Senova Suhan, Querlioz Damien, Thiriez Claire, Jedynak Pierre, Jarraya Béchir, Palfi Stéphane
Neurosurgery Department, Assistance Publique-Hôpitaux de Paris (APHP), Groupe Henri-Mondor Albert-Chenevier, Université Paris 12 UPEC, Faculté de Médecine, Créteil, France.
Stereotact Funct Neurosurg. 2015;93(2):94-101. doi: 10.1159/000369354. Epub 2015 Feb 18.
Background/Aims: Evaluation of tremor constitutes a crucial step from the diagnosis to the initial treatment and follow-up of patients with essential tremor. The severity of tremor can be evaluated using clinical rating scales, accelerometry, or electrophysiology. Clinical scores are subjectively given, may be affected by intra- and interevaluator variations due to different experience, delays between consultations, and subtle changes in tremor severity. Existing medical devices are not routinely used: they are expensive, time-consuming, not easily accessible. We aimed at showing that a smartphone application using the accelerometers embedded in smartphones is effective for quantifying the tremor of patients presenting with essential tremor. Methods: We developed a free iPhone/iPod application, Itremor, and evaluated different parameters on 8 patients receiving deep brain stimulation of the ventral intermediate nucleus of the thalamus: average and maximum accelerations, time above 1 g of acceleration, peak frequency, typical magnitude of tremor, for postural and action tremors, on and off stimulation. Results: We demonstrated good correlations between the parameters measured with Itremor and clinical score in all conditions. Itremor evaluation enabled higher discriminatory power and degree of reproducibility than clinical scores. Conclusion: Itremor can be used for routine objective evaluation of essential tremor, and may facilitate adjustment of the treatment. © 2015 S. Karger AG, Basel.
背景/目的：对震颤的评估是从诊断到特发性震颤患者初始治疗及随访的关键步骤。震颤的严重程度可通过临床评分量表、加速度测量法或电生理学进行评估。临床评分是主观给出的，可能会因评估者的不同经验、会诊间隔时间以及震颤严重程度的细微变化而受到评估者内部和评估者之间差异的影响。现有的医疗设备未被常规使用：它们价格昂贵、耗时且不易获取。我们旨在表明，一款使用智能手机内置加速度计的应用程序对于量化特发性震颤患者的震颤是有效的。方法：我们开发了一款免费的iPhone/iPod应用程序Itremor，并对8例接受丘脑腹中间核深部脑刺激的患者的不同参数进行了评估：平均加速度和最大加速度、加速度超过1g的时间、峰值频率、震颤的典型幅度，用于姿势性震颤和动作性震颤，刺激开启和关闭时的情况。结果：我们证明了在所有情况下，用Itremor测量的参数与临床评分之间具有良好的相关性。与临床评分相比，Itremor评估具有更高的辨别力和可重复性。结论：Itremor可用于特发性震颤的常规客观评估，并可能有助于调整治疗。© 2015 S. Karger AG，巴塞尔。
