Objective: As most functional tremor battery tests rely on accelerometric data, we aimed to evaluate the diagnostic sensitivity of a shortened, accelerometry-only version of the functional tremor battery.

Background: Electrophysiologically supported identification of positive signs is important in confirming the diagnosis of functional tremor. In this respect, the functional tremor battery proposed by Schwingenschuh et al. is a valuable diagnostic tool but requires surface electromyography, specialized equipment and expertise, limiting its routine clinical use. As most tests within the battery rely primarily on accelerometric data, a shortened accelerometry-only version may provide a more accessible alternative for clinical use.

Method: Thirty patients with clinically diagnosed functional tremor were included. All patients underwent the full functional tremor battery (maximum score 10 points). A proposed cutoff score of ≥3 points was used as a standard to ensure a homogeneous cohort. Among patients meeting this cutoff, we examined whether the cutoff would still be met after excluding surface electromyography–based tests (coactivation sign and tremor coherence). Subsequently, the weight loading test was also excluded to evaluate its redundancy in the overall diagnostic sensitivity of the shortened test battery.

Results: Twenty-four of 30 patients (80%) scored ≥3 points on the full battery and were included in further analyses. After exclusion of surface electromyography-based tests, all 24 patients (100%) continued to score ≥3 points. Following additional exclusion of the weight loading test, 23 of 24 patients (95.8%) still met the cutoff.

Conclusion: A shortened accelerometry-based functional tremor battery demonstrates diagnostic sensitivity comparable to the full battery that includes surface electromyography. This simplified approach reduces technical demands, examination time, and required expertise, potentially enabling wider clinical implementation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diagnostic-sensitivity-of-a-shortened-accelerometry-based-functional-tremor-battery/