What is the Functional Significance of Non-dominant Arm Tremor in Essential Tremor?
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Auteurs : Elan D. Louis [États-Unis] ; Marina Gerbin [États-Unis] ; Mary M. Mullaney [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2010.
Abstract
Tremor in the dominant arm is often the focus of clinical attention in essential tremor (ET) yet many daily activities require both arms. The functional relevance of non-dominant arm tremor has rarely been studied.
In 181 right-handed ET patients, action tremor in each arm was rated using a clinical ratings scale. Tremor disability was self-reported and a performance-based test of function was administered.
Independently of tremor on the right, greater tremor severity on the left was associated with greater self-reported disability (p=0.02) and greater performance-based dysfunction (p<0.001). In 5.0% of patients, tremor was largely restricted to the non-dominant arm.
Non-dominant arm tremor, independent of dominant arm tremor, had a significant functional correlate, contributing to both greater perceived and greater observable functional difficulty. In 5% of patients, tremor in the non-dominant arm was the likely motivator for seeking care, which is another indication of its functional significance.
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DOI: 10.1002/mds.23284
PubMed: 20803512
PubMed Central: 2978780
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Louis</name><affiliation wicri:level="1"><nlm:aff id="A1">GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A3">Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A4">Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY</wicri:regionArea></affiliation></author><author><name sortKey="Gerbin, Marina" sort="Gerbin, Marina" uniqKey="Gerbin M" first="Marina" last="Gerbin">Marina Gerbin</name><affiliation wicri:level="1"><nlm:aff id="A1">GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation></author><author><name sortKey="Mullaney, Mary M" sort="Mullaney, Mary M" uniqKey="Mullaney M" first="Mary M." last="Mullaney">Mary M. 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Louis</name><affiliation wicri:level="1"><nlm:aff id="A1">GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A3">Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A4">Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY</wicri:regionArea></affiliation></author><author><name sortKey="Gerbin, Marina" sort="Gerbin, Marina" uniqKey="Gerbin M" first="Marina" last="Gerbin">Marina Gerbin</name><affiliation wicri:level="1"><nlm:aff id="A1">GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation></author><author><name sortKey="Mullaney, Mary M" sort="Mullaney, Mary M" uniqKey="Mullaney M" first="Mary M." last="Mullaney">Mary M. Mullaney</name><affiliation wicri:level="1"><nlm:aff id="A1">GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</nlm:aff><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY</wicri:regionArea></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P5">Tremor in the dominant arm is often the focus of clinical attention in essential tremor (ET) yet many daily activities require both arms. The functional relevance of non-dominant arm tremor has rarely been studied.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P6">In 181 right-handed ET patients, action tremor in each arm was rated using a clinical ratings scale. Tremor disability was self-reported and a performance-based test of function was administered.</p></sec><sec id="S3"><title>Results</title><p id="P7">Independently of tremor on the right, greater tremor severity on the left was associated with greater self-reported disability (p=0.02) and greater performance-based dysfunction (p<0.001). In 5.0% of patients, tremor was largely restricted to the non-dominant arm.</p></sec><sec id="S4"><title>Conclusions</title><p id="P8">Non-dominant arm tremor, independent of dominant arm tremor, had a significant functional correlate, contributing to both greater perceived and greater observable functional difficulty. In 5% of patients, tremor in the non-dominant arm was the likely motivator for seeking care, which is another indication of its functional significance.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8610688</journal-id><journal-id journal-id-type="pubmed-jr-id">5937</journal-id><journal-id journal-id-type="nlm-ta">Mov Disord</journal-id><journal-title>Movement disorders : official journal of the Movement Disorder Society</journal-title><issn pub-type="ppub">0885-3185</issn><issn pub-type="epub">1531-8257</issn></journal-meta><article-meta><article-id pub-id-type="pmid">20803512</article-id><article-id pub-id-type="pmc">2978780</article-id><article-id pub-id-type="doi">10.1002/mds.23284</article-id><article-id pub-id-type="manuscript">NIHMS207955</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>What is the Functional Significance of Non-dominant Arm Tremor in Essential Tremor?</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Louis</surname><given-names>Elan D.</given-names></name><degrees>M.D., M.Sc.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Gerbin</surname><given-names>Marina</given-names></name><degrees>M.P.H.</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mullaney</surname><given-names>Mary M.</given-names></name><degrees>M.S.</degrees><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</aff><aff id="A2"><label>2</label>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</aff><aff id="A3"><label>3</label>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.</aff><aff id="A4"><label>4</label>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.</aff><author-notes><fn id="FN1"><p id="P1">Author Contributions</p><p id="P2"><italic>Elan D. Louis</italic>: Research project conception, organization and execution; statistical analyses design and execution; manuscript writing (writing the first draft and making subsequent revisions).</p><p id="P3"><italic>Mary Mullaney:</italic> Research project execution; manuscript writing (making subsequent revisions).</p><p id="P4"><italic>Marina Gerbin:</italic> Research project execution; manuscript writing (making subsequent revisions).</p></fn><corresp id="CR1"><bold>Correspondence:</bold> Dr. Elan Louis, Unit 198, Neurological Institute, 710 West 168th Street, New York, NY, 10032, USA. Tel: (212) 305 - 9194, FAX: (212) 305 -1304, <email>EDL2@columbia.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>28</day><month>5</month><year>2010</year></pub-date><pub-date pub-type="ppub"><day>15</day><month>11</month><year>2010</year></pub-date><pub-date pub-type="pmc-release"><day>15</day><month>11</month><year>2011</year></pub-date><volume>25</volume><issue>15</issue><fpage>2674</fpage><lpage>2678</lpage><abstract><sec id="S1"><title>Background</title><p id="P5">Tremor in the dominant arm is often the focus of clinical attention in essential tremor (ET) yet many daily activities require both arms. The functional relevance of non-dominant arm tremor has rarely been studied.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P6">In 181 right-handed ET patients, action tremor in each arm was rated using a clinical ratings scale. Tremor disability was self-reported and a performance-based test of function was administered.</p></sec><sec id="S3"><title>Results</title><p id="P7">Independently of tremor on the right, greater tremor severity on the left was associated with greater self-reported disability (p=0.02) and greater performance-based dysfunction (p<0.001). In 5.0% of patients, tremor was largely restricted to the non-dominant arm.</p></sec><sec id="S4"><title>Conclusions</title><p id="P8">Non-dominant arm tremor, independent of dominant arm tremor, had a significant functional correlate, contributing to both greater perceived and greater observable functional difficulty. In 5% of patients, tremor in the non-dominant arm was the likely motivator for seeking care, which is another indication of its functional significance.</p></sec></abstract><kwd-group><kwd>essential tremor</kwd><kwd>clinical</kwd><kwd>function</kwd><kwd>disability</kwd></kwd-group><contract-num rid="NS1">R01 NS039422-11
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