Frequency/amplitude characteristics of postural tremor of the hands in a population of patients with bilateral essential tremor: implications for the classification and mechanism of essential tremor.
Open accessAbstract
Amplitude/frequency characteristics of postural hand tremor in 59 patients with bilateral essential tremor of various degrees of severity were assessed using accelerometric recordings and spectral analysis. Intra-subject comparisons of tremor characteristics between the more and less affected hands were used to control for variability of tremor due to age factors and intersubject differences in amplitude and frequency. Statistical analysis distinguished three different patient groups. Some patients had low amplitude (less than 0.1-0.015 cm) tremor in the less affected limb (which tended to be 7 Hz or more in frequency in the young) and a larger amplitude tremor in the more affected hand which was 1 Hz or more lower in frequency. Other subjects had either bilaterally small or bilaterally large amplitude tremors of similar frequencies. These findings imply that there is a downwards step in frequency between symptomatic tremors of small and large amplitude. The amplitude and frequency of the small amplitude tremors were unrelated but frequency declined with age. The frequency of the large amplitude tremor was generally determined by amplitude but a wide range of amplitudes were compatible with similar frequencies. The frequency of large amplitude tremor also declined with age. It was concluded that there are two types of essential tremor, the smaller amplitude tremor probably derives from an exaggeration of some or all of the mechanisms of normal physiological tremor whereas the larger amplitude tremor probably arises from a separate "pathological" central nervous mechanism. It is not known if or how one may transform into, or be replaced by, the other during progression of the disease.
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Tremor frequencies can range from 2 to 15 Hz, and larger tremor amplitudes tend to occur at lower frequencies.
“While tremor frequencies can vary across a range between 2-15 Hz, higher tremor amplitudes correlate with lower frequencies6.”
From A noninvasive handheld assistive device to accommodate essential tremor: A pilot study (2014) · cites this paper as [6]
The Results and Discussion report an inverse relationship between tremor amplitude and frequency, particularly for more severe essential tremor. But the paper describes the dominant peak-frequency range for postural hand tremor as about 4–11 Hz, not 2–15 Hz (introductory passage indexed under Abstract; page unavailable). (LLM, conf=0.88)
Experimental — accuracy not yet measuredNone of these features alone are able to separate PD and ET due to overlaps in feature distribution.
“However, due to overlaps in feature distribution, none of these features alone are able to separate the two tremors (Capildeo and Findley, 1984; Calzetti et al., 1987; Milanov, 2001).”
From A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor (2018) · cites this paper as Calzetti et al., 1987
The Patients section describes a cohort with bilateral essential tremor, and the Discussion examines variation in tremor frequency and amplitude within that cohort. A search for Parkinson’s disease, parkinsonian tremor, and differential diagnosis found no passage assessing whether overlapping features prevent separation of PD from ET. Page numbers were not available in our copy. (LLM, conf=0.76)
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Cites
Physiologic and essential tremor
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Self-citationCalzetti, S., Findley, L. J. J., Perucca, E., & Richens, A. (1983) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.46.5.393 · Cited by 45 · see citing works
Self-citationDefinition, analysis and genesis of tremor
Gresty, M. A., & Findley, L. J. J. (1984) · Palgrave Macmillan UK eBooks · doi:10.1007/978-1-349-06757-2_2 · Cited by 16 · see citing works
Self-citationFindley, L. J., & Gresty, M. A. (1981) · PubMed · Cited by 10 · see citing works
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Flagged first, then by citations
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Parkinson’s disease and essential tremor classification on mobile device
Woods, A. M., Nowostawski, M., Franz, E. A., & Purvis, M. (2014) · Pervasive and Mobile Computing · doi:10.1016/j.pmcj.2013.10.002 · Cited by 69 · see citing works
A longitudinal study of tremor frequencies in Parkinson’s disease and essential tremor
Hellwig, B., Mund, P., Schelter, B., Guschlbauer, B., Timmer, J., & Lücking, C. H. (2009) · Clinical Neurophysiology · doi:10.1016/j.clinph.2008.11.002 · Cited by 65 · see citing works
Gironell, A., Kulisevsky, J., Pascual-Sedano, B., & Barbanoj, M. (2004) · Journal of Clinical Neurophysiology · doi:10.1097/00004691-200411000-00009 · Cited by 59 · see citing works
A noninvasive handheld assistive device to accommodate essential tremor: A pilot study
Pathak, A., Redmond, J. A., Allen, M., & Chou, K. L. (2014) · Movement Disorders · doi:10.1002/mds.25796 · Cited by 54 · see citing works
“Although tremor frequencies can vary across a range between 2 and 15 Hz, higher tremor amplitudes correlate with lower frequencies.(6) In the example shown in Supporting Figure 2b, the peak amplitude of tremor occurred at 5 Hz.”
BackgroundAsymmetry of tremor intensity and frequency in parkinson's disease and essential tremor
Farkas, Z., Csillik, A., Szirmai, I., & Kamondi, A. (2006) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2005.07.008 · Cited by 44 · 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
A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor
Zhang, B., Huang, F., Liu, J., & Zhang, D. (2018) · Frontiers in Neuroscience · doi:10.3389/fnins.2018.00317 · Cited by 24 · see citing works
“However, due to overlaps in feature distribution, none of these features alone are able to separate the two tremors (Capildeo and Findley, 1984; Calzetti et al., 1987; Milanov, 2001).”
BackgroundWharrad, H. J., & Jefferson, D. (2000) · Human Movement Science · doi:10.1016/s0167-9457(00)00017-8 · Cited by 19 · see citing works
Machowska-Majchrzak, A., Pierzchała, K., Pietraszek, S., & Łabuz-Roszak, B. (2011) · Neurologia i Neurochirurgia Polska · doi:10.1016/s0028-3843(14)60022-0 · Cited by 13 · see citing works
- Authors
- Calzetti, S., Baratti, M., Gresty, M., & Findley, L.
- Affiliations
- University of Parma (IT)
- National Hospital for Neurology and Neurosurgery (GB)
- ORCID
- Calzetti, S
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 1987-05-01
- Volume
- 50
- Issue
- 5
- Pages
- 561-567
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1031967
- OpenAlex
- W2050465280
- Cited by
- 74
- References
- 8
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 2 · 2012: 4
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
- Keywords
- essential tremor, tremor amplitude, tremor frequency, tremor classification, physiological tremor, disease progression
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Functional Laterality, Male, Middle Aged, Posture, Tremor
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