Listen to your patient: A fiddler's tale

A professional violinist reported increasing difficulties playing the violin. He executed the initial half of the musical piece well, but produced an increasing number of mistakes during the second half. Neurological examination was remarkable for bradykinesia and tremor. Formal acoustic analysis of finger taps and pronation-supination showed a decrement in sound intensity and number of taps over time. Oscillations in performance correlated with a parkinsonian tremor. We interpret these findings as the audible equivalent of bradykinesia and tremor. Listening to bradykinesia and quantifying its decrement using acoustic analysis may offer a simple, objective, and reliable supplement to the neurological examination. Ann Neurol 2018;84:931-933.