Related Experiment Video
Updated: Aug 14, 2026
Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Measuring psychomotor agitation via hand tremor in remitted major depressive disorder
Megan E McFarland1, Stewart A Shankman2, James E Glazer3
1Stephen M. Stahl Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA; Department of Psychology, University of Miami, Coral Gables, FL, USA.
Abstract:
Psychomotor agitation (PmA), a common yet understudied symptom in Major Depressive Disorder (MDD), is characterized by heightened motor activity such as restlessness and fidgeting. PmA, like other symptoms of MDD, may persist into remission. This study examined the role of PmA in remitted MDD by using a novel smartphone based physiological measure of tremor. Participants (N = 157) consisted of healthy controls (N = 76) and those with remitted MDD (N = 81, to reduce the impact of current MDD symptoms on PmA), and tremor was assessed under the manipulation of position (palm-up, arm extended) and cognitive load (no cognitive load, cognitive load). Individuals with remitted-MDD exhibited a distinct pattern from HCs: specifically, greater tremor under high cognitive load compared to no cognitive load, while HCs showed lower tremor under cognitive load compared to no cognitive load. These findings suggest that tremor is sensitive to cognitive demands, and that tremor may provide an objective, physiological marker of PmA in remitted MDD. More generally, our results highlight the importance of using instrumental measures to assess PmA.
Insights
Psychomotor agitation (PmA) in remitted Major Depressive Disorder (MDD) patients shows distinct tremor patterns. Smartphone-based tremor measurement reveals PmA is sensitive to cognitive load, offering an objective biomarker.
Area of Science:
- Neuroscience
- Psychiatry
- Biomedical Engineering
Background:
- Psychomotor agitation (PmA) is a common symptom in Major Depressive Disorder (MDD) that can persist even after remission.
- Objective measurement of PmA is challenging, limiting understanding and treatment of this persistent symptom.
Purpose of the Study:
- To investigate the physiological characteristics of PmA in individuals with remitted MDD.
- To explore the utility of a novel smartphone-based tremor measurement for assessing PmA.
Main Methods:
- A cohort of 157 participants (76 healthy controls, 81 remitted MDD) was recruited.
- Tremor was objectively measured using a smartphone application under varying arm positions and cognitive load conditions.
- Tremor patterns were compared between remitted MDD patients and healthy controls.
Main Results:
- Remitted MDD individuals exhibited significantly greater tremor under high cognitive load compared to no cognitive load.
- Healthy controls showed reduced tremor under cognitive load compared to no cognitive load.
- Tremor sensitivity to cognitive demands differed between remitted MDD patients and healthy controls.
Conclusions:
- Tremor is a sensitive physiological marker of psychomotor agitation in remitted Major Depressive Disorder.
- Cognitive load influences tremor patterns differently in remitted MDD patients versus healthy individuals.
- Smartphone-based tremor assessment offers a promising objective method for evaluating PmA in clinical settings.
