J Clin Neurol.  2018 Jul;14(3):381-386. 10.3988/jcn.2018.14.3.381.

Hand Tremor Questionnaire: A Useful Screening Tool for Differentiating Patients with Hand Tremor between Parkinson's Disease and Essential Tremor

Affiliations
  • 1Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
  • 2Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sjchung@amc.seoul.kr
  • 3Department of Neurology and Parkinson's Disease Centre, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. parkinson@korea.ac.kr
  • 4Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 5Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea.
  • 6Department of Neurology, Dongsan Medical Center, Keimyung University, Daegu, Korea.
  • 7Department of Neurology, College of Medicine, Gachon University, Incheon, Korea.

Abstract

BACKGROUND AND PURPOSE
Hand tremor is one of the most frequent symptoms in movement disorders, and differential diagnoses for hand tremor include Parkinson's disease (PD) and essential tremor (ET). However, accurately differentiating between PD and ET in clinical practice remains challenging in patients presenting with hand tremor. We investigated whether a questionnaire-based survey could be useful as a screening tool in patients with hand tremor.
METHODS
A questionnaire related to hand tremor consisting of 12 items was prospectively applied to patients with PD or ET in three movement-disorder clinics. Each question was analyzed, and a query-based scoring system was evaluated for differentiating hand tremors between PD and ET.
RESULTS
This study enrolled 24 patients with PD and 25 patients with ET. Nine of the 12 questions differed significantly between PD and ET: 1 about resting tremor, 4 questions about action tremor, and 4 about asymmetry. A receiver operating characteristics curve analysis revealed that the 9-item questionnaire showed a good discrimination ability, with a sensitivity of 88% and a specificity of 84%.
CONCLUSIONS
The developed Hand Tremor Questionnaire might be a good screening tool for hand tremors in patients with PD and ET.

Keyword

tremor; Hand Tremor Questionnaire; screening; Parkinson's disease; essential tremor; hand

MeSH Terms

Diagnosis, Differential
Discrimination (Psychology)
Essential Tremor*
Hand*
Humans
Mass Screening*
Movement Disorders
Parkinson Disease*
Prospective Studies
ROC Curve
Sensitivity and Specificity
Tremor*

Figure

  • Fig. 1 ROC curve analysis to discriminate between Parkinson's disease and essential tremor: using 12 versus 9 questions. ROC: receiver operating characteristics.


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