BACKGROUND: In descriptive epidemiological studies, investigators must screen large numbers of individuals. How one best screens populations for essential tremor (ET); however, remains an open question. The collection of a standardized writing sample (e.g., a hand-drawn spiral) is a method with many practical advantages, yet there are virtually no data on the validity of this particular method. METHODS: Four hand-drawn spirals (2 right, 2 left) were collected from 831 ET cases across four distinct study settings (population-based study, family study, environmental epidemiological study, brain repository) and, in two of these studies, from 697 controls. Spirals were rated (range 0-3) by a senior movement disorder neurologist. These 1,528 participants also underwent a detailed neurological examination, and total tremor scores (range 0-36) and ET diagnoses were assigned by the neurologist. RESULTS: The proportion of cases with hand-drawn spiral ratings ≥1.5 in either arm ranged from 78.8-97.0%; only 4.7% of controls had spirals with tremor of that severity. The hand-drawn spiral rating was highly correlated with the total tremor score (r = 0.65-0.73, p < 0.001). CONCLUSIONS: The hand-drawn spiral is a sensitive and specific method of screening for ET. Furthermore, it serves as a valid measure of overall tremor severity.
BACKGROUND: In descriptive epidemiological studies, investigators must screen large numbers of individuals. How one best screens populations for essential tremor (ET); however, remains an open question. The collection of a standardized writing sample (e.g., a hand-drawn spiral) is a method with many practical advantages, yet there are virtually no data on the validity of this particular method. METHODS: Four hand-drawn spirals (2 right, 2 left) were collected from 831 ET cases across four distinct study settings (population-based study, family study, environmental epidemiological study, brain repository) and, in two of these studies, from 697 controls. Spirals were rated (range 0-3) by a senior movement disorder neurologist. These 1,528 participants also underwent a detailed neurological examination, and total tremor scores (range 0-36) and ET diagnoses were assigned by the neurologist. RESULTS: The proportion of cases with hand-drawn spiral ratings ≥1.5 in either arm ranged from 78.8-97.0%; only 4.7% of controls had spirals with tremor of that severity. The hand-drawn spiral rating was highly correlated with the total tremor score (r = 0.65-0.73, p < 0.001). CONCLUSIONS: The hand-drawn spiral is a sensitive and specific method of screening for ET. Furthermore, it serves as a valid measure of overall tremor severity.
Authors: Rachel Babij; Michelle Lee; Etty Cortés; Jean-Paul G Vonsattel; Phyllis L Faust; Elan D Louis Journal: Brain Date: 2013-09-12 Impact factor: 13.501
Authors: Elan D Louis; James H Meyers; Olufunmilayo M Badejo; Ashley D Cristal; Ruby Hickman; Pam Factor-Litvak Journal: Neuroepidemiology Date: 2018-01-16 Impact factor: 3.282
Authors: Jordi Solé-Casals; Iker Anchustegui-Echearte; Pere Marti-Puig; Pilar M Calvo; Alberto Bergareche; José Ignacio Sánchez-Méndez; Karmele Lopez-de-Ipina Journal: Front Physiol Date: 2019-01-17 Impact factor: 4.566