them go unchecked.

 Image: © Piyapong Thongcharoen/Getty Images

Do you ever notice that you can't seem to hold a coffee cup still? Or that your hands sometimes tremble so much it interferes with daily chores? Those involuntary hand movements are called tremors. "They're common in middle and older age," says Dr. Chizoba Umeh, a neurologist who specializes in movement disorders at Harvard-affiliated Brigham and Women's hospital. "They're not life-threatening, but people with severe tremors may have a hard time feeding themselves, dressing, or driving."

Tremor symptoms

Hand tremors may occur at rest (such as in Parkinson's disease) or they may occur with activity. Most resting hand tremors look like you're rolling a pill between your thumb and index finger. When you do something, the tremor disappears.

Hand tremors that occur with activity are described based on when they appear:

  • Postural tremor "occurs when your hands are outstretched, and gravity is pulling them down. You can't keep the hands completely steady while they're outstretched," Dr. Umeh says.

  • Intention tremor starts when you're reaching for a target, like a keyhole as you unlock your door.

  • Task-specific tremor occurs when performing an activity, such as when you're writing.


We all have a little bit of tremor called a physiologic tremor; it's natural and not usually noticeable. Tremors that aren't natural include these types:

Enhanced physiologic tremor. Caffeine use, an overactive thyroid, stress, fatigue, or sleep deprivation can intensify physiologic tremor. This tremor may show up as a postural tremor.

Medication-induced tremor. Some medications can cause tremors, such as the antidepressant bupropion (Wellbutrin) and the anti-arrhythmic drug amiodarone (Cordarone). The resulting tremor is often postural.

Parkinsonian tremor. This resting, pill-rolling tremor can occur with or without the degenerative neurological condition Parkinson's disease.

Essential tremor. This is a benign tremor that causes involuntary shaking in various body parts, including the hands, head, and voice box. "A person with essential tremor may have a postural hand tremor or an intention tremor," Dr. Umeh says.

Cerebellar tremor. This is an intention tremor caused by damage to the cerebellum in the back of the brain, often from a stroke or multiple sclerosis. "The cerebellum helps coordinate movement, like reaching out to grasp a doorknob. Cerebellar damage can cause your hand to miss the doorknob," Dr. Umeh says.

Post-stroke tremor. After a stroke, a person can have a variety of tremors. "If there's damage to the cerebellum there can be an intention tremor. If the damage is in the basal ganglia, the person can have a resting tremor," Dr. Umeh explains.

Withdrawal tremor. People suffering alcohol withdrawal can experience postural tremors.


Diagnosing a tremor requires a physical exam and a careful analysis of your medical history. "I want to know what it looks like and if there are any associated features. Is there balance impairment, stiffness, or slowness of movement as in Parkinson's disease? Was there a stroke? Is there a brain lesion? Is the person taking a certain kind of medication? Does the person consume a lot of caffeine or have any other underlying conditions?" asks Dr. Umeh. She says it may be necessary to order lab work to check for thyroid disease or get an image of the brain to check for signs of a past stroke.


Some tremors can be eliminated or dramatically reduced. For enhanced physiologic tremor, you may just need to cut back on caffeine or manage stress. Tremors caused by thyroid disorder or alcohol withdrawal may be reduced by treating those conditions.

Medication-induced tremors may be resolved by switching to a different type of medication. Essential tremor is often treated with medications such as the beta blocker propranolol (Inderal) or the antiseizure drug primidone (Mysoline). Parkinsonian tremors may be reduced with anti-parkinsonian medications or a procedure called deep brain stimulation, in which electrodes are implanted in the brain to stimulate areas regulating movements such as tremors.

"Tremors from multiple sclerosis, strokes, and brain tumors are not typically reversible," Dr. Umeh says.

Other ways to cope

Because hand tremors can interfere with eating and other tasks, it may help to use weighted eating utensils and to work with an occupational therapist for help with fine motor skills, such as buttoning clothes. "Take heart," Dr. Umeh says. "Tremors can be very frustrating, but you can learn to live with them."


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6 handshake rules everyone should remember

March 2, 2020 Relationship

No sweaty hands or long shaking.

A handshake is a very important thing. When you shake hands with someone, the brain releases the confidence hormone oxytocin. You open up for communication, trust each other more and even consider your handshake partner to be a more pleasant person. The same thing happens in his head. But it is important not just to shake hands, but to do it right. How exactly, said Vanessa Van Edwards, psychologist and author of The Science of Communication. nine0129

1. Hold your palm upright

Keep your palm upright when shaking hands. This puts you and the other person on an equal footing.


If someone turns your hand so that you can see your wrist, then he is trying to dominate. Never initiate a handshake from this position yourself. This is how you show your weakness.


2. Make eye contact

Eye contact is not a direct part of the handshake, but it has a huge impact on first impressions. nine0129

When you look into the eyes of another person, it's like saying: "I want to communicate with you. " Such a look is much more important than the first words when meeting, because it, like a handshake, provokes the production of oxytocin. At a subconscious level, a person is perceived as open, pleasant, convincing and memorable. People will want to see you again and get to know you better.

If there is no eye contact at the first meeting, then for the brain it is like a red rag for a bull. The person becomes annoyed, thinks that something is being hidden from him, and is suspicious of you. nine0129

3. Don't squeeze your hand too hard

Squeeze your hand tightly: limp handshakes are unpleasant and people will see you as an insecure person who doesn't want to communicate. But don't do it too hard so you don't make anyone nervous. Too strong handshakes can be intimidating and uncomfortable.

4. Don't hold your hand too long

The perfect handshake lasts 3-5 seconds. Too long causes bewilderment and embarrassment. Too short and jerky - the feeling that a person is not in the mood for communication at all and wants to leave as soon as possible. But if you are really in a hurry and met on the run, then such a handshake would be appropriate. nine0129

5. Don't reach out with a wet hand

Shaking a wet hand is not pleasant, but that's not the only thing. Your hands sweat when you're nervous, and being nervous doesn't make a good first impression. Do not extend a wet hand to greet, do not show your excitement to another person. Just in case, carry paper handkerchiefs with you.

6. Evaluate what is better in a particular situation: shake hands or hug

When you meet an old acquaintance, you can shake his hand and even hug him. Everyone will be comfortable. But if it comes to new people in the environment, then you can get into an awkward situation and confuse a person. You need to know in advance what type of greeting would be appropriate. nine0129

Watch body language when someone approaches you. If the hands cover the torso or one hand is outstretched, then a handshake is appropriate, but hugging is not worth it.

Learn more