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Machine Learning for Differentiating Essential Tremor: A Scoping Review Cover

Machine Learning for Differentiating Essential Tremor: A Scoping Review

Open Access
|May 2026

References

  1. Louis ED, McCreary M. How Common is Essential Tremor? Update on the Worldwide Prevalence of Essential Tremor. Tremor Other Hyperkinet Mov (N Y). 2021;11(1):28. DOI: 10.5334/tohm.632
  2. Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169:467473. DOI: 10.7326/M18-0850
  3. Amlang CJ, Trujillo Diaz D, Louis ED. Essential Tremor as a “Waste Basket” Diagnosis: Diagnosing Essential Tremor Remains a Challenge. Front Neurol. 2020;11:172. DOI: 10.3389/fneur.2020.00172
  4. Lenka A, Jankovic J. Tremor Syndromes: An Updated Review. Front Neurol. 2021;12:684835. DOI: 10.3389/fneur.2021.684835
  5. Louis ED, Ottman R, Allen Hauser W. How common is the most common adult movement disorder? Estimates of the prevalence of essential tremor throughout the world. Mov Disord. 1998;13(1):510. DOI: 10.1002/mds.870130105
  6. Bhatia KP, Bain P, Bajaj N, 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):7587. DOI: 10.1002/mds.27121
  7. Ondo W, Shukla AW, Ondo C, Tremor Research Group OBOT. TETRAS Spirals and Handwriting Samples: Determination of Optimal Scoring Examples. Tremor Other Hyperkinet Mov (N Y). 2021;11(1):50. DOI: 10.5334/tohm.665
  8. Hess CW, Pullman SL. Tremor: Clinical Phenomenology and Assessment Techniques. Tremor Other Hyperkinet Mov (N Y). 2012;2:02. DOI: 10.5334/tohm.115
  9. Legrand AP, Rivals I, Richard A, et al. New insight in spiral drawing analysis methods – Application to action tremor quantification. Clin Neurophysiol. 2017;128(10):18231834. DOI: 10.1016/j.clinph.2017.07.002
  10. Ahsan MM, Luna SA, Siddique Z. Machine-Learning-Based Disease Diagnosis: A Comprehensive Review. Healthcare (Basel). 2022;10(3):541. DOI: 10.3390/healthcare10030541
  11. Xing X, Luo N, Li S, Zhou L, Song C, Liu J. Identification and Classification of Parkinsonian and Essential Tremors for Diagnosis Using Machine Learning Algorithms. Front Neurosci. 2022;16:701632. DOI: 10.3389/fnins.2022.701632
  12. Peng Y, Han S, Wu D, et al. A deep learning approach to remotely assessing essential tremor with handwritten images. Sci Rep. 2025;15(1):10783. DOI: 10.1038/s41598-025-94729-0
  13. Kline A, Wang H, Li Y, et al. Multimodal machine learning in precision health: A scoping review. NPJ Digit Med. 2022;5(1):171. DOI: 10.1038/s41746-022-00712-8
  14. Jumper J, Evans R, Pritzel A, et al. Highly accurate protein structure prediction with AlphaFold. Nature. 2021;596(7873):583589. DOI: 10.1038/s41586-021-03819-2
  15. McKinney SM, Sieniek M, Godbole V, et al. International evaluation of an AI system for breast cancer screening. Nature. 2020;577(7788):8994. DOI: 10.1038/s41586-019-1799-6
  16. Gulshan V, Peng L, Coram M, et al. Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs. JAMA. 2016;316(22):24022410. DOI: 10.1001/jama.2016.17216
  17. Vizcarra JA, Yarlagadda S, Xie K, Ellis CA, Spindler M, Hammer LH. Artificial Intelligence in the Diagnosis and Quantitative Phenotyping of Hyperkinetic Movement Disorders: A Systematic Review. J Clin Med. 2024;13(23):7009. DOI: 10.3390/jcm13237009
  18. De A, Bhatia KP, Volkmann J, Peach R, Schreglmann SR. Machine Learning in Tremor Analysis: Critique and Directions. Mov Disord. 2023;38(5):717731. DOI: 10.1002/mds.29376
  19. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. JBI; 2024 [cited 2025 Jun 9]. Available from: https://jbi-global-wiki.refined.site/space/MANUAL.
  20. Ai L, Wang J, Huang L, Wang X. Hand Tremor Classification Using Bispectrum Analysis of Acceleration Signals and Back-Propagation Neural Network. In: Liu D, Fei S, Hou Z, Zhang H, Sun C. editors. Advances in Neural Networks – ISNN 2007. 2007; p 12021210. DOI: 10.1007/978-3-540-72393-6_142
  21. Ai L, Wang J, Wang X. Multi-features fusion diagnosis of tremor based on artificial neural network and D–S evidence theory. Signal Process. 2008;88(12):29272935. DOI: 10.1016/j.sigpro.2008.06.018
  22. Ai L, Wang J, Yao R. Classification of parkinsonian and essential tremor using empirical mode decomposition and support vector machine. Digit Signal Process. 2011;21(4):543550. DOI: 10.1016/j.dsp.2011.01.010
  23. Anandapadmanabhan R, Vishnoi A, Raman G, et al. Deep Learning–Based Artificial Intelligence Algorithm to Classify Tremors from Hand-Drawn Spirals. Mov Disord. 2025;40(6):11721181. DOI: 10.1002/mds.30176
  24. Aracri F, Quattrone A, Bianco MG, et al. Multimodal imaging and electrophysiological study in the differential diagnosis of rest tremor. Front Neurol. 2024;15:1399124. DOI: 10.3389/fneur.2024.1399124
  25. Aubin PM, Serackis A, Griskevicius J. Support Vector Machine Classification of Parkinson’s Disease, Essential Tremor and Healthy Control Subjects Based on Upper Extremity Motion. In: 2012 International Conference on Biomedical Engineering and Biotechnology. Macau, China; May 2012. pp. 900904. DOI: 10.1109/iCBEB.2012.387
  26. Balachandar A, Algarni M, Oliveira L, et al. Are smartphones and machine learning enough to diagnose tremor? J Neurol. 2022;269(11):61046115. DOI: 10.1007/s00415-022-11293-7
  27. Chandra Reddy G, Kumar AT, Rebello A, Brindha A, Pa S, Sunitha KA. Enhanced Computer Vision Technique for Differentiating Tremor Types. In: 2024 5th International Conference on Biomedical Engineering (IBIOMED). Bali, Indonesia; 2024. p 169174. DOI: 10.1109/iBioMed62485.2024.10875825
  28. Darnall ND, Donovan CK, Aktar S, et al. Application of machine learning and numerical analysis to classify tremor in patients affected with essential tremor or Parkinson’s disease. Gerontechnology. 2012;10(4):208219. DOI: 10.4017/gt.2012.10.4.002.00
  29. Duque JDL, Egea AJS, Reeb T, Rojas HAG, Gonzalez-Vargas AM. Angular Velocity Analysis Boosted by Machine Learning for Helping in the Differential Diagnosis of Parkinson’s Disease and Essential Tremor. IEEE Access. 2020;8:8886688875. DOI: 10.1109/ACCESS.2020.2993647
  30. Engin M, Demirag S, Engin E, et al. The classification of human tremor signals using artificial neural network. Expert Syst Appl. 2007;33(3):754761. DOI: 10.1016/j.eswa.2006.06.014
  31. Ferreira GAS, Teixeira JLS, Rosso ALZ, De Sá AMFLM. On the classification of tremor signals into dyskinesia, Parkinsonian tremor, and Essential tremor by using machine learning techniques. Biomed Signal Process Control. 2022;73:103430. DOI: 10.1016/j.bspc.2021.103430
  32. Ghassemi NH, Marxreiter F, Pasluosta CF, et al. Combined accelerometer and EMG analysis to differentiate essential tremor from Parkinson’s disease. Annu Int Conf IEEE Eng Med Biol Soc. 2016;2016:672675. DOI: 10.1109/EMBC.2016.7590791
  33. González R, Barrientos A, Del Cerro J, Coca B. DIMETER: A Haptic Master Device for Tremor Diagnosis in Neurodegenerative Diseases. Sensors (Basel). 2014;14(3):45364559. DOI: 10.3390/s140304536
  34. Groznik V, Guid M, Sadikov A, et al. Elicitation of neurological knowledge with argument-based machine learning. Artif Intell Med. 2013;57(2):133144. DOI: 10.1016/j.artmed.2012.08.003
  35. Hossen A. Discrimination between parkinsonian tremor and essential tremor using artificial neural network with hybrid features. Technol Health Care. 2022;30(3):691702. DOI: 10.3233/THC-213324
  36. Hossen A, Muthuraman M, Raethjen J, Deuschl G, Heute U. A Neural Network Approach to Distinguish Parkinsonian Tremor from Advanced Essential Tremor. In: Deep K, Nagar A, Pant M, Bansal JC, editors. Proceedings of the International Conference on Soft Computing for Problem Solving (SocProS 2011); 2012. pp. 10511060. DOI: 10.1007/978-81-322-0487-9_96
  37. 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
  38. Jakubowski J, Kwiatos K, Chwaleba A, Osowski S. Higher order statistics and neural network for tremor recognition. IEEE Trans Biomed Eng. 2002;49(2):152159. DOI: 10.1109/10.979354
  39. Kovalenko E, Talitckii A, Anikina A, et al. Distinguishing Between Parkinson’s Disease and Essential Tremor Through Video Analytics Using Machine Learning: A Pilot Study. IEEE Sens J. 2021;21(10):1191611925. DOI: 10.1109/JSEN.2020.3035240
  40. Lee RE, Chan PY. Explainable artificial intelligence for searching frequency characteristics in Parkinson’s disease tremor. Sci Rep. 2023;13(1):18622. DOI: 10.1038/s41598-023-45802-z
  41. Li J, Zhu H, Li J, et al. A Wearable Multi-Segment Upper Limb Tremor Assessment System for Differential Diagnosis of Parkinson’s Disease Versus Essential Tremor. IEEE Trans Neural Syst Rehabil Eng. 2023;31:33973406. DOI: 10.1109/TNSRE.2023.3306203
  42. Lin S, Gao C, Li H, et al. Wearable sensor-based gait analysis to discriminate early Parkinson’s disease from essential tremor. J Neurol. 2023;270(4):22832301. DOI: 10.1007/s00415-023-11577-6
  43. Locatelli P, Alimonti D, Traversi G, Re V. Classification of Essential Tremor and Parkinson’s Tremor Based on a Low-Power Wearable Device. Electronics. 2020;9(10):1695. DOI: 10.3390/electronics9101695
  44. Moon S, Song HJ, Sharma VD, et al. Classification of Parkinson’s disease and essential tremor based on balance and gait characteristics from wearable motion sensors via machine learning techniques: a data-driven approach. J NeuroEngineering Rehabil. 2020;17(1):125. DOI: 10.1186/s12984-020-00756-5
  45. Nanayakkara GRR, Chan PY. Subclinical tremor differentiation using long short-term memory networks. Phys Eng Sci Med. 2025;48(2):591602. DOI: 10.1007/s13246-025-01526-0
  46. Nanda SK, Lin WY, Lee MY, Chen RS. A quantitative classification of essential and Parkinson’s tremor using wavelet transform and artificial neural network on sEMG and accelerometer signals. In: 2015 IEEE 12th International Conference on Networking, Sensing and Control. Taipei, Taiwan, 2015; p 399404. DOI: 10.1109/ICNSC.2015.7116070
  47. Oktay AB, Kocer A. Differential diagnosis of Parkinson and essential tremor with convolutional LSTM networks. Biomed Signal Process Control. 2020;56:101683. DOI: 10.1016/j.bspc.2019.101683
  48. Piepjohn P, Bald C, Kuhlenbäumer G, Becktepe JS, Deuschl G, Schmidt G. Real-time classification of movement patterns of tremor patients. Biomed Tech (Berl). 2022;67(2):119130. DOI: 10.1515/bmt-2021-0140
  49. Ranjan R, Palaniswami M, Bhushan B. A Machine Learning Approach for Classification of Tremor–A Neurological Movement Disorder. In: Bi Y, Bhatia R, Kapoor S, editors. Intelligent Systems and Applications (IntelliSys 2019); 2019. pp. 12891307. DOI: 10.1007/978-3-030-29513-4_95
  50. Saad M, Hefner S, Donovan S, et al. Development of a Tremor Detection Algorithm for Use in an Academic Movement Disorders Center. Sensors. 2024;24(15):4960. DOI: 10.3390/s24154960
  51. Sanderson JB, Yu JH, Liu DD, et al. Multi-Dimensional, Short-Timescale Quantification of Parkinson’s Disease and Essential Tremor Motor Dysfunction. Front Neurol. 2020;11:886. DOI: 10.3389/fneur.2020.00886
  52. Seedat N, Aharonson V, Schlesinger I. Automated machine vision enabled detection of movement disorders from hand drawn spirals. In: 2020 IEEE International Conference on Healthcare Informatics (ICHI). Oldenburg, Germany; 2020. pp. 15. DOI: 10.1109/ICHI48887.2020.9374333
  53. Shahtalebi S, Atashzar SF, Patel RV, Jog MS, Mohammadi A. A deep explainable artificial intelligent framework for neurological disorders discrimination. Sci Rep. 2021;11(1):9630. DOI: 10.1038/s41598-021-88919-9
  54. Shahtalebi S, Atashzar SF, Samotus O, Patel RV, Jog MS, Mohammadi A. PHTNet: Characterization and Deep Mining of Involuntary Pathological Hand Tremor using Recurrent Neural Network Models. Sci Rep. 2020;10(1):2195. DOI: 10.1038/s41598-020-58912-9
  55. Skaramagkas V, Andrikopoulos G, Kefalopoulou Z, Polychronopoulos P. Towards Differential Diagnosis of Essential and Parkinson’s Tremor via Machine Learning. In: 2020 28th Mediterranean Conference on Control and Automation (MED). Saint-Raphaël, France, 2020; pp. 782787. DOI: 10.1109/MED48518.2020.9182922
  56. Skaramagkas V, Andrikopoulos G, Kefalopoulou Z, Polychronopoulos P. A Study on the Essential and Parkinson’s Arm Tremor Classification. Signals. 2021;2(2):201224. DOI: 10.3390/signals2020016
  57. Spyers-Ashby JM, Stokes MJ, Bain PG, Roberts SJ. Classification of normal and pathological tremors using a multidimensional electromagnetic system. Med Eng Phys. 1999;21(10):713723. DOI: 10.1016/S1350-4533(00)00004-7
  58. Surangsrirat D, Thanawattano C, Pongthornseri R, Dumnin S, Anan C, Bhidayasiri R. Support vector machine classification of Parkinson’s disease and essential tremor subjects based on temporal fluctuation. Annu Int Conf IEEE Eng Med Biol Soc. 2016;2016:63896392. DOI: 10.1109/EMBC.2016.7592190
  59. Tang L, Hu Q, Wang X, et al. A multimodal fusion network based on a cross-attention mechanism for the classification of Parkinsonian tremor and essential tremor. Sci Rep. 2024;14(1):28050. DOI: 10.1038/s41598-024-79111-w
  60. Tavakkoli P, Kobravi HR, Shoeibi A, Zakhirehdari N. Discrimination of Parkinsonian Tremor from Essential Tremor Using the Nonlinear Analysis of Wrist Muscle EMG Signals. In: Goh J, editor. The 15th International Conference on Biomedical Engineering; 2014. pp. 667670. DOI: 10.1007/978-3-319-02913-9_170
  61. Teo YX, Lee RE, Nurzaman SG, Tan CP, Chan PY. Action tremor features discovery for essential tremor and Parkinson’s disease with explainable multilayer BiLSTM. Comput Biol Med. 2024;180:108957. DOI: 10.1016/j.compbiomed.2024.108957
  62. Vescio B, De Maria M, Crasà M, et al. Development of a New Wearable Device for the Characterization of Hand Tremor. Bioengineering. 2023;10(9):1025. DOI: 10.3390/bioengineering10091025
  63. Weede P, Smietana PD, Kuhlenbäumer G, Deuschl G, Schmidt G. Two-Stage Convolutional Neural Network for Classification of Movement Patterns in Tremor Patients. Information. 2024;15(4):231. DOI: 10.3390/info15040231
  64. Yang TL, Lin CH, Chen WL, Lin HY, Su CS, Liang CK. Hash Transformation and Machine Learning-Based Decision-Making Classifier Improved the Accuracy Rate of Automated Parkinson’s Disease Screening. IEEE Trans Neural Syst Rehabil Eng. 2020;28(1):7282. DOI: 10.1109/TNSRE.2019.2950143
  65. Chen JJ, Swope DM. Essential Tremor: Diagnosis and Treatment. Pharmacotherapy. 2003;23(9):11051122. DOI: 10.1592/phco.23.10.1105.32750
  66. Jerath NU, Strader SB, Reddy CG, Swenson A, Kimura J, Aul E. Factors influencing aversion to specific electrodiagnostic studies. Brain Behav. 2014;4(5):698702. DOI: 10.1002/brb3.240
  67. Pullman SL. Spiral Analysis: A New Technique for Measuring Tremor With a Digitizing Tablet. Mov Disord. 2008;13(S3):8589. DOI: 10.1002/mds.870131315
  68. Solé-Casals J, Anchustegui-Echearte I, Marti-Puig P, et al. Discrete Cosine Transform for the Analysis of Essential Tremor. Front Physiol. 2019;9:1947. DOI: 10.3389/fphys.2018.01947
  69. Otero JFA, López-de-Ipina K, Caballer OS, et al. EMD-based data augmentation method applied to handwriting data for the diagnosis of Essential Tremor using LSTM networks. Sci Rep. 2022;12(1):12819. DOI: 10.1038/s41598-022-16741-y
  70. International Parkinson and Movement Disorder Society [Internet]. Tremor Study Group. [cited 2025 Jul 1]. Available from: https://www.movementdisorders.org/MDS/About/Study-Groups/Tremor-Study-Group.htm.
DOI: https://doi.org/10.5334/tohm.1182 | Journal eISSN: 2160-8288
Language: English
Page range: 28 - 28
Submitted on: Feb 5, 2026
Accepted on: Apr 28, 2026
Published on: May 6, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2026 David M. Fletcher, Kaitlyn E. Heintzelman, Sumesh B. Ramasamy, Allison Marks, Joseph C. Melott, Amy W. Amara, Adeel A. Memon, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.