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Parkinsonian action tremor: interference with object manipulation and lacking levodopa response.

J Raethjen1, S Pohle, R B Govindan

  • 1Department of Neurology, University of Kiel, Schittenhelmstrasse 10, 24105 Kiel, Germany.

Experimental Neurology
|May 19, 2005
PubMed
Summary

Parkinsonian action tremor, distinct from resting tremor, affects manual dexterity. This tremor, observed during complex movements, is not significantly improved by levodopa medication and worsens with severe akinesia in Parkinson's disease patients.

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Area of Science:

  • Neurology
  • Movement Disorders
  • Biomedical Engineering

Background:

  • Parkinsonian action tremor is hypothesized to differ from resting tremor and impact fine motor skills in Parkinson's disease.
  • Understanding the characteristics of action tremor is crucial for managing Parkinson's disease symptoms and improving patient quality of life.

Purpose of the Study:

  • To investigate the distinct characteristics of Parkinsonian action tremor during pinch grip tasks.
  • To compare action tremor in Parkinson's disease patients with healthy controls.
  • To assess the effect of levodopa medication on action tremor.

Main Methods:

  • Analyzed pinch grip coordination in 20 Parkinson's disease patients and 18 healthy controls.
  • Used force sensors to record finger forces during object grasping, lifting, and holding.

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  • Performed spectral analysis of force traces and measured movement transition times.
  • Main Results:

    • Parkinsonian tremor (3.5-6.5 Hz) was present in 65% of patients, reduced by levodopa.
    • A distinct action tremor (6-15 Hz) was found in 30% of patients (50% with added weight), unaffected by levodopa.
    • This action tremor correlated with movement difficulties in severely akinetic patients.

    Conclusions:

    • Parkinsonian action tremor during voluntary movements is distinct from resting tremor.
    • Action tremor shows limited response to levodopa and significantly impairs dexterity in patients with severe akinesia.