Tremor amplitude is logarithmically related to 4-and 5-point tremor rating scales
Tremor amplitude is logarithmically related to 4-and 5-point tremor rating scales
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DOI：
10.1093/brain/awl190
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发表时间：
2006-10-01
期刊：
影响因子：
14.5
通讯作者：
Tintner, Ron
中科院分区：
文献类型：
--
作者：
Elble, Rodger J.;Pullman, Seth L.;Tintner, Ron
震颤评定量表(TRSS)是临床上常用的震颤评估方法，但TRS与实际震颤幅度的关系从未被量化过。因此，这些量表的分辨率是未知的，TRS中1点变化的临床意义也是不确定的。因此，我们试图确定震颤幅度的变化，对应于典型的5点TRS中1点的变化。分析了来自五个实验室的数据，研究了928例不同类型的手部震颤患者。使用三个不同实验室的图形输入板、三个实验室的加速计和一个实验室的机械联动装置来量化手部颤动。书写、画图、水平姿势、休息和指鼻测试中的震颤使用各种TRSS进行分级。计算每个任务和实验室的TRS评分和震颤幅度之间的关系。尽管评级标准和传感器方法差异很大，但在所有五个实验室中都发现了5点(0-4)TRS与震颤幅度(T，以厘米为单位测量)之间的对数关系。因此，T-2/T-1=10(α(TRS2-TRS1))。α值范围为：书写为0.414~0.441，螺旋形图为0.355~0.574，静止性震颤为0.441~0.488，姿势震颤为0.266~0.577，指鼻测试为0.306。对于α=0.501、0.4、0.5、0.6和0.7时，TRS下降1个点的比率T-2/T-1为0.501、0.398、0.316、0.251和0.200。因此，TRS的1个点的变化代表着震颤幅度的实质性变化。了解TRS与震颤的精确测量之间的关系有助于解释疾病或治疗引起的TRS变化的临床意义。
Tremor rating scales (TRSs) are used commonly in the clinical assessment of tremor, but the relationship of a TRS to actual tremor amplitude has never been quantified. Consequently, the resolution of these scales is unknown, and the clinical significance of a 1-point change in TRS is uncertain. We therefore sought to determine the change in tremor amplitude that corresponds to a 1-point change in a typical 5-point TRS. Data from five laboratories were analysed, and 928 patients with various types of hand tremor were studied. Hand tremor was quantified with a graphics tablet in three different labs, an accelerometer in three labs and a mechanical-linkage device in one lab. Tremor in writing, drawing, horizontal posture, rest and finger-nose testing was graded using a variety of TRSs. The relationship between TRS scores and tremor amplitude was computed for each task and laboratory. A logarithmic relationship between a 5-point (0-4) TRS and tremor amplitude (T, measured in centimetres) was found in all five labs, despite widely varying rating scales and transducer methodology. Thus, T-2/T-1 = 10(alpha(TRS2-TRS1)). The value of alpha ranged from 0.414 to 0.441 for writing, 0.355-0.574 for spiral drawing, 0.441 to 0.488 for rest tremor, 0.266-0.577 for postural tremor and 0.306 for finger-nose testing. For alpha = 0.3, 0.4, 0.5, 0.6 and 0.7, the ratios T-2/T-1 for a 1-point decrease in TRS are 0.501, 0.398, 0.316, 0.251 and 0.200. Therefore, a 1-point change in TRS represents a substantial change in tremor amplitude. Knowledge of the relationship between TRS and precise measures of tremor is useful in interpreting the clinical significance of changes in TRS produced by disease or therapy.