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Combined Measures of Movement and Force Variability Distinguish Parkinson's Disease from Essential Tremor

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Title: Combined Measures of Movement and Force Variability Distinguish Parkinson's Disease from Essential Tremor
Author(s): Poon, Cynthia; Robichaud, Julie A.; Corcos, Daniel M.; Goldman, Jennifer G.; Vaillancourt, David E.
Subject(s): Parkinson's Disease essential tremor variability bradykinesia biomarker
Abstract: Objective: To examine whether behavioral and electrophysiological measures of motor performance accurately differentiate Parkinson’s disease (PD) and essential tremor (ET). Methods: Twenty-four patients (12 PD; 12 ET) performed isometric force, ballistic movements, and tremor tasks. Receiver operating characteristic (ROC) analyses were conducted on all dependent measures that were significantly different between the two patient groups. Results: Patients with PD were more impaired on measures of movement deceleration than ET. Patients with ET were more impaired on measures of force variability than PD. ROC analyses revealed that sensitivity and specificity were excellent when combining measures during the isometric force task (torque rise time and force variability; 92% sensitivity and 92% specificity; AUC = 0.97). When combining measures across the force and movement tasks, the ROC analysis revealed improved sensitivity and specificity (force variability and peak deceleration; 92% sensitivity and 100% specificity; AUC = 0.99). Conclusions: Combining measures of force variability and movement deceleration accurately differentiate patients with PD from those with ET with high sensitivity and specificity. Significance: If validated in a larger sample, these measures can serve as markers to confirm the diagnosis of PD or ET and thus, enhance decision making for appropriate treatments for patients with these respective diseases.
Issue Date: 2011-05-12
Publisher: Elsevier
Citation Info: Poon, C., Robichaud, J. A., Corcos, D. M., Goldman, J. G., & Vaillancourt, D. E. 2011. Combined Measures of Movement and Force Variability Distinguish Parkinson's Disease from Essential Tremor. Clinical Neurophysiology. DOI: 10.1016/j.clinph.2011.04.014
Type: Article
Description: NOTICE: this is the author’s version of a work that was accepted for publication in Clinical Neurophysiology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Clinical Neurophysiology, [(May 12, 2011)] DOI: 10.1016/j.clinph.2011.04.014. The original publication is available at
ISSN: 1388-2457
Sponsor: This research was supported in part by grants from the National Institute of Health (R01-NS-28127, R01-NS-40902, R01-NS-58487, R01-NS-52318).
Date Available in INDIGO: 2011-05-26

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