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[帕金森病中运动性震颤的特征与鉴别]

[Characterization and discrimination of kinetic tremor in Parkinson's disease].

作者信息

Beuter A, Edwards R

机构信息

Cognitive Neuroscience Centre, DS-5749, Université du Québec à Montréal, Canada.

出版信息

Rev Neurol (Paris). 2002 Mar;158(3):338-40.

PMID:11976593
Abstract

Kinetic tremor recorded with a laser system during a compensatory tracking task of the index finger was analyzed in 21 patients with PD whose tremor amplitude was between low and moderate, and 30 control subjects. Nine characteristics quantifying the tracking task and tremor including mean tracking error, reaction time, peakedness, harmonicity, median frequency, proportional power in the 3-4 Hz, 4-6 Hz and 7-12 Hz ranges, and power at 0.25 Hz, were applied to the processed signal. The discriminating power of each characteristic was evaluated using differences between group means (p values), maximum percentage discrimination, and number of outliers in the patient group using z-score and 96.7(th) percentile of the control group. All nine characteristics showed significant differences between means of the two groups using Welch-modified t-tests for unequal variances. The most discriminating characteristics reflected differences in the frequency distribution of the movement and did not correlate highly with postural tremor amplitude nor with clinical ratings of tremor. Discrimination methods classified correctly up to 66.7 p.cent of the patients. Combining representative information about proportional power during posture and tracking gave a much higher discrimination (90 p.cent) with respect to the 96.7th percentile of the control group. These results suggest that by combining information coming from postural and kinetic tremors it is possible to isolate a specific aspect of PD symptomatology which could be used to reevaluate the classic distinction made between the akineto-rigid and tremulous forms of PD independently of tremor amplitude.

摘要

在一项食指补偿性追踪任务中,使用激光系统记录了21例震颤幅度为低至中度的帕金森病(PD)患者以及30名对照者的运动性震颤。对处理后的信号应用了九个量化追踪任务和震颤的特征,包括平均追踪误差、反应时间、峰值、谐波性、中位数频率、3 - 4Hz、4 - 6Hz和7 - 12Hz范围内的比例功率以及0.25Hz处的功率。使用组均值差异(p值)、最大百分比辨别率以及患者组中使用z分数和对照组第96.7百分位数的异常值数量来评估每个特征的辨别能力。使用针对不等方差的韦尔奇修正t检验,所有九个特征在两组均值之间均显示出显著差异。最具辨别力的特征反映了运动频率分布的差异,与姿势性震颤幅度以及震颤的临床评分均无高度相关性。辨别方法正确分类了高达66.7%的患者。结合姿势和追踪过程中比例功率的代表性信息,相对于对照组的第96.7百分位数,辨别率要高得多(90%)。这些结果表明,通过结合来自姿势性和运动性震颤的信息,有可能分离出PD症状学的一个特定方面,可用于重新评估在不考虑震颤幅度的情况下,PD运动不能 - 强直型和震颤型之间的经典区分。

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