Figure 1
Anatomical-functional paradigm of the pronator teres and flexor carpi muscles. Schematic representation of the forearm and finger muscles, illustrating the muscles involved in the anatomical-functional paradigm. The muscles targeted for infiltration are highlighted in bold.
Video 1
Video demonstrating an essential tremor patient exhibiting a supination/pronation pattern, presented pre- and post-ultrasound-guided botulinum toxin infiltration.
Table 1
Demographic characteristics.
| N = 18 | Mean (SD) |
| Age (years) | 68.2 (22.2) |
| Females/Males* | 8/10 |
| Disease onset (years) | 13.5 (3.1) |
| Total TETRAS Sub-score of the treated arm (SPP and FEP) | 2.8 (0.2) |
| SPP | 2.7 (0.4) |
| FEP | 2.9 (0.3) |
| Total Self-evaluating spiral written test (0–4) SPP and FEP | 2.8 (0.4) |
| SPP | 3.1 (0.2) |
| FEP | 2.7 (0.3) |
| QUEST-QOL score | 45.0 (4.0) |
| SPP | 46.0 (2.0) |
| FEP | 43.0 (1.0) |
| Tremor pattern (n) | |
| SPP* | 8 |
| FEP* | 10 |
| Upper limb tremor* | 18 |
| Lower limb tremor* | 8 |
| Voice tremor* | 6 |
| Head tremor* | 3 |
| Resting tremor* | 6 |
[i] FEP, flexor/extensor pattern; QUEST-QOL, quality of life in essential tremor questionnaire; SPP, supination/pronation pattern; TETRAS, the essential tremor rating assessment scale.
*Absolute frequency.
Table 2
36-week follow-up after IncoBoNT ultrasound-guided infiltrations.
| BASAL, MEAN (SD) | 36-WEEK, MEAN (SD) | P | |
|---|---|---|---|
| SPP-ET patients | |||
| TETRAS (sub-score for the treated arm) | 2.7 (0.4) | 1.5 (0.4) | 0.0022 |
| QUEST-QOL score [Ph/Psy] | 46.0 (1.0) [(29.0 (0.8)/16.0 (0.4)] | 16.0 (3.0) [15.0 (0.1)/1.0 (0.7)] | 0.0018 |
| Self-evaluating spiral written test (0–4) | 3.1 (0.2) | 1.3 (0.5) | 0.0022 |
| Neurophysiological parameters (Hz/mm) | |||
| Postural | 9.3 (1.5)/16 (2,5) | 2.2 (0.3)/2 (0,6) | 0.0011/0.0018 |
| Action | 11.2 (1.6)/15 (2,5) | 2.5 (0.8)/1,8 (0,9) | 0.0012/0.0016 |
| Resting | 7.3 (0.5)/11 (2,5) | 2.3 (0.6)/1,9 (0,8) | 0.0021/0.0017 |
| FEP-ET patients | |||
| TETRAS (sub-score for the treated arm) | 2.9 (0.3) | 1.4 (0.3) | 0.0021 |
| QUEST-QOL score (Ph/Psy) | 43.0 (1.0) [28.0 (0.1)/15.0 (0.1)] | 16.4 (1.0) [5.0 (0.3)/11.4 (0.1)] | 0.0018 |
| Self-evaluating spiral written test (0–4) | 2.7 (0.3) | 1.2 (0.4) | 0.0022 |
| Neurophysiological parameters (Hz)/mm | |||
| Postural | 10.2 (1.2)/17 (2,5) | 1.9 (0.2)/2 (0,7) | 0.0011/0.0018 |
| Action | 11.5 (2.1)/18 (2,3) | 2.2 (0.7)/2 (0.8) | 0.0021/0.0015 |
| Resting | 6.8 (0.4)/12 (1,6) | 2.6 (0.4)/1 (0.7) | 0.0019/0.0018 |
[i] ET, essential tremor; FEP, flexor/extensor pattern; Ph, physical subscale; Psy, psychological subscale; QUEST-QOL, quality of life in essential tremor questionnaire; SPP, supination/pronation pattern; TETRAS, the essential tremor rating assessment scale.