Miguel Wilken1,2, Verónica Bruno1, Malco Rossi1,3, Lucía Ameghino1, Günther Deuschl4, Marcelo Merello1,3. 1. Movement Disorders, Neurology Department, FLENI, Buenos Aires, Argentina. 2. Clinical Neurophysiology, Neurology Department, FLENI, Buenos Aires, Argentina. 3. Argentine National Scientific and Technological Research Council (CONICET), Buenos Aires, Argentina. 4. Department of Neurology, University-Hospital Schleswig-Holstein, Campus Kiel, Christian-Albrechts-University, Kiel, Germany.
Abstract
BACKGROUND: Hand position for rest tremor evaluation in PD is not standardized. We evaluated the sensitivity and specificity of different hand positions commonly used to evaluate rest tremor. METHODS: Twenty patients with PD and rest tremor were included as cases and 20 patients with essential tremor without rest tremor as controls. Video and accelerometric recordings were conducted in semiprone, completely prone, and with hands hanging down from armrest positions. Three movement disorder specialists rated tremor in each different position using Movement Disorder Society UPDRS items 3.17 and 3.18. RESULTS: Hands hanging showed the highest amplitude (P = 0.004) and constancy (P = 0.015) scores. Sensitivity and specificity analysis for each position showed the following sensitivity/specificity results: semiprone, 95%/80%; completely prone, 85%/98.33%; and hands hanging, 96.66%/63.33%, respectively. CONCLUSIONS: The hands-hanging position was shown to be the most suitable for evaluating rest tremor amplitude in PD, whereas the completely prone position proved to be more specific to detect rest tremor. The preferred hand position would depend on the purpose of the examination.
BACKGROUND: Hand position for rest tremor evaluation in PD is not standardized. We evaluated the sensitivity and specificity of different hand positions commonly used to evaluate rest tremor. METHODS: Twenty patients with PD and rest tremor were included as cases and 20 patients with essential tremor without rest tremor as controls. Video and accelerometric recordings were conducted in semiprone, completely prone, and with hands hanging down from armrest positions. Three movement disorder specialists rated tremor in each different position using Movement Disorder Society UPDRS items 3.17 and 3.18. RESULTS: Hands hanging showed the highest amplitude (P = 0.004) and constancy (P = 0.015) scores. Sensitivity and specificity analysis for each position showed the following sensitivity/specificity results: semiprone, 95%/80%; completely prone, 85%/98.33%; and hands hanging, 96.66%/63.33%, respectively. CONCLUSIONS: The hands-hanging position was shown to be the most suitable for evaluating rest tremor amplitude in PD, whereas the completely prone position proved to be more specific to detect rest tremor. The preferred hand position would depend on the purpose of the examination.
Authors: Sujitha Mahendran; Oliver Bichsel; Roger Gassert; Christian R Baumann; Lukas L Imbach; Daniel Waldvogel Journal: Clin Park Relat Disord Date: 2022-05-21