Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study
Identifieur interne : 000A39 ( Istex/Corpus ); précédent : 000A38; suivant : 000A40Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study
Auteurs : Petra Schwingenschuh ; Diane Ruge ; Mark Edwards ; Carmen Terranova ; Petra Katschnig ; Fatima Carrillo ; Laura Silveira ; Susanne. Schneider ; Georg K ; Francisco. Palomar ; Penelope Talelli ; John Dickson ; Andrew Lees ; Niall Quinn ; Pablo Mir ; John Rothwell ; Kailash BhatiaSource :
- Movement Disorders [ 0885-3185 ] ; 2010-04-15.
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Abstract
Approximately 10% of patients diagnosed clinically with early Parkinson's disease (PD) have normal dopaminergic functional imaging (Scans Without Evidence of Dopaminergic Deficit [SWEDDs]). An important subgroup of SWEDDs are those with asymmetric rest tremor resembling parkinsonian tremor. Clinical and pathophysiological features which could help to distinguish SWEDDs from PD have not been explored. We therefore studied clinical details including non‐motor symptoms in 25 tremulous SWEDDs patients in comparison to 25 tremor‐dominant PD patients. Blinded video rating was used to compare examination findings. Electrophysiological tremor parameters and also response to a cortical plasticity protocol using paired associative stimulation (PAS) was studied in 9 patients with SWEDDs, 9 with tremor‐dominant PD (with abnormal dopamine transporter single photon emission computed tomography findings), 8 with segmental dystonia, and 8 with essential tremor (ET). Despite clinical overlap, lack of true bradykinesia, presence of dystonia, and head tremor favored a diagnosis of SWEDDs, whereas re‐emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs, and presence of non‐motor symptoms favored PD. A single tremor parameter could not differentiate between groups, but the combination of re‐emergent tremor and highest tremor amplitude at rest was characteristic of PD tremor. SWEDDs and segmental dystonia patients exhibited an abnormal exaggerated response to the PAS protocol, in contrast to a subnormal response in PD and a normal response in ET. We conclude that despite clinical overlap, there are features that can help to distinguish between PD and SWEDDs which may be useful in clinical practice. The underlying pathophysiology of SWEDDs differs from PD but has similarities with primary dystonia. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23019
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Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Edwards, Mark J" sort="Edwards, Mark J" uniqKey="Edwards M" first="Mark" last="Edwards">Mark Edwards</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Terranova, Carmen" sort="Terranova, Carmen" uniqKey="Terranova C" first="Carmen" last="Terranova">Carmen Terranova</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Katschnig, Petra" sort="Katschnig, Petra" uniqKey="Katschnig P" first="Petra" last="Katschnig">Petra Katschnig</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Medical University Graz, Graz, Austria</mods:affiliation></affiliation></author><author><name sortKey="Carrillo, Fatima" sort="Carrillo, Fatima" uniqKey="Carrillo F" first="Fatima" last="Carrillo">Fatima Carrillo</name><affiliation><mods:affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</mods:affiliation></affiliation></author><author><name sortKey="Silveira Oriyama, Laura" sort="Silveira Oriyama, Laura" uniqKey="Silveira Oriyama L" first="Laura" last="Silveira">Laura Silveira</name><affiliation><mods:affiliation>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Schneider, Susanne A" sort="Schneider, Susanne A" uniqKey="Schneider S" first="Susanne" last="Schneider">Susanne. Schneider</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="K Gi, Georg" sort="K Gi, Georg" uniqKey="K Gi G" first="Georg" last="K">Georg K</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Palomar, Francisco J" sort="Palomar, Francisco J" uniqKey="Palomar F" first="Francisco" last="Palomar">Francisco. Palomar</name><affiliation><mods:affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</mods:affiliation></affiliation></author><author><name sortKey="Talelli, Penelope" sort="Talelli, Penelope" uniqKey="Talelli P" first="Penelope" last="Talelli">Penelope Talelli</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Dickson, John" sort="Dickson, John" uniqKey="Dickson J" first="John" last="Dickson">John Dickson</name><affiliation><mods:affiliation>Institute of Nuclear Medicine, UCL, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees</name><affiliation><mods:affiliation>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Quinn, Niall" sort="Quinn, Niall" uniqKey="Quinn N" first="Niall" last="Quinn">Niall Quinn</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Mir, Pablo" sort="Mir, Pablo" uniqKey="Mir P" first="Pablo" last="Mir">Pablo Mir</name><affiliation><mods:affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</mods:affiliation></affiliation></author><author><name sortKey="Rothwell, John C" sort="Rothwell, John C" uniqKey="Rothwell J" first="John" last="Rothwell">John Rothwell</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash" last="Bhatia">Kailash Bhatia</name><affiliation><mods:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-04-15">2010-04-15</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="560">560</biblScope><biblScope unit="page" to="569">569</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">7D1AF556E57AD115978369268BD9F1FE2DE8B0C3</idno><idno type="DOI">10.1002/mds.23019</idno><idno type="ArticleID">MDS23019</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>123I FP‐CIT SPECT</term><term>SWEDDs</term><term>accelerometry</term><term>benign tremulous Parkinson's disease</term><term>dystonic tremor</term><term>paired associative stimulation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Approximately 10% of patients diagnosed clinically with early Parkinson's disease (PD) have normal dopaminergic functional imaging (Scans Without Evidence of Dopaminergic Deficit [SWEDDs]). An important subgroup of SWEDDs are those with asymmetric rest tremor resembling parkinsonian tremor. Clinical and pathophysiological features which could help to distinguish SWEDDs from PD have not been explored. We therefore studied clinical details including non‐motor symptoms in 25 tremulous SWEDDs patients in comparison to 25 tremor‐dominant PD patients. Blinded video rating was used to compare examination findings. Electrophysiological tremor parameters and also response to a cortical plasticity protocol using paired associative stimulation (PAS) was studied in 9 patients with SWEDDs, 9 with tremor‐dominant PD (with abnormal dopamine transporter single photon emission computed tomography findings), 8 with segmental dystonia, and 8 with essential tremor (ET). Despite clinical overlap, lack of true bradykinesia, presence of dystonia, and head tremor favored a diagnosis of SWEDDs, whereas re‐emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs, and presence of non‐motor symptoms favored PD. A single tremor parameter could not differentiate between groups, but the combination of re‐emergent tremor and highest tremor amplitude at rest was characteristic of PD tremor. SWEDDs and segmental dystonia patients exhibited an abnormal exaggerated response to the PAS protocol, in contrast to a subnormal response in PD and a normal response in ET. We conclude that despite clinical overlap, there are features that can help to distinguish between PD and SWEDDs which may be useful in clinical practice. The underlying pathophysiology of SWEDDs differs from PD but has similarities with primary dystonia. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Petra Schwingenschuh MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string><json:string>Department of Neurology, Medical University Graz, Graz, Austria</json:string></affiliations></json:item><json:item><name>Diane Ruge MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Mark J. Edwards PhD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Carmen Terranova MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Petra Katschnig MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string><json:string>Department of Neurology, Medical University Graz, Graz, Austria</json:string></affiliations></json:item><json:item><name>Fatima Carrillo MD</name><affiliations><json:string>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</json:string></affiliations></json:item><json:item><name>Laura Silveira‐Moriyama MD</name><affiliations><json:string>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Susanne A Schneider PhD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Georg Kägi MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Francisco J Palomar MD</name><affiliations><json:string>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</json:string></affiliations></json:item><json:item><name>Penelope Talelli MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>John Dickson PhD</name><affiliations><json:string>Institute of Nuclear Medicine, UCL, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Andrew J. Lees MD</name><affiliations><json:string>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Niall Quinn MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Pablo Mir PhD</name><affiliations><json:string>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</json:string></affiliations></json:item><json:item><name>John C. Rothwell PhD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Kailash P. Bhatia MD</name><affiliations><json:string>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>SWEDDs</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>123I FP‐CIT SPECT</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>benign tremulous Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dystonic tremor</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>accelerometry</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>paired associative stimulation</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Approximately 10% of patients diagnosed clinically with early Parkinson's disease (PD) have normal dopaminergic functional imaging (Scans Without Evidence of Dopaminergic Deficit [SWEDDs]). An important subgroup of SWEDDs are those with asymmetric rest tremor resembling parkinsonian tremor. Clinical and pathophysiological features which could help to distinguish SWEDDs from PD have not been explored. We therefore studied clinical details including non‐motor symptoms in 25 tremulous SWEDDs patients in comparison to 25 tremor‐dominant PD patients. Blinded video rating was used to compare examination findings. Electrophysiological tremor parameters and also response to a cortical plasticity protocol using paired associative stimulation (PAS) was studied in 9 patients with SWEDDs, 9 with tremor‐dominant PD (with abnormal dopamine transporter single photon emission computed tomography findings), 8 with segmental dystonia, and 8 with essential tremor (ET). Despite clinical overlap, lack of true bradykinesia, presence of dystonia, and head tremor favored a diagnosis of SWEDDs, whereas re‐emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs, and presence of non‐motor symptoms favored PD. A single tremor parameter could not differentiate between groups, but the combination of re‐emergent tremor and highest tremor amplitude at rest was characteristic of PD tremor. SWEDDs and segmental dystonia patients exhibited an abnormal exaggerated response to the PAS protocol, in contrast to a subnormal response in PD and a normal response in ET. We conclude that despite clinical overlap, there are features that can help to distinguish between PD and SWEDDs which may be useful in clinical practice. The underlying pathophysiology of SWEDDs differs from PD but has similarities with primary dystonia. © 2010 Movement Disorder Society</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>1868</abstractCharCount><pdfWordCount>5886</pdfWordCount><pdfCharCount>39176</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>264</abstractWordCount></qualityIndicators><title>Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study</title><genre><json:string>article</json:string></genre><host><volume>25</volume><pages><total>10</total><last>569</last><first>560</first></pages><issn><json:string>0885-3185</json:string></issn><issue>5</issue><subject><json:item><value>Research Article</value></json:item></subject><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1002/mds.23019</json:string></doi><id>7D1AF556E57AD115978369268BD9F1FE2DE8B0C3</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/7D1AF556E57AD115978369268BD9F1FE2DE8B0C3/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/7D1AF556E57AD115978369268BD9F1FE2DE8B0C3/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/7D1AF556E57AD115978369268BD9F1FE2DE8B0C3/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2010</date></publicationStmt><notesStmt><note type="content">*Potential conflict of interest: nothing to report.</note><note>Austrian Science Fund (FWF) - No. J 2764;</note><note>Action Medical Research</note><note>National Institutes of Health Research (NIHR)</note><note>Ministerio de Educación y Ciencia de España - No. SAF2007–60700;</note><note>Consejería de Innovación, Ciencia y Empresa de la Junta de Andalucía - No. CVI‐02526;</note><note>Consejería de Salud de la Junta de Andalucía - No. PI‐0377/2007;</note><note>Sociedad Andaluza de Neurología</note><note>Brain Research Trust UK</note><note>Swiss Parkinson's Disease Association</note><note>Sir Halley Stewart Trust</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study</title><author><persName><forename type="first">Petra</forename><surname>Schwingenschuh</surname></persName><roleName type="degree">MD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><affiliation>Department of Neurology, Medical University Graz, Graz, Austria</affiliation></author><author><persName><forename type="first">Diane</forename><surname>Ruge</surname></persName><roleName type="degree">MD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">Mark J.</forename><surname>Edwards</surname></persName><roleName type="degree">PhD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">Carmen</forename><surname>Terranova</surname></persName><roleName type="degree">MD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">Petra</forename><surname>Katschnig</surname></persName><roleName type="degree">MD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><affiliation>Department of Neurology, Medical University Graz, Graz, Austria</affiliation></author><author><persName><forename type="first">Fatima</forename><surname>Carrillo</surname></persName><roleName type="degree">MD</roleName><affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</affiliation></author><author><persName><forename type="first">Laura</forename><surname>Silveira‐Moriyama</surname></persName><roleName type="degree">MD</roleName><affiliation>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</affiliation></author><author><persName><forename type="first">Susanne A</forename><surname>Schneider</surname></persName><roleName type="degree">PhD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">Georg</forename><surname>Kägi</surname></persName><roleName type="degree">MD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">Francisco J</forename><surname>Palomar</surname></persName><roleName type="degree">MD</roleName><affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</affiliation></author><author><persName><forename type="first">Penelope</forename><surname>Talelli</surname></persName><roleName type="degree">MD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">John</forename><surname>Dickson</surname></persName><roleName type="degree">PhD</roleName><affiliation>Institute of Nuclear Medicine, UCL, London, United Kingdom</affiliation></author><author><persName><forename type="first">Andrew J.</forename><surname>Lees</surname></persName><roleName type="degree">MD</roleName><affiliation>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</affiliation></author><author><persName><forename type="first">Niall</forename><surname>Quinn</surname></persName><roleName type="degree">MD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">Pablo</forename><surname>Mir</surname></persName><roleName type="degree">PhD</roleName><affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</affiliation></author><author><persName><forename type="first">John C.</forename><surname>Rothwell</surname></persName><roleName type="degree">PhD</roleName><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author><author><persName><forename type="first">Kailash P.</forename><surname>Bhatia</surname></persName><roleName type="degree">MD</roleName><note type="correspondence"><p>Correspondence: Sobell Department, Institute of Neurology, UCL, Queen Square, London WC1N 3BG, United Kingdom</p></note><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-04-15"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="560">560</biblScope><biblScope unit="page" to="569">569</biblScope></imprint></monogr><idno type="istex">7D1AF556E57AD115978369268BD9F1FE2DE8B0C3</idno><idno type="DOI">10.1002/mds.23019</idno><idno type="ArticleID">MDS23019</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Approximately 10% of patients diagnosed clinically with early Parkinson's disease (PD) have normal dopaminergic functional imaging (Scans Without Evidence of Dopaminergic Deficit [SWEDDs]). An important subgroup of SWEDDs are those with asymmetric rest tremor resembling parkinsonian tremor. Clinical and pathophysiological features which could help to distinguish SWEDDs from PD have not been explored. We therefore studied clinical details including non‐motor symptoms in 25 tremulous SWEDDs patients in comparison to 25 tremor‐dominant PD patients. Blinded video rating was used to compare examination findings. Electrophysiological tremor parameters and also response to a cortical plasticity protocol using paired associative stimulation (PAS) was studied in 9 patients with SWEDDs, 9 with tremor‐dominant PD (with abnormal dopamine transporter single photon emission computed tomography findings), 8 with segmental dystonia, and 8 with essential tremor (ET). Despite clinical overlap, lack of true bradykinesia, presence of dystonia, and head tremor favored a diagnosis of SWEDDs, whereas re‐emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs, and presence of non‐motor symptoms favored PD. A single tremor parameter could not differentiate between groups, but the combination of re‐emergent tremor and highest tremor amplitude at rest was characteristic of PD tremor. SWEDDs and segmental dystonia patients exhibited an abnormal exaggerated response to the PAS protocol, in contrast to a subnormal response in PD and a normal response in ET. We conclude that despite clinical overlap, there are features that can help to distinguish between PD and SWEDDs which may be useful in clinical practice. The underlying pathophysiology of SWEDDs differs from PD but has similarities with primary dystonia. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>SWEDDs</term></item><item><term>123I FP‐CIT SPECT</term></item><item><term>benign tremulous Parkinson's disease</term></item><item><term>dystonic tremor</term></item><item><term>accelerometry</term></item><item><term>paired associative stimulation</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-10-19">Received</change><change when="2009-12-18">Registration</change><change when="2010-04-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/7D1AF556E57AD115978369268BD9F1FE2DE8B0C3/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="50"><doi origin="wiley" registered="yes">10.1002/mds.v25:5</doi><numberingGroup><numbering type="journalVolume" number="25">25</numbering><numbering type="journalIssue">5</numbering></numberingGroup><coverDate startDate="2010-04-15">15 April 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="70" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23019</doi><idGroup><id type="unit" value="MDS23019"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2009-10-19"></event><event type="manuscriptRevised" date="2009-12-07"></event><event type="manuscriptAccepted" date="2009-12-18"></event><event type="firstOnline" date="2010-02-03"></event><event type="publishedOnlineFinalForm" date="2010-04-21"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-02-03"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.5.2 mode:FullText" date="2011-08-12"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">560</numbering><numbering type="pageLast">569</numbering></numberingGroup><correspondenceTo>Sobell Department, Institute of Neurology, UCL, Queen Square, London WC1N 3BG, United Kingdom</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23019.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="5"></count><count type="referenceTotal" number="32"></count><count type="wordTotal" number="8417"></count></countGroup><titleGroup><title type="main" xml:lang="en">Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study<link href="#fn1"></link></title><title type="short" xml:lang="en">Upper Limb Tremor Misdiagnosed as PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Petra</givenNames><familyName>Schwingenschuh</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Diane</givenNames><familyName>Ruge</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Mark J.</givenNames><familyName>Edwards</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Carmen</givenNames><familyName>Terranova</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Petra</givenNames><familyName>Katschnig</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Fatima</givenNames><familyName>Carrillo</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Laura</givenNames><familyName>Silveira‐Moriyama</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Susanne A</givenNames><familyName>Schneider</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Georg</givenNames><familyName>Kägi</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Francisco J</givenNames><familyName>Palomar</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Penelope</givenNames><familyName>Talelli</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af5"><personName><givenNames>John</givenNames><familyName>Dickson</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au13" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Andrew J.</givenNames><familyName>Lees</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au14" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Niall</givenNames><familyName>Quinn</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au15" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Pablo</givenNames><familyName>Mir</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au16" creatorRole="author" affiliationRef="#af1"><personName><givenNames>John C.</givenNames><familyName>Rothwell</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au17" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Kailash P.</givenNames><familyName>Bhatia</familyName><degrees>MD</degrees></personName><contactDetails><email>k.bhatia@ion.ucl.ac.uk</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="GB" type="organization"><unparsedAffiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="AT" type="organization"><unparsedAffiliation>Department of Neurology, Medical University Graz, Graz, Austria</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="ES" type="organization"><unparsedAffiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="GB" type="organization"><unparsedAffiliation>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="GB" type="organization"><unparsedAffiliation>Institute of Nuclear Medicine, UCL, London, United Kingdom</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">SWEDDs</keyword><keyword xml:id="kwd2">123I FP‐CIT SPECT</keyword><keyword xml:id="kwd3">benign tremulous Parkinson's disease</keyword><keyword xml:id="kwd4">dystonic tremor</keyword><keyword xml:id="kwd5">accelerometry</keyword><keyword xml:id="kwd6">paired associative stimulation</keyword></keywordGroup><fundingInfo><fundingAgency>Austrian Science Fund (FWF)</fundingAgency><fundingNumber>J 2764</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Action Medical Research</fundingAgency></fundingInfo><fundingInfo><fundingAgency>National Institutes of Health Research (NIHR)</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Ministerio de Educación y Ciencia de España</fundingAgency><fundingNumber>SAF2007–60700</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Consejería de Innovación, Ciencia y Empresa de la Junta de Andalucía</fundingAgency><fundingNumber>CVI‐02526</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Consejería de Salud de la Junta de Andalucía</fundingAgency><fundingNumber>PI‐0377/2007</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Sociedad Andaluza de Neurología</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Brain Research Trust UK</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Swiss Parkinson's Disease Association</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Sir Halley Stewart Trust</fundingAgency></fundingInfo><supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23019:MDS_23019_sm_Supinfo1"></mediaResource><caption>Supplemental Information.</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23019:MDS_23019_sm_Supinfo2"></mediaResource><caption>Supplemental Information.</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23019:23019"></mediaResource><caption>Video.</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Approximately 10% of patients diagnosed clinically with early Parkinson's disease (PD) have normal dopaminergic functional imaging (Scans Without Evidence of Dopaminergic Deficit [SWEDDs]). An important subgroup of SWEDDs are those with asymmetric rest tremor resembling parkinsonian tremor. Clinical and pathophysiological features which could help to distinguish SWEDDs from PD have not been explored. We therefore studied clinical details including non‐motor symptoms in 25 tremulous SWEDDs patients in comparison to 25 tremor‐dominant PD patients. Blinded video rating was used to compare examination findings. Electrophysiological tremor parameters and also response to a cortical plasticity protocol using paired associative stimulation (PAS) was studied in 9 patients with SWEDDs, 9 with tremor‐dominant PD (with abnormal dopamine transporter single photon emission computed tomography findings), 8 with segmental dystonia, and 8 with essential tremor (ET). Despite clinical overlap, lack of true bradykinesia, presence of dystonia, and head tremor favored a diagnosis of SWEDDs, whereas re‐emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs, and presence of non‐motor symptoms favored PD. A single tremor parameter could not differentiate between groups, but the combination of re‐emergent tremor and highest tremor amplitude at rest was characteristic of PD tremor. SWEDDs and segmental dystonia patients exhibited an abnormal exaggerated response to the PAS protocol, in contrast to a subnormal response in PD and a normal response in ET. We conclude that despite clinical overlap, there are features that can help to distinguish between PD and SWEDDs which may be useful in clinical practice. The underlying pathophysiology of SWEDDs differs from PD but has similarities with primary dystonia. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Upper Limb Tremor Misdiagnosed as PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: A clinical and electrophysiological study</title></titleInfo><name type="personal"><namePart type="given">Petra</namePart><namePart type="family">Schwingenschuh</namePart><namePart 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Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carmen</namePart><namePart type="family">Terranova</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Petra</namePart><namePart type="family">Katschnig</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><affiliation>Department of Neurology, Medical University Graz, Graz, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fatima</namePart><namePart 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Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Georg</namePart><namePart type="family">Kägi</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francisco J</namePart><namePart type="family">Palomar</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Penelope</namePart><namePart type="family">Talelli</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">John</namePart><namePart type="family">Dickson</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Institute of Nuclear Medicine, UCL, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andrew J.</namePart><namePart type="family">Lees</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Niall</namePart><namePart type="family">Quinn</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pablo</namePart><namePart type="family">Mir</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, CIBERNED, Seville, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">John C.</namePart><namePart type="family">Rothwell</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kailash P.</namePart><namePart type="family">Bhatia</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom</affiliation><description>Correspondence: Sobell Department, Institute of Neurology, UCL, Queen Square, London WC1N 3BG, United Kingdom</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-04-15</dateIssued><dateCaptured encoding="w3cdtf">2009-10-19</dateCaptured><dateValid encoding="w3cdtf">2009-12-18</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">5</extent><extent unit="references">32</extent><extent unit="words">8417</extent></physicalDescription><abstract lang="en">Approximately 10% of patients diagnosed clinically with early Parkinson's disease (PD) have normal dopaminergic functional imaging (Scans Without Evidence of Dopaminergic Deficit [SWEDDs]). An important subgroup of SWEDDs are those with asymmetric rest tremor resembling parkinsonian tremor. Clinical and pathophysiological features which could help to distinguish SWEDDs from PD have not been explored. We therefore studied clinical details including non‐motor symptoms in 25 tremulous SWEDDs patients in comparison to 25 tremor‐dominant PD patients. Blinded video rating was used to compare examination findings. Electrophysiological tremor parameters and also response to a cortical plasticity protocol using paired associative stimulation (PAS) was studied in 9 patients with SWEDDs, 9 with tremor‐dominant PD (with abnormal dopamine transporter single photon emission computed tomography findings), 8 with segmental dystonia, and 8 with essential tremor (ET). Despite clinical overlap, lack of true bradykinesia, presence of dystonia, and head tremor favored a diagnosis of SWEDDs, whereas re‐emergent tremor, true fatiguing or decrement, good response to dopaminergic drugs, and presence of non‐motor symptoms favored PD. A single tremor parameter could not differentiate between groups, but the combination of re‐emergent tremor and highest tremor amplitude at rest was characteristic of PD tremor. SWEDDs and segmental dystonia patients exhibited an abnormal exaggerated response to the PAS protocol, in contrast to a subnormal response in PD and a normal response in ET. We conclude that despite clinical overlap, there are features that can help to distinguish between PD and SWEDDs which may be useful in clinical practice. The underlying pathophysiology of SWEDDs differs from PD but has similarities with primary dystonia. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: nothing to report.</note><note type="funding">Austrian Science Fund (FWF) - No. J 2764; </note><note type="funding">Action Medical Research</note><note type="funding">National Institutes of Health Research (NIHR)</note><note type="funding">Ministerio de Educación y Ciencia de España - No. SAF2007–60700; </note><note type="funding">Consejería de Innovación, Ciencia y Empresa de la Junta de Andalucía - No. CVI‐02526; </note><note type="funding">Consejería de Salud de la Junta de Andalucía - No. PI‐0377/2007; </note><note type="funding">Sociedad Andaluza de Neurología</note><note type="funding">Brain Research Trust UK</note><note type="funding">Swiss Parkinson's Disease Association</note><note type="funding">Sir Halley Stewart Trust</note><subject lang="en"><genre>Keywords</genre><topic>SWEDDs</topic><topic>123I FP‐CIT SPECT</topic><topic>benign tremulous Parkinson's disease</topic><topic>dystonic tremor</topic><topic>accelerometry</topic><topic>paired associative stimulation</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Supplemental Information. - Supplemental Information. - Video. - </note><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>25</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>560</start><end>569</end><total>10</total></extent></part></relatedItem><identifier type="istex">7D1AF556E57AD115978369268BD9F1FE2DE8B0C3</identifier><identifier type="DOI">10.1002/mds.23019</identifier><identifier type="ArticleID">MDS23019</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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