Rest tremor in Parkinson's disease: Body distribution and time of appearance

Gigante, Angelo Fabio; Pellicciari, Roberta; Iliceto, Giovanni; Liuzzi, Daniele; Mancino, Paola; Custodero, Giacomo Emanuele; Guido, Marco; Livrea, Paolo; Defazio, Giovanni

doi:10.1016/j.jns.2016.12.057

Cited by 15 publications

(8 citation statements)

References 25 publications

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“…Those in the ET group were split between disciplines at the first visit corresponding to their primary complaint for voice or extremities. These findings suggest that PD and ET groups more commonly experience tremor first in their extremities 5,18,24‐26 . Interestingly, voice was a primary issue for nearly half of the ET group; this may reflect that half experienced onset of tremor first in the voice, or were bothered by VT more than extremity tremor.…”

Section: Discussionmentioning

confidence: 83%

Classification of vocal tremor using updated consensus‐based tremor classification criteria

Torrecillas

Dwenger

Barkmeier-Kraemer

2021

Laryngoscope Investig Oto

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Objectives This study characterized the clinical phenotypes of individuals with vocal tremor (VT) using tremor classification criteria published by the International Parkinson and Movement Disorder Society (IPMDS) including laryngeal features from the American Academy of Otolaryngology—Head and Neck Surgery (AAO‐HNS). Methods VT phenotypic descriptors were extracted from participant medical records from 2017 to 2019. Clinical phenotype descriptors included the: (a) chief complaint and discipline for the first appointment, (b) demographics, (c) tremor body distribution, condition, frequency, and progression, (d) exacerbating/alleviating factors, (e) treatment approaches, and (g) neurologic comorbidities. Descriptive statistics were conducted. Results Of 179 meeting inclusion criteria, 2/3 were female; tremor onset affected voice (43%) or extremity (32%) and 2/3 were documented with tremor duration of 3 years or more. Those with primary VT first saw otolaryngology or speech language pathology (59%), whereas those with primary extremity/head tremor first saw neurology (36%). Documentation commonly omitted tremor clinical features such as (a) observed conditions of tremor (64%), (b) laryngeal features (64%), and (c) tremor frequency (92%). Thus, VT classification was based on comorbidity in 49% of patients (ie, essential tremor (48%), dystonia (72%), and Parkinson's disease (100%)) and 32% had inadequate documentation to classify. Conclusion The majority of individuals with VT were unable to be classified based on documented clinical features highlighting the need for consistent multidisciplinary assessment of tremor affecting speech structures. The primary site of tremor determined the first discipline seen. Most commonly classified VT categories included essential tremor (47%), dystonia (28%), Parkinsonism (7%), and isolated VT (19%). Level of Evidence 4.

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Section: Discussionmentioning

confidence: 83%

Classification of vocal tremor using updated consensus‐based tremor classification criteria

Torrecillas

Dwenger

Barkmeier-Kraemer

2021

Laryngoscope Investig Oto

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“…In 2018, the consensus statement (CS) on the classification of tremor [ 20 ] classified parkinsonian tremor among the forms of tremor associated with other pre-eminent neurological signs. The CS defined it as a rest tremor (RT), considered as the classic PD tremor, with a frequency of 4–7 Hz.…”

Section: Description Of the Analyzed Parkinson’s Symptomsmentioning

confidence: 99%

Parkinson’s Disease Patient Monitoring: A Real-Time Tracking and Tremor Detection System Based on Magnetic Measurements

Milano

Cerro

Santoni

et al. 2021

Sensors

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Reliable diagnosis of early-stage Parkinson’s disease is an important task, since it permits the administration of a timely treatment, slowing the progression of the disease. Together with non-motor symptoms, other important signs of disease can be retrieved from the measurement of the movement trajectory and from tremor appearances. To measure these signs, the paper proposes a magnetic tracking system able to collect information about translational and vibrational movements in a spatial cubic domain, using a low-cost, low-power and highly accurate solution. These features allow the usage of the proposed technology to realize a portable monitoring system, that may be operated at home or in general practices, enabling telemedicine and preventing saturation of large neurological centers. Validation is based on three tests: movement trajectory tracking, a rest tremor test and a finger tapping test. These tests are considered in the Unified Parkinson’s Disease Rating Scale and are provided as case studies to prove the system’s capabilities to track and detect tremor frequencies. In the case of the tapping test, a preliminary classification scheme is also proposed to discriminate between healthy and ill patients. No human patients are involved in the tests, and most cases are emulated by means of a robotic arm, suitably driven to perform required tasks. Tapping test results show a classification accuracy of about 93% using a k-NN classification algorithm, while imposed tremor frequencies have been correctly detected by the system in the other two tests.

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“…The classical PD tremor has a main frequency of 4–7 Hz and is most often present at rest in the hands or arms of the affected subjects. Postural and kinetic tremors are also common in the upper extremities whereas tremors in the lower extremities are rarer [2, 3]. Furthermore, re-emergent tremor in terms of tremor re-occurring after repositioning of the limb is frequent [4].…”

Section: Introductionmentioning

confidence: 99%

The effect of 8 weeks of treatment with transcranial pulsed electromagnetic fields on hand tremor and inter-hand coherence in persons with Parkinson’s disease

Malling

Morberg

Wermuth

et al. 2019

J NeuroEngineering Rehabil

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BackgroundParkinson’s disease (PD) tremor comprises asymmetric rest and postural tremor with unilateral onset. Tremor intensity can be amplified by stress and reduced by attention, and the medical treatment is complex. Mirror movements and unintentional synchronization of bimanual movements, possibly caused by insufficient inhibition of inter-hemispheric crosstalk, have been reported in PD, indicating a lag of lateralization.Potential neuroprotective effects of pulsed electromagnetic fields (PEMF) have been reported in-vitro and in rodents, as have influences of PEMF on human tremor.The aim was to investigate the effect of 8 weeks daily transcranial PEMF treatment (T-PEMF) of persons with PD on rest and postural hand tremor characteristics and on inter-hand coherence.MethodsHand accelerations of 50 PD participants with uni- or bilateral tremor participating in a clinical trial were analysed. A rest and postural tremor task performed during serial subtraction was assessed before and after 8 weeks of T-PEMF (30 min/day, 50 Hz, ±50 V, 3 ms squared pulses) or placebo treatment (sham stimulation 30 min/day). Forty matched healthy persons (no treatment) were included as reference. Intensity and inter-hand coherence related measures were extracted.ResultsThe T-PEMF treatment decreased the inter-hand coherence in the PD group with unilateral postural tremor. The PD group with unilateral postural tremor was less clinically affected by the disease than the PD group with bilateral postural tremor. However, no differences between T-PEMF and placebo treatment on either intensity related or coherence related measures were found when all persons with PD were included in the analyses. The peak power decreased and the tremor intensity tended to decrease in both treatment groups.ConclusionsEight weeks of T-PEMF treatment decreased inter-hand coherence in the PD group with unilateral postural tremor, while no effects of T-PEMF treatment were found for the entire PD group. The unilateral postural tremor group was less clinically affected than the bilateral postural tremor group, suggesting that early treatment initiation may be beneficial. In theory, a reduced inter-hand coherence could result from a neuronal treatment response increasing inter-hemispheric inhibition. However, this requires further studies to determine. Studies of even longer treatment periods would be of interest.Trial registrationClinicalTrials.gov, NCT02125032. Registered 29 April 2014, https://clinicaltrials.gov/ct2/show/NCT02125032?term=NCT02125032&rank=1Electronic supplementary materialThe online version of this article (10.1186/s12984-019-0491-2) contains supplementary material, which is available to authorized users.

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Rest tremor in Parkinson's disease: Body distribution and time of appearance

Abstract: This study provides new information about body distribution and timing of rest tremor appearance during the course of early stages of Parkinson's disease that may help clinicians in patients' counselling.

Cited by 15 publications

References 25 publications

Classification of vocal tremor using updated consensus‐based tremor classification criteria

Classification of vocal tremor using updated consensus‐based tremor classification criteria

Parkinson’s Disease Patient Monitoring: A Real-Time Tracking and Tremor Detection System Based on Magnetic Measurements

The effect of 8 weeks of treatment with transcranial pulsed electromagnetic fields on hand tremor and inter-hand coherence in persons with Parkinson’s disease

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