Objective: To establish whether isolated hand fingers tremor (IFT) is more frequent in Pakinson’s (PD) disease than in essential tremor (ET).

Background: Postural tremor may be present in both ET and PD. Detailed tremor characterization may be of help in differentiating ET and PD, for example, unilateral tremor, re-emergent tremor, alternating agonist/antagonist pattern and the presence of a pronation/supination component, may prone us to diagnose PD.

Methods: We defined IFT as unequivocal pseudo-rhythmic displacement of one or more fingers in the horizontal plane, in the position of hands stretched forward. 55 consecutive patients and 17 controls were recruited from a Movement Disorders Unit of a tertiary Hospital. Patients were diagnosed by experimented movement disorders specialists, according to the standard diagnostic criteria, in 34 PD and 17 ET, 4 patients were not finally included. All subjects were videofilmed and the videotapes were analyzed by 2 independent specialist in a blinded fashion.

Results: Mean age was 75.2 years (64-89) for controls, 74 years (49-92) for PD and 76,6 years (60-85) for ET. The disease duration was 0.5-16 years for PD and 4-50 years for ET. There was a slight predominance of females in the 3 groups. After examination of videotapes segments, subjects were divided in IFT + if they have isolated hand fingres tremor as defined, or IFT – if not. IFT was present in 20 PD patients, 4 ET patients and 1 control. The sensitivity of IFT+ for PD diagnosis was 59% and specificity was 76%. Positive predictive value = 83% and Odss Ratio=4.64 IC 95% (1.24-17.23).

Conclusions: IFT can assist in differential diagnosis between PD and ET.

This study was previously presented in Spanish Neurology Society meeting in novemeber 2015.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/isolated-finger-tremor-in-parkinsons-disease-and-essential-tremor/