Linear and nonlinear tremor acceleration characteristics in patients with Parkinson's disease

The purpose of the study was to evaluate linear and nonlinear tremor characteristics of the hand in patients with Parkinson's disease (PD) and to compare the results with those of healthy old and young control subjects. Furthermore, the aim was to study correlation between tremor characteristics and clinical signs. A variety of nonlinear (sample entropy, cross-sample entropy, recurrence rate, determinism and correlation dimension) and linear (amplitude, spectral peak frequency and total power, and coherence) hand tremor parameters were computed from acceleration measurements for PD patients (n = 30, 68.3 ± 7.8 years), and old (n = 20, 64.2 ± 7.0 years) and young (n = 20, 18.4 ± 1.1 years) control subjects. Nonlinear tremor parameters such as determinism, sample entropy and cross-sample entropy were significantly different between the PD patients and healthy controls. These parameters correlated with the Unified Parkinson's disease rating scale (UPDRS), tremor and finger tapping scores, but not with the rigidity scores. Linear tremor parameters such as the amplitude and the maximum power (power corresponding to peak frequency) also correlated with the clinical findings. No major difference was detected in the tremor characteristics between old and young control subjects. The study revealed that tremor in PD patients is more deterministic and regular when compared to old or young healthy controls. The nonlinear tremor parameters can differentiate patients with PD from healthy control subjects and these parameters may have potential in the assessment of the severity of PD (UPDRS).