How Normal Is ‘Normal'?

Louis, Elan D.; Ford, Blair; Pullman, Seth L.; Baron, Keren

doi:10.1001/archneur.55.2.222

Cited by 68 publications

(17 citation statements)

References 26 publications

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“…This side-side difference has been demonstrated in numerous studies of adults 1, 12 as well as our prior study of children. 4 Motor control, in general, is superior in the dominant than non-dominant arm, and this is one possible explanation.…”

Section: Discussionsupporting

confidence: 72%

“…Despite this, the method we used is very sensitive. Our data in other studies 1 has indicated that spiral drawings are a reasonably sensitive measure of tremor, as 97.0% of individuals with mild or greater tremor on a more detailed tremor examination exhibited ratings of 0.5 in one or more hands during spiral drawing. Second, the current results reflect a sample of low-income children in New York City, and future studies should assess whether they may be generalized to other cohorts.…”

Section: Discussionsupporting

confidence: 67%

“…1–3 The focus of tremor research has almost exclusively been on adult populations. Curiously, there have been virtually no surveys of the prevalence, clinical features or correlates of tremor among children.…”

Section: Introductionmentioning

confidence: 99%

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Tremor in a Population-Based Cohort of Children in New York City

Louis

Garcia

Rauh

2015

Pediatric Neurology

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Background There have been virtually no surveys of the prevalence, clinical features or correlates of tremor in children, and none in the United States. Methods 317 children (age 11.0 ± 1.1 years, range = 9.0 – 14.7) underwent an evaluation at one time point. Each drew Archimedes spirals, which were rated by a senior neurologist specializing in movement disorders. Results A spiral score of 1 (mild but consistent tremor) was present in either hand in 105 (33.1%) children; a higher score (1.5, mild to moderate tremor) was present in either hand in 7 (2.2%) children. Higher spiral scores were associated with poorer motor hand function as assessed using the Purdue Pegboard test. Spiral scores were higher in boys than girls, were inversely associated with age, and were higher in the non-dominant than dominant hand. Spiral scores were highest in children who were taking psychiatric medications and in children with psychiatric or neurological disorders. Conclusions Mild tremor is common in children, and covaries significantly with several demographic and clinical factors as well as usage of certain medications. It also lessens with advancing age. Rather than an isolated finding, tremor was associated with other measures of poorer motor hand function.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 67%

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Tremor in a Population-Based Cohort of Children in New York City

Louis

Garcia

Rauh

2015

Pediatric Neurology

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“…However, prior studies suggest that spiral drawings are a reasonably sensitive measure of tremor, as 97.0% of individuals with mild or greater tremor on a more detailed tremor examination exhibited ratings of 0.5 in one or more arms during spiral drawing (Louis et al, 1998). …”

Section: Discussionmentioning

confidence: 99%

“…Tremor is a condition that is highly prevalent in human populations, particularly among the elderly (Louis et al, 1998, 2000; Lieberman et al, 1994). Among adults, tremor is associated with exposure to several environmental chemicals, including lead (Louis et al, 2003; Dogu et al, 2007), pesticides (Louis et al, 2006; Jiménez-Jiménez et al, 2007) and harmane, a beta-carboline alkaloid found in coffee, tobacco smoke, and animal protein (Louis et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Prenatal exposure to the organophosphate pesticide chlorpyrifos and childhood tremor

et al. 2015

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Background The organophosphate insecticide chlorpyrifos (CPF), widely used for agricultural purposes, has been linked to neurodevelopmental deficits. Possible motor effects at low to moderate levels of exposure have not been evaluated. Methods Prenatal exposure to CPF was measured in umbilical cord blood in a sample of 263 inner-city minority children, who were followed prospectively. At approximately 11 years of age (mean age 10.9 ± 0.85 years, range = 9.0–13.9), during a neuropsychological assessment, children were asked to draw Archimedes spirals. These were rated by a senior neurologist specializing in movement disorders who was blind to CPF exposure level. Results Compared to all other children, those with prenatal CPF exposure in the upper quartile range (n = 43) were more likely to exhibit mild or mild to moderate tremor (≥1) in either arm (p = 0.03), both arms (p = 0.02), the dominant arm (p = 0.01), and the non-dominant arm (p = 0.055). Logistic regression analyses showed significant CPF effects on tremor in both arms, either arm, the dominant arm (p-values < 0.05), and the non-dominant arm (p = 0.06), after adjustment for sex, age at testing, ethnicity, and medication. Conclusion Prenatal CPF exposure is associated with tremor in middle childhood, which may be a sign of the insecticide's effects on nervous system function.

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