Distal Upper Limb Tremor during Walking in Parkinson's Disease

Matteo Costanzo; Carolina Cutrona; Giorgio Leodori; Maria Ilenia De Bartolo; Andrea Fabbrini; Giorgio Vivacqua; Antonella Conte; Giovanni Fabbrini; Alfredo Berardelli; Daniele Belvisi

doi:10.1002/mdc3.13814

Distal Upper Limb Tremor during Walking in Parkinson's Disease

Mov Disord Clin Pract. 2023 Jun 22;10(8):1198-1202. doi: 10.1002/mdc3.13814. eCollection 2023 Aug.

Authors

Matteo Costanzo¹, Carolina Cutrona¹, Giorgio Leodori^{1

2}, Maria Ilenia De Bartolo¹, Andrea Fabbrini², Giorgio Vivacqua^{3

4}, Antonella Conte^{1

2}, Giovanni Fabbrini^{1

2}, Alfredo Berardelli^{1

2}, Daniele Belvisi^{1

2}

Affiliations

¹ IRCCS Neuromed Pozzilli Italy.
² Department of Human Neurosciences Sapienza University of Rome Rome Italy.
³ Department of Experimental Morphology and Microscopy - Integrated Research Center (PRAAB) - Campus Biomedico University of Rome Rome Italy.
⁴ Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences Sapienza University of Rome Rome Italy.

Abstract

Background: Distal upper limb tremor during walking (TW) is frequently observed in Parkinson's disease (PD) but its clinical features are unknown.

Objective: To characterize the occurrence and the clinical features of TW in comparison to the other types of tremors in PD.

Methods: Fifty-one PD patients with rest tremor were evaluated off- and on-treatment. Occurrence, body distribution, severity and latency of TW and of other tremor types were assessed.

Results: TW was present in 78% of the PD patients examined. TW body distribution and severity were similar to those of rest and re-emergent tremor but different from the postural tremor presented by the same patients. TW latency, observed in 85% of patients, was on average 5.8 s. Dopaminergic treatment significantly improved TW, rest, and re-emergent tremor severity but left TW latency unaffected.

Conclusions: TW is a frequent motor sign in PD and is likely a clinical variant of rest tremor.

Keywords: Parkinson's disease; gait; neurodegenerative disease; tremor; tremor during walking.