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Provocation of Parkinsonian tremor
Author(s) -
Raethjen Jan,
Austermann Kristina,
Witt Karsten,
Zeuner Kirsten E.,
Papengut Frank,
Deuschl Günther
Publication year - 2008
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.22014
Subject(s) - provocation test , physical medicine and rehabilitation , rest (music) , essential tremor , psychology , medicine , physical therapy , movement disorders , disease , cardiology , pathology , alternative medicine
Classical Parkinsonian rest tremor typically fluctuates over time and can be provoked by stressful situations. We quantified and compared the influence of different provocation methods on classical rest tremor severity. The effect of counting backwards from 100, tapping of the contralateral foot and a Stroop test on the Unified Parkinson's Disease Rating Scale (UPDRS) III rest tremor scores and the accelerometrically measured tremor amplitudes (total power) were analyzed in 18 patients with Parkinson's disease and a Type I tremor. Each of the three provocation methods increased the UPDRS III rest tremor score by 1–2 and the total power by 1–2 orders of magnitude compared with baseline ( P < 0.001). The maximal effect was reached on average after 2–3 minutes of provocation. The effects were not significantly different. Provocations clearly influence the result of clinical rest tremor ratings, with the kind of provocation being of minor importance. We therefore suggest that each assessment of Parkinsonian rest tremor should include a systematic provocation and this should be formally included in future versions of the UPDRS. © 2008 Movement Disorder Society