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Orthostatic Tremor: A Spectrum of Fast and Slow Frequencies or Distinct Entities? Cover

Orthostatic Tremor: A Spectrum of Fast and Slow Frequencies or Distinct Entities?

Open Access
|Aug 2015

Figures & Tables

tre-05-324-7132-1-g001.jpg
Figure 1

Histogram Analysis Showing the Distribution of Dominant Tremor Frequencies.

Table 1

Neurophysiologic Features

<10 Hz (n = 8)10–13 Hz (n = 6)>13 Hz (n = 14)
Phase relationship1
 Mixed319
 Alternating232
 Co-contraction323
Mean inter-muscular coherence (95% CI)2 0.53 (0.43–0.63)0.74 (0.60–0.89)0.91 (0.88–0.94)
Mean width in Hz of dominant frequency peak at half peak amplitude (95% CI)1.51 (1.24–1.79)1.00 (0.65–1.35)0.66 (0.59–0.72)
Arm tremor leaning3 3/3 (all <10 Hz)1/1 (12.45 Hz)8/8 (all 13–19Hz)
Arm tremor with postural activation (n, %)6 (75)2 (33.3)9 (64.2)
Arm tremor discharges 13–18 Hz005
Arm tremor discharges 10–13 Hz220
Arm tremor discharges <10 Hz404

1 Between ipsilateral antagonist leg muscles on standing.

2 Between right and left tibialis anterior muscles on standing.

3 Maneuver performed by the number of patients indicated in the denominator.

tre-05-324-7132-1-g002.jpg
Figure 2

Surface Electromyography Tracings and Spectral Analysis in Patients with High-, Intermediate-, and Low-Frequency Orthostatic Tremor.

tre-05-324-7132-1-g003.jpg
Figure 3

Dominant Tremor Frequency vs. Spectral Peak Width at Half Peak Amplitude for Each Patient (blue <10 Hz; green 10–13 Hz; red 13–19 Hz)..

Table 2

Demographic and Clinical Information

<10 Hz (n = 8)10–13 Hz (n = 6)>13 Hz (n = 14)p-value
Mean age (years)7569.571.210.690
Gender female/male (% female)7/1 (87.5)2/4 (33.3)8/6 (57.1)0.122
Mean disease duration (years) 2.00 7.96 11.43 0.002
Mean age at disease onset (years)72.8861.359.710.093
Symptoms1
 Feeling of tremor 4 (50) 6 (100) 13 (92.8) 0.032
 Unsteadiness with standing8 (100)6 (100)14 (100)
 Unsteadiness with walking 6/7 (85.7) 4 (66.6) 3 (21.4) 0.016
 Documented falls 3 (37.5) 3 (50) 0 (0.00) 0.010
Examination
 Leg tremor5 (62.5)5 (83.3)12 (85.7)0.493
 Abnormal gait 5/7 (71.4) 4 (66) 2 (14.3) 0.017
Family history of tremor3 (37.5)0 (0)3 (21.4)0.145

1 Data presented as n (%).

The rows containing significant p-values are in bold

Table 3

Proportion of Patients Experiencing at Least Partial Benefit from Medication

<10 Hz10–13 Hz>13 Hz
Clonazepam1/12/31/5
Gabapentin2/21/24/9
Primidone1/31/6
Propanolol1/2
Topiramate0/4
Valproic acid0/2
Levodopa0/2
Pramipexole0/1
Alprazolam0/2
DOI: https://doi.org/10.5334/tohm.238 | Journal eISSN: 2160-8288
Language: English
Submitted on: May 6, 2015
Accepted on: Jul 15, 2015
Published on: Aug 25, 2015
Published by: Columbia University Libraries/Information Services
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2015 Heather B. Rigby, Matthew H. Rigby, John N. Caviness, published by Columbia University Libraries/Information Services
This work is licensed under the Creative Commons License.