The usefulness of accelerometric registration with assessment of tremor parameters and their symmetry in differential diagnosis of parkinsonian, essential and cerebellar tremor

Machowska-Majchrzak, Agnieszka; Pierzchała, Krystyna; Pietraszek, S.; Łabuz-Roszak, Beata; Bartman, Wojciech

doi:10.5114/ninp.2012.28257

Cited by 11 publications

(6 citation statements)

References 34 publications

(57 reference statements)

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“…Multiple studies have explored using harmonics of tremor motion to identify different types of pathological tremors. Majchrzak et al demonstrated that, compared to healthy controls, the harmonic index of tremor motions (the distance of the spectrum to the single narrow peak, which was normalized to the highest peak) was significantly higher in patients with Parkinsonian tremor, essential tremor, and cerebellar tremor ( 24 ). Jang et al reported that the harmonic ratio (the value of the total harmonic peak power divided by the number of harmonic peaks) was remarkably lower in PD patients than in drug-induced Parkinsonism patients ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

The Characteristics of Tremor Motion Help Identify Parkinson's Disease and Multiple System Atrophy

Yang

et al. 2020

Front. Neurol.

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Background/Objectives: Distinguishing between Parkinson's disease (PD) and multiple system atrophy (MSA) is challenging in the clinic because patients with these two conditions present with similar symptoms in motor dysfunction. Here, we aimed to determine whether tremor characteristics can serve as novel markers for distinguishing the two conditions. Methods: Ninety-one subjects with clinically diagnosed PD and 93 subjects with MSA were included. Tremor of the limbs was measured in different conditions (such as resting, postural, and weight-holding) using electromyography (EMG) surface electrodes and accelerometers. The dominant frequency, tremor occurrence rate, and harmonic occurrence rate (HOR) of the tremor were then calculated. Results: Our results demonstrated that the tremor dominant frequency in the upper limbs of the MSA group was significantly higher than that in the PD group across all resting ( F = 5.717, p = 0.023), postural ( F = 13.409, p < 0.001), and weight-holding conditions ( F = 9.491, p < 0.001) and that it was not dependent on the patient's age or disease course. The tremor occurrence rate (75.6 vs. 14.9%, χ 2 = 68.487, p < 0.001) and HOR (75.0 vs. 4.5%, χ 2 = 46.619, p < 0.001) in the resting condition were significantly lower in the MSA group than in the PD group. The sensitivity of the harmonic for PD diagnosis was 75.0% and the specificity was relatively high, in some cases up to 95.5%. The PPV and NPV were 95.2 and 75.9%, respectively. Conclusion: Our study confirmed that several tremor characteristics, including the dominant tremor frequency and the occurrence rate in different conditions, help detect PD and MSA. The presence of harmonics may serve as a novel marker to help distinguish PD from MSA with high sensitivity and specificity.

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Section: Discussionmentioning

confidence: 99%

The Characteristics of Tremor Motion Help Identify Parkinson's Disease and Multiple System Atrophy

Yang

et al. 2020

Front. Neurol.

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“…The literature cites only a few references concerning the correlation of tremor with hand laterality. For example, Machowska-Majchrzak discovered that the essential tremor was more intense in the N extremity in 62% of patients [44,45]. In contrast, no correlation of arm swing in walking was identified with laterality, possibly due to an important central component in this involuntary movement [46].…”

Section: Discussionmentioning

confidence: 99%

Methods Evaluating Upper Arm and Forearm Movement During a Quiet Stance

et al. 2019

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The article focuses on designing methods for quantitative assessment of the postural stability in a quiet stance by measuring segments of the appendicular skeleton, namely upper and forearms by inertial measurement units (IMU). Although an array of quantitative analysis methods assessing data of postural stability in the quiet stance exist by measuring the head and trunk movement, these methods have not been used to date to assess the behaviour of appendicular skeleton segments, namely the upper limbs. The applicability of methods assessing arm movement during the quiet stance has been verified by comparing the values of healthy subjects performing various stance tasks. The tests determined the quantitative evaluation of acceleration measured on individual anatomical axes. The quantities included: the volume of a convex polyhedron (PV), the volume of confidence ellipsoid (EV) and average velocity (AV) obtained by plotting three accelerations against each other. The most important findings in this study concern significant differences of PV and AV between dominant and non-dominant upper extremities and significant differences of EV, PV and AV between the data measured with a subject's eyes closed and open. Higher values of indicators were in the non-dominant extremities when subjects were measured with closed eyes. Interestingly, statistically significant differences between dominant and non-dominant arm movements were documented in PV and AV cases. This is due to the PV calculation being more sensitive to random deviations, i.e. the range of measured data, since the polyhedron bounds all the measured data, as opposed to the method, where the ellipse bounds only 95% of the measured data. In the case of the AV method, it is due to higher sensitivity to movements corresponding with arm tremors; the AV calculation relates not only to the range of measured data but, above all, to the intensity of data changes in the segment measured in a particular space and time interval. These conclusions demonstrate that it is possible to apply the proposed methods in the assessment of arm movement during a quiet stance since the differences between individual stance tasks and the dominant and non-dominant arms in specific cases of quiet stance have been identified. These conclusions also indicate a potentially more extensive medical application of the proposed quantitative data evaluation obtained from IMU, for example, within the rehabilitation process of injured appendicular skeleton segments. The use of cheaper IMU methods in mobile phones or watches can be of significant benefit in measuring the segmental movement of the appendicular skeleton in quiet stance. The methods outlined in this paper have remarkable potential in the field of telemedicine.

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“…The relationship between tremor intensity or frequency in ET and PD is controversial. An inverse correlation between tremor intensity and centre frequency was found in ET patients while patients with PD showed only significant correlation between centre frequency and the hand with more severe tremor, not in the other hand (Machowska-Majchrzak et al, 2012). Other studies reported a significant inverse correlation between tremor intensity and centre frequency in both hands in patients with PD (Farkas et al, 2006).…”

Section: Current Approaches For Diagnosis Of Et and Pdmentioning

confidence: 98%

Mini Review: linkages between essential tremor and Parkinson’s disease?

Wu¹,

Ding²,

Gao³

et al. 2013

Front. Cell. Neurosci.

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Essential tremor (ET) and Parkinson’s disease (PD) are two of the most common movement disorders. Tremors are the primary symptoms of ET and of some PD patients, the two are often mistaken for each other. Especially since there are no available differentiate tests for the tremor of ET or PD, the early diagnoses mainly based on clinical assessments of medical symptoms, family and medication history, and examination by physicians. There is increasing evidence suggesting an association between ET and PD, such as a similar tremor frequency, overlapping resting tremors (a typical PD tremor), postural tremors (mainly in ET patients) in both ET and PD patients, and many ET patients develop PD later in life. Although it is difficult to make a differential diagnosis of ET and tremor-dominant PD based on clinical assessment, recent developments of objective measurements, such as brain imaging, neuropathology, and genetic analysis, has opened a helpful window for distinguishing ET from PD. In this mini review, we included literatures of ET and PD studies and discussed various advanced methods for differential diagnosis between ET and PD such as neuroimaging, genetic markers, tremor intensity and frequency, and drug-responses.

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The usefulness of accelerometric registration with assessment of tremor parameters and their symmetry in differential diagnosis of parkinsonian, essential and cerebellar tremor

Abstract: Standard deviation of centre frequency and harmonic index are the most valuable variables in differentiation of tremor. The assessment of symmetry of tremor parameters is useful in discrimination of various types of pathological tremor.

Cited by 11 publications

References 34 publications

The Characteristics of Tremor Motion Help Identify Parkinson's Disease and Multiple System Atrophy

The Characteristics of Tremor Motion Help Identify Parkinson's Disease and Multiple System Atrophy

Methods Evaluating Upper Arm and Forearm Movement During a Quiet Stance

Mini Review: linkages between essential tremor and Parkinson’s disease?

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