Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, SS 554 km 4.500, 09042, Monserrato, Cagliari, Italy.
Department of Medical Science and Public Health, Institute of Neurology, University of Cagliari, Cagliari, Italy.
J Neural Transm (Vienna). 2022 Dec;129(12):1481-1485. doi: 10.1007/s00702-022-02551-z. Epub 2022 Oct 26.
Action tremor in Parkinson's disease may present in up to 46% of patients, either as postural or kinetic tremor. How action tremor may affect handwriting has been the object of some investigations; however, clinical features of writing tremor in Parkinson's disease are still not well-characterised. One hundred consecutive patients with idiopathic Parkinson's disease were included in the study. Demographic and clinical data were collected through a standardized questionnaire. Patients were assessed for the presence of rest, action and writing tremor in on condition. The effect of a standardised sensory trick (gently touching the wrist of the upper limb manifesting tremor with the contralateral hand) was also investigated in all patients with action tremor. Writing tremor was found in 10% of patients (26% of patients with postural/kinetic tremor, either alone or in combination with rest tremor). Severity of writing tremor did not correlated with that of the other tremor variants and to the other clinical variables. Writing tremor was task-specific in 4/10 patients, no task-specific in 6/10. Sensory trick was effective on writing tremor in two patients but did not improve action tremor in any of the study patients. Results showed that writing tremor in Parkinson's disease is less common than other tremor variants, may be associated with other forms of action tremor, and may sometimes have dystonic features, including task-specificity and sensitivity to sensory trick.
帕金森病患者的动作性震颤可高达 46%，表现为姿势性或运动性震颤。动作性震颤如何影响书写一直是一些研究的对象；然而，帕金森病书写震颤的临床特征仍未得到很好的描述。本研究纳入了 100 例连续的特发性帕金森病患者。通过标准化问卷收集人口统计学和临床数据。在特定条件下评估患者是否存在静止、动作和书写震颤。还对所有有动作性震颤的患者进行了标准化感觉技巧（用对侧手轻轻触摸表现震颤的上肢手腕）的效果研究。10%的患者（姿势/运动性震颤的患者为 26%，无论是单独存在还是与静止性震颤同时存在）存在书写震颤。书写震颤的严重程度与其他震颤类型以及其他临床变量均无相关性。4/10 的患者书写震颤具有任务特异性，6/10 的患者无任务特异性。感觉技巧对 2 例患者的书写震颤有效，但对研究中的任何患者的动作性震颤均无改善作用。结果表明，帕金森病的书写震颤比其他震颤类型少见，可能与其他形式的动作性震颤有关，有时可能具有运动障碍特征，包括任务特异性和对感觉技巧的敏感性。
