Objective: Our main aims were to 1) increase diagnostic accuracy and 2) reduce the time needed to reach the correct diagnosis in three disorders with tremor using an novel comprehensive objective quantification tool assessing motor symptoms.

Background: Clinical experience and studies show that the differential diagnosis of disorders presenting with tremor is challenging even for neurologists (1). This leads to delayed diagnoses for patients with tremor disorders, including Parkinson’s disease (PD, 2), essential tremor (ET), and functional tremor. Some patients with PD and ET present with an additional functional component, adding more complexity to reaching the correct diagnosis. Thus, there is a clear unmet need to facilitate differential diagnosis in tremor disorders.

Method: We investigated the use of an automated motor assessment device, which is fast and easy to apply, in the differential diagnosis of tremor in three distinct neurological diseases. To this aim we include 100 patients with a clinical diagnosis of PD, ET, and functional tremor. The diagnoses were reached clinically by experienced Movement Disorder specialists, in some instances DaTSCAN was additionally performed. Some ET and PD patients showed a functional component. We applied simple established motor tasks using a tablet and a multi-sensor digital pen to analyse rest tremor, action tremor, and postural tremor characteristics, including the entrainment test, and hypokinesia.  Data analysis is performed using complex signal processing algorithms extracting very high resolution information on tremor amplitude and frequency properties, allowing analysis of tremor invisible to the naked eye.

Results: We present results on the diagnostic accuracy reached by application of the motor symptoms measurement device and the most striking differences between the three tremor diseases unmasked by the tool’s complex analytical engine. The study is ongoing, results of the first 50 patients included are presented.

Conclusion: Our data strongly suggests that simple motor tasks performed by patients using an the assessment tool can offer strong support for clinicians, including primary care physicians, in differentiating tremor diseases. Using the tool, we expect the time to diagnosis to decrease drastically and the diagnostic accuracy to increase substantially.

References: 1) Amlang CJ, Diaz DT, Louis ED. Essential Tremor as a “Waste Basket” Diagnosis: Diagnosing Essential Tremor Remains a Challenge. Front Neurol 2020; 25;11: 172.

2) Rossi M, Perez-Lloret S, Merello M. How much time is needed in clinical practice to reach a diagnosis of clinically established Parkinson’s disease? Parkinsonism & Related Disorders 2021; 92: 53-8.

« Back to 2025 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/distinguishing-functional-and-essential-tremor-from-tremor-in-parkinsons-disease-using-an-objective-comprehensive-motor-symptom-assessment-device/