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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Schwingenschuh, P; Katschnig, P; Seiler, S; Saifee, TA; Aguirregomozcorta, M; Cordivari, C; Schmidt, R; Rothwell, JC; Bhatia, KP; Edwards, MJ.
Moving toward "laboratory-supported" criteria for psychogenic tremor.
Mov Disord. 2011; 26(14):2509-2515 Doi: 10.1002/mds.23922 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Führende Autor*innen der Med Uni Graz
Schwingenschuh Petra
Co-Autor*innen der Med Uni Graz
Katschnig-Winter Petra
Schmidt Reinhold
Seiler Stephan
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Abstract:
A confident clinical diagnosis of psychogenic tremor is often possible, but, in some cases, a "laboratory-supported" level of certainty would aid in early positive diagnosis. Various electrophysiological tests have been suggested to identify patients with psychogenic tremor, but their diagnostic reliability has never been assessed "head to head" nor compared to forms of organic tremor other than essential tremor or PD. We compared baseline tremor characteristics (e.g., frequency and amplitude) as well as electrophysiological tests previously reported to distinguish psychogenic and organic tremor in a cohort of 13 patients with psychogenic tremor and 25 patients with organic tremor, the latter including PD, essential-, dystonic-, and neuropathic tremors. We assessed between-group differences and calculated sensitivity and specificity for each test. A number of tests, including entrainment or frequency changes with tapping, pause of tremor during contralateral ballistic movements, increase in tremor amplitude with loading, presence of coherence, and tonic coactivation at tremor onset, revealed significant differences on a group level, but there was no single test with adequate sensitivity and specificity for separating the groups (33%-77% and 84%-100%, respectively). However, a combination of electrophysiological tests was able to distinguish psychogenic and organic tremor with excellent sensitivity and specificity. A laboratory-supported level of diagnostic certainty in psychogenic tremor is likely to require a battery of electrophysiological tests to provide sufficient specificity and sensitivity. Our data suggest such a battery that, if supported in a prospective study, may form the basis of laboratory-supported criteria for the diagnosis of psychogenic tremor.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Diagnosis, Differential -
Diagnostic Techniques, Neurological - standards
Electromyography - methods
Evidence-Based Medicine -
Female -
Humans -
Male -
Middle Aged -
Movement -
Neurologic Examination - methods
Psychophysiologic Disorders - diagnosis
Reproducibility of Results -
Sensitivity and Specificity -
Tremor - diagnosis

Find related publications in this database (Keywords)
psychogenic tremor
tremor analysis
electrophysiology
diagnostic criteria
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