Objective: We aimed to describe the prevalence and patterns of rest and action tremor in a large, prospective cohort of Parkinson’s disease (PD) patients.

Background: Rest tremor (RT) a cardinal and most visible symptoms of PD[1]. However, there is a surprising lack of data its prevalence in PD. The relationship of RT with action tremor (AT) in PD is also poorly described.

Method: Baseline data of PD patients (n = 418) from the Parkinson Progression Marker Initiative (PPMI) study[2], were accessed as of September 1, 2018. RT, postural tremor, and kinetic tremor were captured by value of >= 1 on items 3.17, 3.15, and 3.16, respectively, in part III (motor) of the MDS-UPDRS scale. AT was defined by presence of both postural AND kinetic tremor. RT severity was calculated by adding five sub-items of RT (3.17) and then multiplying the sum with constancy of RT (3.18).

Results: Approximately 88% of patients had at either rest, postural or action tremor [figure1], compared to 27% of patients who had rest, postural and action tremor [figure2]. Prevalence of RT was highest at ~ 69% [figure3] followed by postural tremor at ~ 53% [figure4] and kinetic tremor at ~ 51% [figure5]. AT was present in 37% (156/423) patients [figure6], among which ~74% also had RT [figure7]. Among patients with RT (290/423), 40% had AT [figure8]. In contrast, among patients with no RT (156/ 423), ~ 30% had AT [figure9]. Among patients with RT (290/423), those with AT had significantly (p = 0.000) higher RT severity (7 ± 5.4) versus those without AT (3.9 ± 3.3).

Conclusion: Prevalence of RT is 69% compared to prevalence of AT of 37% in drug-naive PD patients. The PD patients with RT have higher prevalence and severity of AT, compared to the PD patients without RT. These results suggest that there may be cross-interactions between basal ganglia and cerebellothalamic circuitry in mediating RT and AT, respectively, in PD.

References: 1. Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Movement disorders 2008;30:1591-1601. 2. Marek K, Jennings D, Lasch S, et al. The parkinson progression marker initiative (PPMI). Progress in neurobiology 2011;95:629-635. 3. Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society‐sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing results. Movement disorders 2008;23:2129-2170.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-and-patterns-of-rest-and-action-tremor-in-drug-naive-parkinsons-disease/