Do Bradykinesia and Tremor Interfere in Voluntary Movement of Essential Tremor Patients? Preliminary Findings

Tremor Other Hyperkinet Mov (N Y). 2017 Jun 22:7:459. doi: 10.7916/D822319X. eCollection 2017.

Abstract

Background: The aim of this study was to determine whether tremor and bradykinesia impacted a dexterous activity performed by patients with essential tremor (ET).

Methods: Core bradykinesia was assessed in 27 controls and 15 patients with ET using a rapid alternating movement (RAM) task. Then, participants performed a "counting money" counting tasks while equipped with inertial measurement units to detect and quantify tremor during movement. The time required to perform subsections of the tasks and the rate of failure (errors) were compared between groups using Mann-Whitney U tests and a chi-square test, respectively.

Results: Patients with ET presented with significant bradykinesia during the RAM task and had more tremor during the counting money task. However, the time required to perform the task and rate of failure were similar between groups.

Discussion: Results show that even though bradykinesia was detected during fast movements, and that tremor was present during a task requiring dexterity, both symptoms did not interfere with the performance of patients with ET. This pilot study suggests that there may be a threshold at which tremor will become problematic. Determining this threshold for a wide range of daily activities may help determine when it is appropriate to initiate treatment for patients with ET.

Keywords: Activities of daily living; accelerometer; core bradykinesia; essential tremor.