Prevalence of movement disorders in men and women aged 50–89 years (Bruneck Study cohort): a population-based study

Wenning, Gregor K.; Kiechl, Stefan; Seppi, Klaus; Müller, Joerg; Högl, Birgit; Saletu, M.; Rungger, Gregor; Gasperi, Arno; Willeit, Johann; Poewe, Werner

doi:10.1016/s1474-4422(05)70226-x

Cited by 270 publications

(212 citation statements)

References 27 publications

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“…For the same reason, we could not evaluate the long-term tracking of tremor characteristics. Finally, we focused on the discrimination of ET and PD patients because these are the most prevalent types of tremor [1,49]. The analyses of other types of tremor such as dystonic tremor are left for future work.…”

Section: Discussionmentioning

confidence: 99%

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New Perspectives for Computer-Aided Discrimination of Parkinson’s Disease and Essential Tremor

et al. 2017

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Pathological tremor is a common but highly complex movement disorder, affecting ∼5% of population older than 65 years. Different methodologies have been proposed for its quantification. Nevertheless, the discrimination between Parkinson's disease tremor and essential tremor remains a daunting clinical challenge, greatly impacting patient treatment and basic research. Here, we propose and compare several movement-based and electromyography-based tremor quantification metrics. For the latter, we identified individual motor unit discharge patterns from high-density surface electromyograms and characterized the neural drive to a single muscle and how it relates to other affected muscles in 27 Parkinson's disease and 27 essential tremor patients. We also computed several metrics from the literature. The most discriminative metrics were the symmetry of the neural drive to muscles, motor unit synchronization, and the mean log power of the tremor harmonics in movement recordings. Noteworthily, the first two most discriminative metrics were proposed in this study. We then used decision tree modelling to find the most discriminative combinations of individual metrics, which increased the accuracy of tremor type discrimination to 94%. In summary, the proposed neural drive-based metrics were the most accurate at discriminating and characterizing the two most common pathological tremor types.

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Section: Discussionmentioning

confidence: 99%

“…About ∼4% of the elderly (>65 years) suffer from essential tremor (ET), whereas ∼1% of the population of age >50 years suffer from Parkinson's disease (PD) [1].…”

Section: Introductionmentioning

confidence: 99%

New Perspectives for Computer-Aided Discrimination of Parkinson’s Disease and Essential Tremor

et al. 2017

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“…13,24 A preponderance of women is often reported, attributed to drug dosing or interaction issues or hormonal influences. 15,16,18,[25][26][27][28] In addition to old age and female sex, commonly accepted patient-related risk factors for DIP ( In a group of 67 patients with intellectual disability, DIP did not correlate with overt brain damage. 37 Dopamine receptor gene variations seem uninvolved.…”

Section: Definition and Epidemiologymentioning

confidence: 99%

Drug-induced parkinsonism: diagnosis and management

Blanchet

Kivenko²

2016

JPRLS

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Drug-induced parkinsonism (DIP) has been known for >60 years. It is the second leading cause of parkinsonism, but still underdiagnosis is likely to influence reported incidence figures. Since DIP is clinically undistinguishable from Lewy-body Parkinson’s disease, any new case of parkinsonism should prompt the search for an offending antipsychotic, hidden neuroleptic, or nonneuroleptic agent that may produce DIP. DIP is reversible upon drug withdrawal in most cases. There is no consensus regarding the duration of the recovery period to allow motor signs to fully remit in order to confirm the diagnosis of DIP following removal of the causative agent, but a drug-free interval of at least 6 months is generally recommended. Interestingly, up to 30% of DIP cases may show persisting or worsening motor signs beyond 6 months following drug withdrawal or adjustment, due to complex postsynaptic and presynaptic factors that may variably interact to negatively influence nigrostriatal dopamine transmission in a so-called “double-hit” hypothesis. The condition significantly impacts on quality of life and increases the risks of morbidity and mortality. Management is challenging in psychiatric patients and requires a team approach to achieve the best outcome

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“…Equation (13) indicates that the EMG or force (equivalent for acceleration) signals are filtered versions of the neural drive to muscles. The effect of the filters on the relative power of tremor harmonics (7/2/7/1) is obtained by substituting equation (13) in equation (1). The Results will show that, because the average action potential and twitch waveforms vary across subjects, muscles, and conditions, their filtering effect partly hinders the discriminatory power of the neural drive to muscle for identifying the tremor pathology.…”

Section: >(F)mentioning

confidence: 99%

One central oscillatory drive is compatible with experimental motor unit behaviour in essential and Parkinsonian tremor

et al. 2015

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Objective. Pathological tremors are symptomatic to several neurological disorders that are difficult to differentiate and the way by which central oscillatory networks entrain tremorogenic contractions is unknown. We considered the alternative hypotheses that tremor arises from one oscillator (at the tremor frequency) or, as suggested by recent findings from the superimposition of two separate inputs (at the tremor frequency and twice that frequency). Approach. Assuming one central oscillatory network we estimated analytically the relative amplitude of the harmonics of the tremor frequency in the motor neuron output for different temporal behaviors of the oscillator. Next, we analyzed the bias in the relative harmonics amplitude introduced by superimposing oscillations at twice the tremor frequency. These findings were validated using experimental measurements of wrist angular velocity and surface electromyography (EMG) from 22 patients (11 essential tremor, 11 Parkinson's disease). The ensemble motor unit action potential trains identified from the EMG represented the neural drive to the muscles. Main results. The analytical results showed that the relative power of the tremor harmonics in the analytical models of the neural drive was determined by the variability and duration of the tremor bursts and the presence of the second oscillator biased this power towards higher values. The experimental findings accurately matched the analytical model assuming one oscillator, indicating a negligible functional role of secondary oscillatory inputs. Furthermore, a significant difference in the relative power of harmonics in the neural drive was found across the patient groups, suggesting a diagnostic value of this measure (classification accuracy: 86%). This diagnostic power decreased substantially when estimated from limb acceleration or the EMG. Signficance. The results indicate that the neural drive in pathological tremor is compatible with one central network providing neural oscillations at the tremor frequency. Moreover, the regularity of this neural oscillation varies across tremor pathologies, making the relative amplitude of tremor harmonics a potential biomarker for diagnostic use.

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Prevalence of movement disorders in men and women aged 50–89 years (Bruneck Study cohort): a population-based study

Cited by 270 publications

References 27 publications

New Perspectives for Computer-Aided Discrimination of Parkinson’s Disease and Essential Tremor

New Perspectives for Computer-Aided Discrimination of Parkinson’s Disease and Essential Tremor

Drug-induced parkinsonism: diagnosis and management

One central oscillatory drive is compatible with experimental motor unit behaviour in essential and Parkinsonian tremor

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