Assessing tremor severity.

Bain, Peter G.; Findley, Leslie J.; Atchison, P. R.; Behari, Madhuri; Vidailhet, Marie; Gresty, Michael A.; Rothwell, John C.; Thompson, Paulette; Marsden, C. D.

doi:10.1136/jnnp.56.8.868

Cited by 396 publications

(340 citation statements)

References 12 publications

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“…The Bain scale (Bain et al., 1993) evaluated severity of patient's head, voice tremors, and postural tremor of the both upper and lower limbs. The modified FTM rating scale (Elble et al., 2006) graded severity of the tremor during daily life activities, specifically finger‐ and dot‐pointing, Archimedes spiral drawing, drawing of a straight line and sine wave, handwriting, and water pouring for both hands.…”

Section: Methodsmentioning

confidence: 99%

White matter measures correlate with essential tremor severity—A pilot diffusion tensor imaging study

et al. 2018

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BackgroundAn evolving pathophysiological concept of essential tremor (ET) points to diffuse brain network involvement, which emphasizes the need to investigate white matter (WM) changes associated with motor symptoms of ET.ObjectivesTo investigate ET‐related WM changes and WM correlates of tremor severity using tremor clinical rating scales and accelerometry.MethodsTract‐based spatial statistics (TBSS) approach was utilized to compare 3 Tesla diffusion tensor imaging (DTI) data from 12 ET patients and 10 age‐ and gender‐matched healthy individuals. Clinical scales, tremor frequency and amplitude as measured by accelerometry were correlated with DTI data.Results ET patients demonstrated mean (MD) and radial diffusivity (RD) abnormalities in tracts involved in primary and associative motor functions such as bilateral corticospinal tracts, the superior longitudinal fascicles, and the corpus callosum but also in nonmotor regions including the inferior fronto‐occipital and longitudinal fascicles, cingulum bundles, anterior thalamic radiations, and uncinate fascicles. A combined tremor frequency and amplitude score correlated with RD and MD in extensive WM areas, which partially overlapped the regions that were associated with tremor frequency. No significant relationship was found between DTI measures and clinical rating scales scores.ConclusionsThe results show that ET‐related diffusion WM changes and their correlates with tremor severity are preferentially located in the primary and associative motor areas. In contrast, a relationship between WM was not detected with clinical rating scales. Accelerometry parameters may, therefore, serve as a potentially useful clinical measures that relate to WM deficits in ET.

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Section: Methodsmentioning

confidence: 99%

White matter measures correlate with essential tremor severity—A pilot diffusion tensor imaging study

et al. 2018

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“…Tukey post-hoc comparisons indicate that the mean spiral score (mean ± SD; [95% CI for mean]) in DYS state (5.2 ± 1.8; [5.12, 5.28]) was higher than the mean spiral score in OFF (4.3 ± 1.7; [4.22, 4.37]) and ON (4.2 ± 1.7; [4.17,4.29]) states (Fig 2). The mean spiral score was also significantly different among individual TRS values of slightly 'off' (4.02 ± 1.63), 'on' (4.07 ± 1.65) and slightly 'dyskinetic' (4.6 ± 1.71), (p<0.001).…”

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confidence: 99%

“…The spirals were processed by a computer-based method that generates a "spiral score" representing the PDrelated drawing impairment [3]. The scale for the score was based on a modified Bain & Findley rating scale [4] in the range from 0 = no impairment to 5 = moderate impairment to 10 = extremely severe impairment (Fig 1b). …”

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Spiral drawing during self-rated dyskinesia is more impaired than during self-rated off

Memedi

Westin

Nyholm

2013

Parkinsonism & Related Disorders

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ResultsThe mean spiral score differed significantly across the three self-assessed motor states (p<0.001, ANOVA test). Tukey post-hoc comparisons indicate that the mean spiral score (mean ± SD; [95% CI for mean]) in DYS state (5.2 ± 1.8; [5.12, 5.28]) was higher than the mean spiral score in OFF (4.3 ± 1.7; [4.22, 4.37]) and ON (4.2 ± 1.7; [4.17,4.29]) states (Fig 2). The mean spiral score was also significantly different among individual TRS values of slightly 'off' (4.02 ± 1.63), 'on' (4.07 ± 1.65) and slightly 'dyskinetic' (4.6 ± 1.71), (p<0.001). There were no differences in drawing completion times among the three motor states (p=0.509). In the OFF and ON states, patients drew slightly more impaired spirals in the afternoon whereas in the DYS state the spiral drawing performance was more impaired in the morning (Fig 3). ConclusionsIt was found that when patients considered themselves as being dyskinetic spiral drawing was more impaired (nearly one unit change in a 0-10 scale) compared to when they considered themselves as being 'off' and 'on'. The spiral drawing at patients that self-assessed their motor state as dyskinetic was slightly more impaired in the morning hours, between 8 and 12 o'clock, a situation possibly caused by the morning dose effect. BackgroundA mobile device test battery, consisting of a patient diary collection section with disease-related questions and a fine motor test section (including spiral drawing tasks), was used by 65 patients with advanced Parkinson's disease (PD) (treated with intraduodenal levodopa/carbidopa gel infusion, Duodopa®, or candidates for this treatment) on 10439 test occasions in their home environments [1]. On each occasion, patients traced three pre-drawn Archimedes spirals using an ergonomic stylus (Fig 1a) and self-assessed their motor function on a global Treatment Response Scale (TRS) [2] ranging from -3 = very 'off' to 0 = 'on' to +3 = very dyskinetic, as shown in Table 1. The spirals were processed by a computer-based method that generates a "spiral score" representing the PDrelated drawing impairment [3]. The scale for the score was based on a modified Bain & Findley rating scale [4] in the range from 0 = no impairment to 5 = moderate impairment to 10 = extremely severe impairment (Fig 1b). ObjectiveTo analyze the test battery data for the purpose to find differences in spiral drawing performance of PD patients in relation to their self-assessments of motor function.

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“…Além disto, este método não avalia o tremor postural de membros superiores 1 . Já os aparelhos de detecção ou interrupção de luz, como os goniômetros de luz polarizada são de difícil obtenção.…”

Section: Discussionunclassified

“…Sua compreensão fica muito mais acessível para a maioria dos médicos, e até mesmo para os próprios pacientes. Para propósito de avaliação de ensaios clínicos a escala produz resultados confiáveis 1 .…”

Section: Discussionunclassified

Somatotrophic and corticotrophic function outcome after transesphenoidal surgery in patients with sellar tumors and pre-operative endocrine deficits

Pimentel-Filho

Salgado

Cukiert

et al. 1997

Arq. Neuro-Psiquiatr.

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Sixteen patients with sellar tumors that were treated surgically and who had pre-operative somatotrophic and corticotrophic function deficits were submitted to pre- and early post-operative insulin tolerance tests (ITTs). Seven patients had non-functioning adenomas, 5 had prolactinomas, 3 had craniopharyngioma and 1 had cordoma of the clivus. All patients had macro-tumors and none received radiotherapy within the studied period. Seven patients had GH, 4 had Cortisol and 5 had both GH/cortisol function pre-operative deficit. Five patients with isolated GH, 4 with isolated Cortisol and 3 with both GH/cortisol deficiencies showed a postoperative functional recovery. New Cortisol secretion deficits were observed in 2 patients postoperatively and both required long-term steroid replacement. These data suggest that preoperative endocrine deficits may be reversible after surgical decompression of the sellar region and that new endocrine deficits are rarely seen after surgery. All such patients should be tested postoperatively from an endocrinological point of view to reevaluate the need for replacement therapies.

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Assessing tremor severity.

Cited by 396 publications

References 12 publications

White matter measures correlate with essential tremor severity—A pilot diffusion tensor imaging study

White matter measures correlate with essential tremor severity—A pilot diffusion tensor imaging study

Spiral drawing during self-rated dyskinesia is more impaired than during self-rated off

Somatotrophic and corticotrophic function outcome after transesphenoidal surgery in patients with sellar tumors and pre-operative endocrine deficits

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