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Schwingenschuh, Petra; Saifee, Tabish A.; Katschnig-Winter, Petra; Macerollo, Antonella; Koegl-Wallner, Mariella; Culea, Valeriu; Ghadery, Christine; Hofer, Edith; Pendl, Tamara; Seiler, Stephan; Werner, Ulrike; Franthal, Sebastian; Maurits, Natasha M.; Tijssen, Marina A.; Schmidt, Reinhold; Rothwell, John C.; Bhatia, Kailash P.; Edwards, Mark J.
Movement disorders, April 2016, Letnik: 31, Številka: 4Journal Article
ABSTRACT Background In a small group of patients, we have previously shown that a combination of electrophysiological tests was able to distinguish functional (psychogenic) tremor and organic tremor with excellent sensitivity and specificity. Objectives This study aims to validate an electrophysiological test battery as a tool to diagnose patients with functional tremor with a “laboratory‐supported” level of certainty. Methods For this prospective data collection study, we recruited 38 new patients with functional tremor (mean age 37.9 ± 24.5 years; mean disease duration 5.9 ± 9.0 years) and 73 new patients with organic tremor (mean age 55.4 ± 25.4 years; mean disease duration 15.8 ± 17.7 years). Tremor was recorded at rest, posture (with and without loading), action, while performing tapping tasks (1, 3, and 5 Hz), and while performing ballistic movements with the less‐affected hand. Electrophysiological tests were performed by raters blinded to the clinical diagnosis. We calculated a sum score for all performed tests (maximum of 10 points) and used a previously suggested cut‐off score of 3 points for a diagnosis of laboratory‐supported functional tremor. Results We demonstrated good interrater reliability and test‐retest reliability. Patients with functional tremor had a higher average score on the test battery when compared with patients with organic tremor (3.6 ± 1.4 points vs 1.0 ± 0.8 points; P < .001), and the predefined cut‐off score for laboratory‐supported functional tremor yielded a test sensitivity of 89.5% and a specificity of 95.9%. Conclusion We now propose this test battery as the basis of laboratory‐supported criteria for the diagnosis of functional tremor, and we encourage its use in clinical and research practice. © 2016 International Parkinson and Movement Disorder Society
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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