Amplitude fluctuations in essential tremor

Mostile, Giovanni; Fekete, Róbert; Giuffrida, Joseph P.; Yaltho, Toby C.; Davidson, Anthony; Nicoletti, Alessandra; Zappia, Mario; Jankovic, Joseph

doi:10.1016/j.parkreldis.2012.04.019

Cited by 45 publications

(50 citation statements)

References 27 publications

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“…Nevertheless, this advantage is mitigated by the natural variability in tremor amplitude (46). Studies suggest that wearable transducers were no more sensitive to clinical changes than a 0-4 rating scale (47,48). The minimum detectable change in tremor is comparable between sensors and rating scales (47,48).…”

Section: Limitationsmentioning

confidence: 99%

Objective and quantitative assessment of motor function in Parkinson’s disease—from the perspective of practical applications

et al. 2016

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Parkinson's disease (PD) is a common neurodegenerative disorder with high morbidity because of the coming aged society. Currently, disease management and the development of new treatment strategies mainly depend on the clinical information derived from rating scales and patients' diaries, which have various limitations with regard to validity, inter-rater variability and continuous monitoring. Recently the prevalence of mobile medical equipment has made it possible to develop an objective, accurate, remote monitoring system for motor function assessment, playing an important role in disease diagnosis, home-monitoring, and severity evaluation. This review discusses the recent development in sensor technology, which may be a promising replacement of the current rating scales in the assessment of motor function of PD.

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Section: Limitationsmentioning

confidence: 99%

Objective and quantitative assessment of motor function in Parkinson’s disease—from the perspective of practical applications

et al. 2016

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“…Signal epochs selection was performed randomly to ensure data generalizability by two blinded independent operators for each group. Duration of signal epochs as well as signal detrending were chosen to minimize effects of long-term fluctuations detectable in biological signals [15]. Totally, N ¼ 1040 signal samples (N ¼ 520 couples of signal epochs per homologous site) were collected to be analyzed.…”

Section: Eeg Signal Processing and Index Computationmentioning

confidence: 99%

Electroencephalographic lateralization, clinical correlates and pharmacological response in untreated Parkinson's disease

Mostile

Dibilio

Luca

et al. 2015

Parkinsonism & Related Disorders

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“…Action tremor can be reliably measured with spiral drawing [16,17]. Maybe in the future modern mobile applications [18] will allow long-duration monitoring of treatment effects, which may be helpful considering minute-to-minute variations of tremors including ET [19].…”

Section: Measurements Of Tremormentioning

confidence: 99%

“…However, side effects are common and frequently doselimiting (see below). The average study cohort size was 18 adults (range, [11][12][13][14][15][16][17][18][19][20][21][22], and thus similar to beta blocker studies, but many randomized patients in studies did not complete the trials. Besides drowsiness and dizziness reported by most patients on total daily dosages of 500 mg or more, children, elderly, and patients with comorbid psychiatric disorders are prone to develop depression, cognitive, and behavioral effects.…”

Section: Primidonementioning

confidence: 99%

The Treatment of Tremor

Schneider

Deuschl

2014

Neurotherapeutics

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Tremor is a hyperkinetic movement disorder characterized by rhythmic oscillations of one or more body parts. It can be disabling and may impair quality of life. Various etiological subtypes of tremor are recognized, with essential tremor (ET) and Parkinsonian tremor being the most common. Here we review the current literature on tremor treatment regarding ET and head and voice tremor, as well as dystonic tremor, orthostatic tremor, tremor due to multiple sclerosis (MS) or lesions in the brainstem or thalamus, neuropathic tremor, and functional (psychogenic) tremor, and summarize main findings. Most studies are available for ET and only few studies specifically focused on other tremor forms. Controlled trials outside ET are rare and hence most of the recommendations are based on a low level of evidence. For ET, propranolol and primidone are considered drugs of first choice with a mean effect size of approximately 50 % tremor reduction. The efficacy of topiramate is also supported by a large double-blind placebocontrolled trial, while other drugs have less supporting evidence. With a mean effect size of about 90 % deep brain stimulation in the nucleus ventralis intermedius or the subthalamic nucleus may be the most potent treatment; however, there are no controlled trials and it is reserved for severely affected patients. Dystonic limb tremor may respond to anticholinergics. Botulinum toxin improves head and voice tremor. Gabapentin and clonazepam are often recommended for orthostatic tremor. MS tremor responds only poorly to drug treatment. For patients with severe MS tremor, thalamic deep brain stimulation has been recommended. Patients with functional tremor may benefit from antidepressants and are best be treated in a multidisciplinary setting. Several tremor syndromes can already be treated with success. But new drugs specifically designed for tremor treatment are needed. ET is most likely covering different entities and their delineation may also improve treatment. Modern study designs and long-term studies are needed.

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Amplitude fluctuations in essential tremor

Cited by 45 publications

References 27 publications

Objective and quantitative assessment of motor function in Parkinson’s disease—from the perspective of practical applications

Objective and quantitative assessment of motor function in Parkinson’s disease—from the perspective of practical applications

Electroencephalographic lateralization, clinical correlates and pharmacological response in untreated Parkinson's disease

The Treatment of Tremor

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