Schirinzi Tommaso, Imbriani Paola, D'Elia Alessio, Bentivoglio Anna Rita, Pisani Antonio
Neurology Department of Systems Medicine University of Rome Tor Vergata Rome Italy.
Institute of Neurology Università Cattolica del Sacro Cuore Rome Italy.
Mov Disord Clin Pract. 2015 Dec 24;3(4):421-424. doi: 10.1002/mdc3.12302. eCollection 2016 Jul-Aug.
Asymmetric rest tremor is one of the main features of patients diagnosed with scans without evidence of dopaminergic deficit (SWEDD). Clinical and neurophysiological evidence suggests a dystonic origin of this tremor, although the underlying pathophysiology is still unclear. Dystonic tremor has a great tendency to vary with different postures or voluntary motor tasks. Here, we performed a phenomenological analysis of tremor in 14 patients with normal scans and in 14 tremor-dominant Parkinson's disease (PD) patients by assessing the presence of writing tremor. The Wilcoxon-Mann-Whitney's test revealed that patients with normal scans exhibit writing tremor more frequently, regardless of the side mostly affected by motor disturbances in handwriting ( < 0.01) and drawing (right hand: = 0.01; left hand: < 0.05). Our findings show that patients with asymmetric rest tremor and normal scans, contrarily to PD patients, present more commonly action tremor during writing tasks. This feature may thus be helpful to distinguish the two conditions.
不对称静止性震颤是诊断为无多巴胺能缺陷扫描（SWEDD）患者的主要特征之一。临床和神经生理学证据表明这种震颤起源于肌张力障碍，尽管其潜在的病理生理学仍不清楚。肌张力障碍性震颤很容易随不同姿势或随意运动任务而变化。在此，我们通过评估书写震颤的存在，对14例扫描正常的患者和14例以震颤为主的帕金森病（PD）患者的震颤进行了现象学分析。Wilcoxon-Mann-Whitney检验显示，扫描正常的患者书写震颤更频繁，无论书写时运动障碍主要影响哪一侧（<0.01）以及绘画时（右手：=0.01；左手：<0.05）。我们的研究结果表明，与PD患者相反，不对称静止性震颤且扫描正常的患者在书写任务中更常见动作性震颤。因此，这一特征可能有助于区分这两种情况。
