Rest tremor revisited: Parkinson’s disease and other disorders

Chen, Wei; Hopfner, Franziska; Becktepe, Jos S.; Deuschl, Günther

doi:10.1186/s40035-017-0086-4

Cited by 37 publications

(30 citation statements)

References 69 publications

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“…Although different types of tremor may occur in PD patients (Deuschl, Bain, & Brin, 1998), the most common of these is rest tremor. This is a slow, biplanar, pill-rolling, 4-6 Hz tremor in the fully supported limb; the tremor decreases during movement (Chen, Hopfner, Becktepe, & Deuschl, 2017). Despite the high prevalence of tremor among PD patients, it remains one of the most enigmatic hallmarks of this disease, which is an essentially a hypokinetic movement disorder.…”

Section: Introductionmentioning

confidence: 99%

Tremor severity in Parkinson's disease and cortical changes of areas controlling movement sequencing: A preliminary study

Benito‐León

Serrano

Louis

et al. 2018

J of Neuroscience Research

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There remains much to learn about the changes in cortical anatomy that are associated with tremor severity in Parkinson's disease (PD). For this reason, we used a combination of structural neuroimaging to measure cortical thickness and neurophysiological studies to analyze whether PD tremor was associated with cortex integrity. Magnetic resonance imaging and neurophysiological assessment were performed in 13 nondemented PD patients (9 women, 69.2%) with a clearly tremor-dominant phenotype. Cortical reconstruction and volumetric segmentation were performed with the Freesurfer image analysis software. Assessment of tremor was performed by means of high-density surface electromyography (hdEMG) and inertial measurement units (IMUs). Individual motor unit discharge patterns were identified from surface hdEMG and tremor metrics quantifying motor unit synchronization from IMUs. Increased motor unit synchronization (i.e., more severe tremor) was associated with cortical changes (i.e., atrophy) in wide-spread cortical areas, including caudal middle frontal regions bilaterally (dorsal premotor cortices), left inferior parietal lobe (posterior parietal cortex), left lateral orbitofrontal cortex, cingulate cortex bilaterally, left posterior and transverse temporal cortex, and left occipital lobe, as well as reduced left middle temporal volume. Given that the majority of these areas are involved in controlling movement sequencing, our results support Albert's classic hypothesis that PD tremor may be the result of an involuntary activation of a program of motor behavior used in the genesis of rapid voluntary alternating movements.

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Section: Introductionmentioning

confidence: 99%

Tremor severity in Parkinson's disease and cortical changes of areas controlling movement sequencing: A preliminary study

Benito‐León

Serrano

Louis

et al. 2018

J of Neuroscience Research

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“…Diagnosing a tremor disorder accurately is challenging as similar clinical entities can be caused by different diseases . Therefore, in the absence of biomarkers, misdiagnoses between tremor in Parkinson's disease (PD), tremor in dystonia (TiD), and essential tremor (ET) frequently occur . Ioflupane‐based single photon emission computed tomography ( 123 I‐FP‐CIT DAT‐SPECT) can assist in differentiating PD from ET and TiD by detecting a presynaptic dopaminergic deficit .…”

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confidence: 99%

“…1 Therefore, in the absence of biomarkers, misdiagnoses between tremor in Parkinson's disease (PD), tremor in dystonia (TiD), and essential tremor (ET) frequently occur. 2 Ioflupane-based single photon emission computed tomography ( 123 I-FP-CIT DAT-SPECT) can assist in differentiating PD from ET and TiD by detecting a presynaptic dopaminergic deficit. 3 In recent years, quantitative magnet resonance imaging (MRI) markers have been studied as widely available, noninvasive, radiation-free alternative.…”

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confidence: 99%

Nigral iron deposition in common tremor disorders

et al. 2018

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We investigated R2* relaxation rates as a marker of iron content in the substantia nigra in patients with common tremor disorders and explored their diagnostic properties. Methods: Mean nigral R2* rates were measured in 40 patients with tremor-dominant Parkinson's disease (PD), 15 with tremor in dystonia, 25 with essential tremor, and 25 healthy controls. Results: Tremor-dominant PD patients had significantly higher nigral R2* values (34.1 AE 5.7) than those with tremor in dystonia (30.0 AE 3.9), essential tremor (30.6 AE 4.8), and controls (30.0 AE 2.8). An R2* threshold of 31.15 separated tremor-dominant PD from controls with a sensitivity and specificity of 67.5% and 72%. The sensitivity and specificity for discrimination between PD and non-PD tremor patients was 67.5% and 60%. Conclusion: Iron content in the substantia nigra is significantly higher in tremor-dominant PD than in tremor in dystonia, essential tremor, and controls. Because of the considerable overlap, nigral R2* cannot be suggested as a useful diagnostic tool.

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“…The current data show that the presence of tremor is not significantly associated with the level of certainty for PD. A possible explanation for this finding could be the presence of tremor associated with dystonia, drug‐induced tremor, or essential tremor (ET) in the elderly . Some patients enrolled in PD studies, with PD, have been found to have normal presynaptic dopaminergic imaging (DaT scan).…”

Section: Discussionmentioning

confidence: 99%

Are Clinical Certainty Ratings Helpful in the Diagnosis of Parkinson's Disease?

Gupta

Mehta

Zhang

et al. 2018

Movement Disord Clin Pract

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Background Clinical diagnostic criteria for PD rely on rest tremor, bradykinesia, and rigidity. These features are non‐specific and neuropathological confirmation remains the gold standard for diagnosis. This study presents data on clinical certainty ratings in autopsy‐proven PD. Methods Subjects were assessed annually by a movement disorders specialist and assigned to a clinical certainty group for PD based on multiple clinical features before autopsy. The three groups considered for analysis are as follows: Group I 0–49% certainty, Group II 50‐89% certainty, and Group III 90–100% certainty. All subjects were autopsied and had a standardized neuropathological assessment. Results 275 subjects were assigned a PD certainty at their last visit before death. Group I had 80 subjects, Group II 56 subjects, and Group III 139 subjects. The clinical features recorded in Group I, II, and III, were as follows: rest tremor, bradykinesia, rigidity, postural instability, asymmetric onset, persistent asymmetry, current response to dopaminergic treatment, motor fluctuations, and dyskinesia. Rigidity, postural instability, asymmetric onset, current response to dopaminergic treatment, motor fluctuation, and dyskinesia were more likely to be present in the group which was rated with higher certainty. The final diagnosis of PD was confirmed by neuropathological assessment in 85% of the patients in Group III as compared to 30% in Group II and 5% in Group I. Conclusions High certainty (90–100%) had strong positive predictive value (85%) for autopsy‐proven PD as compared to either lower certainty groups (0–49% and 50–89%) which had lower predictive value (5% and 30% respectively).

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Rest tremor revisited: Parkinson’s disease and other disorders

Cited by 37 publications

References 69 publications

Tremor severity in Parkinson's disease and cortical changes of areas controlling movement sequencing: A preliminary study

Tremor severity in Parkinson's disease and cortical changes of areas controlling movement sequencing: A preliminary study

Nigral iron deposition in common tremor disorders

Are Clinical Certainty Ratings Helpful in the Diagnosis of Parkinson's Disease?

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