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Updated: Jan 20, 2026

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Re-emergent tremor provocation.

Miguel Wilken1, Malco Rossi2, Alberto D Rivero3

  • 1Movement Disorders, Neurology Department, FLENI, Montañeses 2325, C1428AQK, Buenos Aires, Argentina; Clinical Neurophysiology, Neurology Department, FLENI, Montañeses 2325, C1428AQK, Buenos Aires, Argentina.

Parkinsonism & Related Disorders
|September 1, 2019
PubMed
Summary
This summary is machine-generated.

Provoking tremors in Parkinson's disease (PD) significantly reduces rest and re-emergent tremor (RET) duration and variability. This method enhances tremor amplitude but may obscure the pause preceding RET, impacting clinical assessment.

Keywords:
DistractionNeurophysiologyParkinson's diseaseParkinsonian tremorProvocationRe-emergent tremor

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Area of Science:

  • Neurology
  • Movement Disorders
  • Parkinson's Disease Research

Background:

  • Rest and re-emergent tremor (RET) in Parkinson's disease (PD) exhibit significant variability.
  • Understanding factors influencing RET is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the impact of tremor provocation on the latency and variability of RET in PD patients.
  • To quantify changes in RET characteristics under provoked conditions.

Main Methods:

  • A prospective observational study involving 21 PD patients with RET.
  • Accelerometric analysis of hand movements during both resting and provoked (mental arithmetic) states.
  • Measurement of RET pause duration, tremor power, RMS, and slope of return, alongside inter- and intra-subject variability.

Main Results:

  • Tremor provocation decreased RET pause duration by 75% (p < 0.001), with 52% of cases showing no pause.
  • Provocation increased tremor power (2.57x, p < 0.001), RMS (1.37x, p < 0.001), and slope of return (2.47x, p < 0.001).
  • A significant reduction in inter-subject variability of RET was observed (p = 0.001).

Conclusions:

  • Tremor provocation increases RET amplitude and decreases pause duration and variability.
  • While useful for evaluating rest tremor, provocation may hinder the identification of the pre-re-emergent tremor pause.