Movement Disorders Service, Neurology Department, FLENI. Montañeses 2325, C1428AQK, Buenos Aires, Argentina; Clinical Neurophysiology Service, Neurology Department, FLENI. Montañeses 2325, C1428AQK, Buenos Aires, Argentina.
Movement Disorders Service, Neurology Department, FLENI. Montañeses 2325, C1428AQK, Buenos Aires, Argentina; Argentine National Scientific and Technological Research Council (CONICET), Godoy Cruz 2290, C1425FQB, Buenos Aires, Argentina.
Parkinsonism Relat Disord. 2019 Apr;61:166-169. doi: 10.1016/j.parkreldis.2018.10.019. Epub 2018 Oct 15.
Re-emergent tremor (RET) is a common form of postural tremor observed in Parkinson's disease (PD) patients. Recent studies have shown that administration of levodopa decreases RET amplitude. However, drug effects on tremor pause duration are less clear.
We performed a prospective observational study in PD patients with RET, subjected to acute levodopa challenge. Tremor activity was measured during OFF and ON states both clinically, as well as by using accelerometers taped to the back of both hands. Correlation between RET amplitude and pause duration, as well with MDS-UPDRS scores were investigated. The slope of gradual increase of postural tremor after the pause was also measured in the OFF and ON states.
Significant inverse correlation between tremor amplitude and RET pause duration was observed in OFF (rs = -0.474, p = 0.030) and ON (rs = -0.569, p = 0.006) states. Levodopa reduced tremor amplitude (26%, p = 0.004) dampening slope gradient (22%, p = 0.029). Tremor pause duration also showed inverse correlation with postural tremor amplitude measured by MDS-UPDRS in OFF (rs = -0.311, p = 0.048) and ON (rs = -0.503, p = 0.020) states, as well as with total MDS-UPDRS Part III score (rs = -0.295, p = 0.009). Finally, accelerometric analysis proved to be more sensitive than visual inspection for detecting tremor pauses.
Our results suggest RET pause duration is amplitude related, since levodopa-induced amplitude decrease led to pause prolongation, associated with decreased tremor intensity and slope gradient dampening.
复发性震颤（RET）是帕金森病（PD）患者中常见的姿势性震颤形式。最近的研究表明，左旋多巴的给药会降低 RET 的振幅。然而，药物对震颤暂停持续时间的影响尚不清楚。
我们对患有 RET 的 PD 患者进行了一项前瞻性观察研究，这些患者接受了急性左旋多巴挑战。在 OFF 和 ON 状态下，通过临床检查以及在手背粘贴加速度计来测量震颤活动。研究了 RET 振幅和暂停持续时间以及 MDS-UPDRS 评分之间的相关性。还测量了 OFF 和 ON 状态下暂停后姿势性震颤逐渐增加的斜率。
在 OFF（rs= -0.474，p= 0.030）和 ON（rs= -0.569，p= 0.006）状态下，观察到震颤振幅与 RET 暂停持续时间之间存在显著的负相关。左旋多巴降低了震颤振幅（26%，p= 0.004），降低了阻尼斜率梯度（22%，p= 0.029）。在 OFF（rs= -0.311，p= 0.048）和 ON（rs= -0.503，p= 0.020）状态下，以及在 MDS-UPDRS 第三部分总分（rs= -0.295，p= 0.009）中，震颤暂停持续时间也与姿势性震颤振幅呈负相关。此外，与视觉检查相比，加速度计分析被证明更能敏感地检测到震颤暂停。
我们的结果表明，RET 暂停持续时间与振幅有关，因为左旋多巴诱导的振幅降低导致暂停延长，这与震颤强度降低和阻尼斜率梯度降低有关。
