
Diagnostic Accuracy of the Archimedes Spiral Test for Essential Tremor: A Meta-Analysis
References
- Louis ED, Ottman R, Clark LN. Clinical classification of borderline cases in the family study of essential tremor: an analysis of phenotypic features. DOAJ. 2014;1:1–8. DOI: 10.5334/tohm.191
- Song P, Zhang Y, Zha M, Yang Q, Ye X, Yi Q, et al. The global prevalence of essential tremor, with emphasis on age and sex: a meta-analysis. J Glob Health. 2021;11:
08003 . DOI: 10.7189/jogh.11.04028 - Louis ED, Mccreary M. How common is Essential Tremor? Update on the worldwide prevalence of essential tremor. Tremor and Other Hyperkinetic Movements. 2021;11(1):1–14. DOI: 10.5334/tohm.632
- Bhatia KP, Bain P, Bajaj N, Elble RJ, Hallett M, Louis ED, et al. Consensus statement on the classification of tremors from the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord. 2018;33(1):75–87. DOI: 10.1002/mds.27121
- Louis ED. Essential tremor: a nuanced approach to the clinical features. Pract Neurol. 2019;19(5):389–98. DOI: 10.1136/practneurol-2018-002183
- Alty J, Cosgrove J, Thorpe D, Kempster P. How to use pen and paper tasks to aid tremor diagnosis in the clinic. Pract Neurol. 2017;17(6):456–63. DOI: 10.1136/practneurol-2017-001719
- Fahn S, Tolosa E, Marín C.
Clinical rating scale for tremor . In: Jankovic J, Tolosa E, editors. Parkinson’s Disease and Movement Disorders. Baltimore–Munich: Urban & Schwarzenberg; 1988. p. 225–34. - Bain PG, Findley LJ, Atchison P, et al. Bain and Findley Tremor ADL Scale. APA PsycTests. 1993;1:1–5. DOI: 10.1037/t79876-000
- Elble RJ, Higgins C, Leffler K, Comella CL, Gironell A, Deuschl G. Quantification of essential tremor in writing and drawing. Mov Disord. 1996;11(1):70–8. DOI: 10.1002/mds.870110113
- Haubenberger D, Hallett M. Validation of digital spiral analysis as outcome parameter for clinical trials in essential tremor. Mov Disord. 2011;26(11):2073–80. DOI: 10.1002/mds.23808
- Elble RJ, Comella CL, Fahn S, Deuschl G, Bain PG. Reliability of a new scale for essential tremor. Mov Disord. 2012;27(12):1567–9. DOI: 10.1002/mds.25162
- Wang Y, Li J, Zhang X, et al. Application of optimized convolutional neural networks for early aided diagnosis of essential tremor: automatic handwriting recognition and feature analysis. Med Eng Phys. 2023;113:
103962 . DOI: 10.1016/j.medengphy.2023.103962 - Ishii N, Mochizuki Y, Shiomi K, Nakazato M, Mochizuki H. Spiral drawing: quantitative analysis and artificial intelligence-based diagnosis using a smartphone. J Neurol Sci. 2020;411:
116723 . DOI: 10.1016/j.jns.2020.116723 - Holcomb JM, Maldjian JA, Xi Y, O’Suilleabhain P, Louis ED, Shah B. Electronic Archimedes spiral neural network (ELANN). Park Relat Disord. 2023;115:
105837 . DOI: 10.1016/j.parkreldis.2023.105837 - Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:
n71 . DOI: 10.1136/bmj.n71 - Research Rabbit. Research discovery platform. ResearchRabbitApp.com. 2024.
- Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):
210 . DOI: 10.1186/s13643-016-0384-4 - Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36. DOI: 10.7326/0003-4819-155-8-201110180-00009
- Lorenz D, Papengut F, Frederiksen H, Kopper F, Klebe S, Christensen K, et al. Evaluation of a screening instrument for essential tremor. Mov Disord. 2008;23(7):1006–12. DOI: 10.1002/mds.22010
- Roth N, Braun-Benyamin O, Rosenblum S. Drawing direction effect on a task’s performance characteristics among people with essential tremor. Sensors (Basel). 2021;21(17):
5814 . DOI: 10.3390/s21175814 - Rajan R, Anandapadmanabhan R, Nageswaran S, Radhakrishnan V, Saini A, Krishnan S, et al. Automated analysis of pen-on-paper spirals for tremor detection, quantification, and differentiation. Ann Mov Disord. 2023;6(1):17–25. DOI: 10.4103/aomd.aomd_50_22
- Deuschl G, Bain P, Brin M. Consensus statement of the Movement Disorder Society on tremor. Mov Disord. 1998;13(Suppl 3):2–23. DOI: 10.1002/mds.870131303
- López-de-Ipiña K, Solé-Casals J, Faúndez-Zanuy M, Calvo P, Sesa E, Roure J, et al. Automatic analysis of Archimedes’ spiral for characterization of genetic essential tremor based on Shannon’s entropy and fractal dimension. Entropy (Basel). 2018;20(7):
531 . DOI: 10.3390/e20070531 - De A, Bhatia KP, Volkmann J, Peach RL, Schreglmann SR. Machine learning in tremor analysis: critique and directions. Mov Disord. 2023;38(5):717–31. DOI: 10.1002/mds.29376
- Ma C, Li D, Pan L, Li X, Yin C, Li A, et al. Quantitative assessment of essential tremor based on machine learning methods using wearable device. Biomed Signal Process Control. 2022;71:
103244 . DOI: 10.1016/j.bspc.2021.103244 - López-de-Ipiña K, Bergareche A, de la Riva P, Faundez-Zanuy M, Calvo PM, Roure J, et al. Automatic non-linear analysis of non-invasive writing signals applied to essential tremor. J Appl Log. 2015;16:50–9. DOI: 10.1016/j.jal.2015.02.003
- López-de-Ipiña K, Solé-Casals J, Faundez-Zanuy M, Calvo P, Sesa E, Martinez de Lizarduy U, et al. Selection of entropy-based features for automatic analysis of essential tremor. Entropy (Basel). 2016;18(5):
184 . DOI: 10.3390/e18050184 - Solé-Casals J, Anchustegui-Echearte I, Marti-Puig P, Calvo PM, Bergareche A, Sánchez-Méndez JI, et al. Discrete cosine transform for the analysis of essential tremor. Front Physiol. 2019;9:1–8. DOI: 10.3389/fphys.2018.01947
- Ondo WG, Wang A, Thomas M, Vuong KD. Evaluating factors that can influence spirography ratings in patients with essential tremor. Park Relat Disord. 2005;11(1):45–8. DOI: 10.1016/j.parkreldis.2004.07.005
- Louis ED, Ford B, Wendt KJ, Lee H, Andrews H. A Comparison of Different Bedside Tests for Essential Tremor. Mov Disord. 1999;14(3):462–67. DOI: 10.1002/1531-8257(199905)14:3<;462::AID-MDS1012>3.0.CO;2-V
DOI: https://doi.org/10.5334/tohm.1151 | Journal eISSN: 2160-8288
Language: English
Page range: 25 - 25
Submitted on: Dec 7, 2025
Accepted on: Feb 19, 2026
Published on: Apr 10, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
© 2026 Victor Fellipe Bispo Macêdo, Matheus Lang, Jorge Artur Peçanha de Miranda Coelho, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.