van der Stouwe A M M, Broersma M, Buijink A W G, van Rootselaar A F, Maurits N M
Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Parkinsonism Relat Disord. 2015 Jun;21(6):654-7. doi: 10.1016/j.parkreldis.2015.03.004. Epub 2015 Mar 13.
We investigated the relation between changes in clinician-based and patient-based measures of tremor severity, within the Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and Visual Analogue Scale (VAS) in essential tremor patients.
Thirty-seven patients were assessed twice: on- and off-medication. Clinician-based, objective TRS assessments, consisting of part A (postures/movements) and part B (tremor-inducing tasks) were conducted by a blinded assessor using video-tapes. Patients completed TRS part C (limitations in activities of daily life) and indicated subjective tremor severity using VAS.
Patients' total TRS and VAS scores improved on-medication (both p < 0.001). Mean improvement was 6.3 (sd 5.4) points on the total TRS and 2.3 (sd 2.3) points on the VAS score. Within the TRS, we found moderate correlations between changes in clinician-based TRS-B and patient-based TRS-C scores (ρ = 0.387, p = 0.011), but not between changes in clinician-based TRS-A and TRS-C scores (ρ = 0.128, p = 0.232). Moreover, changes in subjective VAS scores correlated with changes in total TRS (ρ = 0.422, p = 0.007), changes in TRS-C scores (ρ = 0.367, p = 0.015) and, more weakly, with changes in TRS-B scores (ρ = 0.281, p = 0.049), but again: not with changes in TRS-A scores (ρ = -0.008, p = 0.482).
We found no correlation between changes in clinician-based TRS-A, and patient-based measures TRS-C or VAS scores, and a weak correlation between clinician-based TRS-B and VAS scores. The limited correlations between changes in clinician-based and patient-based measures of tremor severity suggest that the different scales measure different aspects of tremor severity and support the additional use of subjective patient-based assessments in clinical practice and clinical trials.
我们研究了在法恩 - 托洛萨 - 马林震颤评定量表（TRS）和视觉模拟量表（VAS）中，基于临床医生评估和基于患者评估的震颤严重程度变化之间的关系，研究对象为特发性震颤患者。
37名患者接受了两次评估：一次在服药时，一次在停药时。由一名不知情的评估者使用录像带进行基于临床医生的客观TRS评估，包括A部分（姿势/运动）和B部分（诱发震颤任务）。患者完成TRS的C部分（日常生活活动受限情况），并使用VAS表明主观震颤严重程度。
患者的TRS总分和VAS得分在服药时有所改善（两者p < 0.001）。TRS总分的平均改善为6.3（标准差5.4）分，VAS得分的平均改善为2.3（标准差2.3）分。在TRS中，我们发现基于临床医生的TRS - B变化与基于患者的TRS - C得分之间存在中度相关性（ρ = 0.387，p = 0.011），但基于临床医生的TRS - A变化与TRS - C得分之间不存在相关性（ρ = 0.128，p = 0.232）。此外，主观VAS得分的变化与TRS总分的变化相关（ρ = 0.422，p = 0.007），与TRS - C得分的变化相关（ρ = 0.367，p = 0.015），与TRS - B得分的变化相关性较弱（ρ = 0.281，p = 0.049），但同样与TRS - A得分的变化无关（ρ = -0.008，p = 0.482）。
我们发现基于临床医生的TRS - A变化与基于患者的TRS - C或VAS得分之间无相关性，基于临床医生的TRS - B与VAS得分之间存在弱相关性。基于临床医生和基于患者的震颤严重程度测量变化之间的有限相关性表明，不同量表测量的是震颤严重程度的不同方面，并支持在临床实践和临床试验中额外使用基于患者的主观评估。
