Long-term EMG recordings differentiate between parkinsonian and essential tremor
Abstract
The differential diagnosis of tremor is mainly based on clinical criteria.Nevertheless, these criteria are in some cases not sufficient to differentiate between different tremor forms. Long-term EMG has proven to be a valid and reliable method for the quantification of pathological tremors. The aim of the study was to develop a long-term EMG-based automated analysis procedure that separates parkinsonian tremor from essential tremor. Using longterm EMG tremor was recorded in 45 consecutive patients, 26 with Parkinson's disease (PD) and 19 with essential tremor (ET). Eight tremor parameters were generated automatically. By stepwise backward regression a subset of these criteria was extracted to achieve an automated classification of the tremor by a mathematical model. The obtained model was then tested on a new group of 13 patients in early stages of the disease. Significant differences between groups were found for tremor occurrence, tremor asymmetry, mean tremor frequency and standard deviation of phase of antagonistic muscles. Due to data overlap a classification of the two tremor forms was not possible based on a single tremor parameter. Using logistic regression, a linear formula based on the three parameters tremor occurrence, mean tremor frequency and standard deviation of phase was established and predicted the correct diagnosis in 93% of patients. The validation of the model on the new group of patients in early stages of the tremor disease yielded a correct diagnosis in 100% of cases. We conclude that long-term EMG recording allows a rater-independent classification of parkinsonian versus essential tremor.
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Long-term EMG recordings allow a rater-independent classification of parkinsonian versus essential tremor.
“Recent works indicate that these recordings allow a rater-independent classification of parkinsonian versus essential tremor [23].”
From Neurological Tremor: Sensors, Signal Processing and Emerging Applications (2010) · cites this paper as [23]
Cites
Salarian, A., Russmann, H., Wider, C., Burkhard, P. R., Vingerhoets, F. J. G., & Aminian, K. (2007) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2006.886670 · Cited by 416 · cited 2× · see citing works
“Other types of long-term tremor monitoring based on accelerometers, gyroscopes and actigraphs are also in use to detect and quantify tremor and other motor symptoms in PD [19, 27, 33, 35–37].”
BackgroundPhysiologic and essential tremor
Elble, R. J. (1986) · Neurology · doi:10.1212/wnl.36.2.225 · Cited by 231 · cited 3× · see citing works
“Meanwhile, both forms of muscle activation have been found in either condition [12, 23, 26], and switches between these activation patterns were detected in one and the same patient [4, 13].”
BackgroundResultHomberg, V, Hefter, H., Reiners, K., & Freund, H. J. (1987) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.50.5.568 · Cited by 147 · cited 1× · see citing works
“However, this hypothesis is not supported by previous work, showing that the frequency of pathological tremors does not change with loading [17].”
ResultCharacteristics of hand tremor time series
Timmer, J., Gantert, C., Deuschl, G., & Honerkamp, J. (1993) · Biological Cybernetics · doi:10.1007/bf00202568 · Cited by 112 · see citing works
Electromyographic differentiation of tremors
Milanov, I. (2001) · Clinical Neurophysiology · doi:10.1016/s1388-2457(01)00629-0 · Cited by 107 · see citing works
Physiological and pharmacological aids in the differential diagnosis of tremor
Shahani, B. T., & Young, R. R. (1976) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.39.8.772 · Cited by 102 · see citing works
Action tremor with alternating activity in antagonist muscles
Sabra, A. F., & Hallett, M. (1984) · Neurology · doi:10.1212/wnl.34.2.151 · Cited by 88 · see citing works
van Someren, E. J. W., van Gool, W. A., Vonk, B. F. M., Mirmiran, M., Speelman, J. D., Bosch, D. A., & Swaab, D. F. (1993) · Journal of the Neurological Sciences · doi:10.1016/0022-510x(93)90148-r · Cited by 56 · see citing works
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Neurological Tremor: Sensors, Signal Processing and Emerging Applications
Grimaldi, G., & Manto, M. (2010) · Sensors · doi:10.3390/s100201399 · Cited by 138 · see citing works
“Recent works indicate that these recordings allow a rater-independent classification of parkinsonian versus essential tremor [23].”
BackgroundHossen, A., Muthuraman, M., Raethjen, J., Deuschl, G., & Heute, U. (2010) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2010.02.005 · Cited by 57 · see citing works
Costa, J., González, H. A., Valldeoriola, F., Gaig, C., Tolosa, E., & Valls‐Solé, J. (2010) · Movement Disorders · doi:10.1002/mds.23334 · Cited by 33 · see citing works
Corticomuscular Transmission of Tremor Signals by Propriospinal Neurons in Parkinson's Disease
Hao, M., He, X., Xiao, Q., Alstermark, B., & Lan, N. (2013) · PLoS ONE · doi:10.1371/journal.pone.0079829 · Cited by 31 · 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
How to Tackle Tremor – Systematic Review of the Literature and Diagnostic Work-Up
Buijink, A. W. G., Contarino, M. F., Koelman, J. H. T. M., Speelman, J. D., & van Rootselaar, A. F. (2012) · Frontiers in Neurology · doi:10.3389/fneur.2012.00146 · Cited by 24 · see citing works
Hossen, A., Deuschl, G., Groppa, S., Heute, U., & Muthuraman, M. (2020) · Technology and Health Care · doi:10.3233/thc-191947 · Cited by 18 · see citing works
- Authors
- Breit, S., Spieker, S., Schulz, J. B., & Gasser, T.
- Affiliations
- Hertie Institute for Clinical Brain Research (DE)
- Städtisches Klinikum Dessau (DE)
- Corresponding author
- Breit, S.
- Venue
- Journal of Neurology
- Published
- 2008-01
- Volume
- 255
- Issue
- 1
- Pages
- 103-111
- ISSN
- 0012-1037 (ISSN-L)
- 0340-5354
- 1432-1459
- OpenAlex
- W2069930252
- Cited by
- 63
- References
- 8
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 6 · 2022: 2 · 2021: 8 · 2020: 7 · 2019: 2 · 2018: 4 · 2017: 2 · 2015: 1 · 2014: 2 · 2013: 5 · 2012: 5
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Keywords
- parkinsonian tremor, essential tremor, tremor classification, Parkinson's disease, tremor differential diagnosis, tremor frequency, automated diagnosis, early-stage disease
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diagnosis, Differential, Electromyography, Extremities, Female, Humans, Functional Laterality, Male, Middle Aged, Models, Neurological, Parkinson Disease, Signal Processing, Computer-Assisted, Time Factors, Muscle, Skeletal, Essential Tremor
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