Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society
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Background: Consensus criteria for classifying tremor disorders were published by the International Parkinson and Movement Disorder Society in 1998. Subsequent advances with regard to essential tremor, tremor associated with dystonia, and other monosymptomatic and indeterminate tremors make a significant revision necessary. Objectives: Convene an international panel of experienced investigators to review the definition and classification of tremor. Methods: Computerized MEDLINE searches in January 2013 and 2015 were conducted using a combination of text words and MeSH terms: “tremor”, “tremor disorders”, “essential tremor”, “dystonic tremor”, and “classification” limited to human studies. Agreement was obtained using consensus development methodology during four in‐person meetings, two teleconferences, and numerous manuscript reviews. Results: Tremor is defined as an involuntary, rhythmic, oscillatory movement of a body part and is classified along two axes: Axis 1—clinical characteristics, including historical features (age at onset, family history, and temporal evolution), tremor characteristics (body distribution, activation condition), associated signs (systemic, neurological), and laboratory tests (electrophysiology, imaging); and Axis 2—etiology (acquired, genetic, or idiopathic). Tremor syndromes, consisting of either isolated tremor or tremor combined with other clinical features, are defined within Axis 1. This classification scheme retains the currently accepted tremor syndromes, including essential tremor, and provides a framework for defining new syndromes. Conclusions: This approach should be particularly useful in elucidating isolated tremor syndromes and syndromes consisting of tremor and other signs of uncertain significance. Consistently defined Axis 1 syndromes are needed to facilitate the elucidation of specific etiologies in Axis 2. © 2017 International Parkinson and Movement Disorder Society
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All ET participants complied with the Axis 1 definition of ET in the 2018 Consensus Statement, and none met the Axis 1 exclusion criteria for ET and ET plus.
“All ET participants compiled with the Axis 1 definition of ET in the 2018 Consensus Statement on the Classification of Tremors [54]. No participant with ET met any of the Axis 1 exclusion criteria for ET and ET plus.”
From Wearable Accelerometer and Gyroscope Sensors for Estimating the Severity of Essential Tremor (2024) · cites this paper as [54]
The criteria for ET plus do not include tremor severity.
“While criteria for ET plus do not include tremor severity”
From Wearable sensors during drawing tasks to measure the severity of essential tremor (2022) · cites this paper as [6]
All ET participants complied with the Axis 1 definition of ET in the 2018 Consensus Statement on the Classification of Tremors.
“All complied with the Axis 1 definition of ET in the 2018 Consensus Statement on the Classification of Tremors6.”
From Wearable sensors during drawing tasks to measure the severity of essential tremor (2022) · cites this paper as [6]
The sub-classification of ET into ET and ET plus is based on the presence of additional clinical features, the majority of which are unrelated to tremor.
“The sub-classification of the disorder into ET and ET plus is based on the presence of additional clinical features, the majority of which are unrelated to tremor.”
From Wearable sensors during drawing tasks to measure the severity of essential tremor (2022) · cites this paper as [6]
The International Parkinson and Movement Disorders Society Task Force on Tremor has proposed that individuals exhibiting symptoms other than tremor should be labeled as having ET plus syndrome.
“Very recently, the International Parkinson and Movement Disorders Society Task Force on Tremor has proposed that individuals exhibiting symptoms other than tremor should be labeled as having ET plus syndrome (14).”
From Could Wearable and Mobile Technology Improve the Management of Essential Tremor? (2018) · cites this paper as [14]
The effectiveness of medication for management of tremor in ET is quite variable, likely due to several factors including the multiple etiologies of ET.
“However, the effectiveness of medication for management of tremor in ET is quite variable, likely due to several factors including the multiple etiologies of ET (14).”
From Could Wearable and Mobile Technology Improve the Management of Essential Tremor? (2018) · cites this paper as [14]
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- [34]MacMahon B, Pugh TF. Causes and entities of disease. In: Clark DW, MacMahon B, eds. Preventive Medicine Boston, MA: Little, Brown; 1967: 26– 33.
- [46]Schwingenschuh P, Ruge D, Edwards MJ, Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson’s disease: a clinical and electrophysiological study. Mov Disord 2011; 25: 560– 569. PMC2996567 20131394
- [90]Schiebler S, Schmidt A, Zittel S, Arm tremor in cervical dystonia—is it a manifestation of dystonia or essential tremor? Mov Disord 2011; 26: 1789– 1792. 21735481
Cited by
Sorted by citations
Balestrino, R., & Schapira, A. H. V. (2020) · European Journal of Neurology · doi:10.1111/ene.14108 · Cited by 1,508 · see citing works
Sex differences in movement disorders
Meoni, S., Macerollo, A., & Moro, E. (2020) · Nature Reviews Neurology · doi:10.1038/s41582-019-0294-x · Cited by 207 · see citing works
Prospective home-use study on non-invasive neuromodulation therapy for essential tremor
Isaacson, S. H., Peckham, E., Tse, W., Waln, O., Way, C., Petrossian, M. T., Dahodwala, N., Soileau, M. J., Lew, M., Dietiker, C., et al. (2020) · Tremor and Other Hyperkinetic Movements · doi:10.5334/tohm.59 · Cited by 79 · see citing works
Self-citationSystematic clinical approach for diagnosing upper limb tremor
Wardt, J. V. D., van der Stouwe, A. M. M., Dirkx, M., Elting, J. W. J., Post, B., Tijssen, M. A., & Helmich, R. C. (2020) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2019-322676 · Cited by 72 · see citing works
Peripheral electrical stimulation to reduce pathological tremor: a review
Pascual-Valdunciel, A., Hoo, G. W., Avrillon, S., Barroso, F. O., Goldman, J. G., Hernandez-Pavon, J. C., & Pons, J. L. (2021) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-021-00811-9 · Cited by 66 · see citing works
“However, the clinical diagnosis of ET is typically due to the exclusion of other pathologies causing tremor [1, 8].”
BackgroundA Review on Wearable Technologies for Tremor Suppression
Lora-Millan, J. S., Delgado-Oleas, G., Benito-León, J., & Rocon, E. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.700600 · Cited by 62 · see citing works
“Tremors arise due to various conditions (4), and their exact underlying mechanisms have not been elucidated; thus, none of them is wholly understood (1).”
BackgroundMethodInfluentialVoice Analysis with Machine Learning: One Step Closer to an Objective Diagnosis of Essential Tremor
Suppa, A., Asci, F., Saggio, G., Di Leo, P., Zarezadeh, Z., Ferrazzano, G., Ruoppolo, G., Berardelli, A., & Costantini, G. (2021) · Movement Disorders · doi:10.1002/mds.28508 · Cited by 54 · see citing works
Louis, E. D. (2020) · Neuroepidemiology · doi:10.1159/000502862 · Cited by 41 · see citing works
Self-citationIs there evidence of bradykinesia in essential tremor?
Bologna, M., Paparella, G., Colella, D., Cannavacciuolo, A., Angelini, L., Alunni‐Fegatelli, D., Guerra, A., & Berardelli, A. (2020) · European Journal of Neurology · doi:10.1111/ene.14312 · Cited by 40 · see citing works
Pascual-Valdunciel, A., Gonzalez-Sanchez, M., Muceli, S., Adan-Barrientos, B., Escobar-Segura, V., Perez-Sanchez, J. R., Jung, M. K., Schneider, A., Hoffmann, K.-P., Moreno, J. C., et al. (2021) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2020.3015572 · Cited by 37 · see citing works
“Inclusion criteria included diagnosis of ET according to Tremor Research Investigation Group criteria [17], presenting clinically postural tremor; age between 18-80 years; tremor affecting at least one of the upper limbs, with prominent wrist flexion-extension; absence of another”
MethodWearable sensors during drawing tasks to measure the severity of essential tremor
Ali, S. M., Arjunan, S. P., Peters, J., Perju-Dumbrava, L., Ding, C., Eller, M., Raghav, S., Kempster, P., Motin, M. A., Radcliffe, P. J., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-08922-6 · Cited by 35 · see citing works
A Novel Soft Glove for Hand Tremor Suppression: Evaluation of Layer Jamming Actuator Placement
Awantha, W. V. I., Wanasinghe, A. T., Kavindya, A. G. P., Kulasekera, A. L., & Chathuranga, D. S. (2020) · 2020 3rd IEEE International Conference on Soft Robotics (RoboSoft) · doi:10.1109/robosoft48309.2020.9115994 · Cited by 31 · see citing works
Yu, J. Y., Rajagopal, A., Syrkin-Nikolau, J., Shin, S., Rosenbluth, K. H., Khosla, D., Ross, E. K., & Delp, S. L. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.530300 · Cited by 32 · see citing works
Luft, F., Sharifi, S., Mugge, W., Schouten, A., Bour, L., van Rootselaar, A.-F., Veltink, P., & Heida, T. (2019) · Sensors · doi:10.3390/s19194301 · Cited by 27 · see citing works
Could Wearable and Mobile Technology Improve the Management of Essential Tremor?
Daneault, J.-F. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.00257 · Cited by 21 · see citing works
Wearable Accelerometer and Gyroscope Sensors for Estimating the Severity of Essential Tremor
Ali, S. M., Arjunan, S. P., Peter, J., Perju-Dumbrava, L., Ding, C., Eller, M., Raghav, S., Kempster, P., Motin, M. A., Radcliffe, P. J., et al. (2024) · IEEE Journal of Translational Engineering in Health and Medicine · doi:10.1109/jtehm.2023.3329344 · Cited by 20 · see citing works
Real-time classification of movement patterns of tremor patients
Piepjohn, P., Bald, C., Kuhlenbäumer, G., Becktepe, J. S., Deuschl, G., & Schmidt, G. (2022) · Biomedical Engineering / Biomedizinische Technik · doi:10.1515/bmt-2021-0140 · Cited by 5 · see citing works
Self-citationMahali, M. I., Leu, J.-S., Avian, C., Darmawan, J. T., Faisal, M., Putro, N. A. S., & Prakosa, S. W. (2025) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2025.106599 · Cited by 1 · see citing works
- Authors
- Bhatia, K. P., Bain, P., Bajaj, N., Elble, R. J., Hallett, M., Louis, E. D., Raethjen, J., Stamelou, M., Testa, C. M., Deuschl, G., & the Tremor Task Force of the International Parkinson and Movement Disorder Society
- Affiliations
- UCL Queen Square Institute of Neurology (GB)
- Charing Cross Hospital (GB)
- Nottingham University Hospitals NHS Trust (GB)
- SIU Medicine (US)
- National Institutes of Health (US)
- Yale University (US)
- Christian-Albrechts-Universität zu Kiel (DE)
- Department of Neurology, Philipps University, Marburg, Germany; Department of Neurology, Attikon Hospital University of Athens Athens Greece
- Virginia Commonwealth University (US)
- Department of Neurology, Universitätsklinikum Schleswig‐Holstein, Kiel Campus Christian Albrechts University Kiel Kiel Germany
- ORCID
- Venue
- Movement Disorders
- Publisher
- Wiley
- Published
- 2017-11-30
- Volume
- 33
- Issue
- 1
- Pages
- 75-87
- ISSN
- 0885-3185 (ISSN-L)
- 1531-8257
- PMC
- PMC6530552
- OpenAlex
- W2773390988
- Cited by
- 1,575
- References
- 93
- Citations by year
- 2026: 179 · 2025: 238 · 2024: 239 · 2023: 202 · 2022: 218 · 2021: 156 · 2020: 149 · 2019: 131 · 2018: 58 · 2017: 3
- FWCI
- 64.91
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Movement Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Neurological Disorders and Stroke (Z01NS002667)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
- Keywords
- tremor classification, essential tremor, dystonic tremor, tremor syndromes, tremor etiology
- MeSH terms
- Humans, International Cooperation, Societies, Medical, Tremor, MEDLINE, Consensus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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