Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: a clinical and electrophysiological study.
Identifieur interne : 001978 ( PubMed/Curation ); précédent : 001977; suivant : 001979Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: a clinical and electrophysiological study.
Auteurs : Petra Schwingenschuh [Royaume-Uni] ; Diane Ruge ; Mark J. Edwards ; Carmen Terranova ; Petra Katschnig ; Fatima Carrillo ; Laura Silveira-Moriyama ; Susanne A. Schneider ; Georg K Gi ; Francisco J. Palomar ; Penelope Talelli ; John Dickson ; Andrew J. Lees ; Niall Quinn ; Pablo Mir ; John C. Rothwell ; Kailash P. BhatiaSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Analysis of Variance, Case-Control Studies, Dopamine (deficiency), Dopamine Agents (therapeutic use), Electromyography, Evoked Potentials, Motor (physiology), Female, Humans, Magnetic Resonance Imaging, Male, Median Nerve (physiology), Middle Aged, Muscle, Skeletal (physiopathology), Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (radionuclide imaging), Retrospective Studies, Tomography, Emission-Computed, Single-Photon, Transcranial Magnetic Stimulation, Tremor (diagnosis), Tremor (drug therapy), Tremor (physiopathology), Tremor (radionuclide imaging).
- MESH :
- chemical , deficiency : Dopamine.
- chemical , therapeutic use : Dopamine Agents.
- diagnosis : Parkinson Disease, Tremor.
- drug therapy : Parkinson Disease, Tremor.
- physiology : Evoked Potentials, Motor, Median Nerve.
- physiopathology : Muscle, Skeletal, Parkinson Disease, Tremor.
- radionuclide imaging : Parkinson Disease, Tremor.
- Aged, Aged, 80 and over, Analysis of Variance, Case-Control Studies, Electromyography, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Tomography, Emission-Computed, Single-Photon, Transcranial Magnetic Stimulation.
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.
DOI: 10.1002/mds.23019
PubMed: 20131394
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Edwards</name></author><author><name sortKey="Terranova, Carmen" sort="Terranova, Carmen" uniqKey="Terranova C" first="Carmen" last="Terranova">Carmen Terranova</name></author><author><name sortKey="Katschnig, Petra" sort="Katschnig, Petra" uniqKey="Katschnig P" first="Petra" last="Katschnig">Petra Katschnig</name></author><author><name sortKey="Carrillo, Fatima" sort="Carrillo, Fatima" uniqKey="Carrillo F" first="Fatima" last="Carrillo">Fatima Carrillo</name></author><author><name sortKey="Silveira Moriyama, Laura" sort="Silveira Moriyama, Laura" uniqKey="Silveira Moriyama L" first="Laura" last="Silveira-Moriyama">Laura Silveira-Moriyama</name></author><author><name sortKey="Schneider, Susanne A" sort="Schneider, Susanne A" uniqKey="Schneider S" first="Susanne A" last="Schneider">Susanne A. Schneider</name></author><author><name sortKey="K Gi, Georg" sort="K Gi, Georg" uniqKey="K Gi G" first="Georg" last="K Gi">Georg K Gi</name></author><author><name sortKey="Palomar, Francisco J" sort="Palomar, Francisco J" uniqKey="Palomar F" first="Francisco J" last="Palomar">Francisco J. Palomar</name></author><author><name sortKey="Talelli, Penelope" sort="Talelli, Penelope" uniqKey="Talelli P" first="Penelope" last="Talelli">Penelope Talelli</name></author><author><name sortKey="Dickson, John" sort="Dickson, John" uniqKey="Dickson J" first="John" last="Dickson">John Dickson</name></author><author><name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew J" last="Lees">Andrew J. Lees</name></author><author><name sortKey="Quinn, Niall" sort="Quinn, Niall" uniqKey="Quinn N" first="Niall" last="Quinn">Niall Quinn</name></author><author><name sortKey="Mir, Pablo" sort="Mir, Pablo" uniqKey="Mir P" first="Pablo" last="Mir">Pablo Mir</name></author><author><name sortKey="Rothwell, John C" sort="Rothwell, John C" uniqKey="Rothwell J" first="John C" last="Rothwell">John C. Rothwell</name></author><author><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. Bhatia</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Analysis of Variance</term><term>Case-Control Studies</term><term>Dopamine (deficiency)</term><term>Dopamine Agents (therapeutic use)</term><term>Electromyography</term><term>Evoked Potentials, Motor (physiology)</term><term>Female</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Median Nerve (physiology)</term><term>Middle Aged</term><term>Muscle, Skeletal (physiopathology)</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (radionuclide imaging)</term><term>Retrospective Studies</term><term>Tomography, Emission-Computed, Single-Photon</term><term>Transcranial Magnetic Stimulation</term><term>Tremor (diagnosis)</term><term>Tremor (drug therapy)</term><term>Tremor (physiopathology)</term><term>Tremor (radionuclide imaging)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="deficiency" xml:lang="en"><term>Dopamine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Dopamine Agents</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Evoked Potentials, Motor</term><term>Median Nerve</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Muscle, Skeletal</term><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="radionuclide imaging" xml:lang="en"><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Analysis of Variance</term><term>Case-Control Studies</term><term>Electromyography</term><term>Female</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Tomography, Emission-Computed, Single-Photon</term><term>Transcranial Magnetic Stimulation</term></keywords></textClass></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.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">20131394</PMID><DateCreated><Year>2010</Year><Month>04</Month><Day>28</Day></DateCreated><DateCompleted><Year>2010</Year><Month>07</Month><Day>23</Day></DateCompleted><DateRevised><Year>2014</Year><Month>08</Month><Day>27</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>25</Volume><Issue>5</Issue><PubDate><Year>2010</Year><Month>Apr</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: a clinical and electrophysiological study.</ArticleTitle><Pagination><MedlinePgn>560-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.23019</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>(c) 2010 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Schwingenschuh</LastName><ForeName>Petra</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, Queen Square, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ruge</LastName><ForeName>Diane</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Edwards</LastName><ForeName>Mark J</ForeName><Initials>MJ</Initials></Author><Author ValidYN="Y"><LastName>Terranova</LastName><ForeName>Carmen</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Katschnig</LastName><ForeName>Petra</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Carrillo</LastName><ForeName>Fatima</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Silveira-Moriyama</LastName><ForeName>Laura</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Schneider</LastName><ForeName>Susanne A</ForeName><Initials>SA</Initials></Author><Author ValidYN="Y"><LastName>Kägi</LastName><ForeName>Georg</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Palomar</LastName><ForeName>Francisco J</ForeName><Initials>FJ</Initials></Author><Author ValidYN="Y"><LastName>Talelli</LastName><ForeName>Penelope</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Dickson</LastName><ForeName>John</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Lees</LastName><ForeName>Andrew J</ForeName><Initials>AJ</Initials></Author><Author ValidYN="Y"><LastName>Quinn</LastName><ForeName>Niall</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>Mir</LastName><ForeName>Pablo</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Rothwell</LastName><ForeName>John C</ForeName><Initials>JC</Initials></Author><Author ValidYN="Y"><LastName>Bhatia</LastName><ForeName>Kailash P</ForeName><Initials>KP</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>G0500258</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>J 2764-B02</GrantID><Agency>Austrian Science Fund FWF</Agency><Country>Austria</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015259">Dopamine Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>VTD58H1Z2X</RegistryNumber><NameOfSubstance UI="D004298">Dopamine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2008 Sep 15;23(12):1784-7</RefSource><PMID Version="1">18661568</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 2008 Sep;79(9):985-90</RefSource><PMID Version="1">17634214</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 2009 Jul;80(7):744-8</RefSource><PMID Version="1">19276101</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Brain. 2000 Mar;123 Pt 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Disord. 2008 Jan;23(1):101-6</RefSource><PMID Version="1">17994582</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Mov Disord. 2010 Dec 15;25(16):2899</RefSource><PMID Version="1">20925066</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000369">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000704">Analysis of Variance</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016022">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D004298">Dopamine</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000172">deficiency</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D015259">Dopamine Agents</DescriptorName><QualifierName 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