An Ambulatory Tremor Score for Parkinson%26apos;s Disease

作者：Braybrook Michelle; O' Connor Sam; Churchward Philip; Perera Thushara; Farzanehfar Parisa; Horne Malcolm

来源：Journal of Parkinson's Disease, 2016, 6(4): 723-731.

DOI：10.3233/JPD-160898

• Tremor
• Parkinson disease
• ambulatory monitoring
• tremor dominant Parkinsons

Background: While tremor in Parkinson's Disease (PD) can be characterised in the consulting room, its relationship to treatment and fluctuations can be clinically helpful.
Objective: To develop an ambulatory assessment of tremor of PD.
Methods: Accelerometry datawas collected using the Parkinson's KinetiGraph System (PKG, Global Kinetics). An algorithm was developed, which could successfully distinguish been subjects with a resting or postural tremor that involved the wrist whose frequency was greater than 3 Hz. Percent of time that tremor was present (PTT) between 09 : 00 and 18 : 00 was calculated.
Results: This algorithm was applied to 85 people with PD who had been assessed clinically for the presence and nature of tremor. The Sensitivity and Selectivity of a PTT >= 0.8% was 92.5% and 92.9% in identifying tremor, providing that the tremor was not a fine kinetic and postural tremor or was not in the upper limb. A PTT > 1% provide high likely hood of the presence of clinical meaningful tremor. These cut-offs were retested on a second cohort (n = 87) with a similar outcome. The Sensitivity and Selectivity of the combined group was 88.7% and 89.5% respectively. Using the PTT, 50% of 22 newly diagnosed patients had a PTT > 1.0%.
The PKG's simultaneous bradykinesia scores was used to find a threshold for the emergence of tremor. Tremor produced artefactual increase in the PKG's dyskinesia score in 1% of this sample.
Conclusions: We propose this as a means of assessing the presence of tremor and its relationship to bradykinesia.

• 出版日期2016