A new diagnostic test to distinguish tremulous Parkinson's disease from advanced essential tremor

Muthuraman Muthuraman, Abdulnasir Hossen, Ulrich Heute, Günther Deuschl, Jan Raethjen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

51 Citations (Scopus)


Background: Clinical distinction between advanced essential tremor and tremulous Parkinson's disease can be difficult. Methods: In selected power spectra of accelerometric postural tremor recordings on the more affected side of 41 patients with essential tremor and 39 patients with tremulous Parkinson's disease being indistinguishable by tremor frequency, peak power or number of harmonic peaks, waveform asymmetry (autocorrelation decay), and mean peak power of all harmonic peaks were computed. Cutoff for essential tremor-Parkinson's disease distinction was determined by receiver operating characteristics. Diagnostic yield was tested in 12 clinically unclear patients with monosymptomatic tremor, subsequently definitively diagnosed with essential tremor (n = 2) or Parkinson's disease (n = 10) by 123-I FP-CIT-single-photon emission computed tomography, fluorodopa-positron emission tomography, or clinical course. Results: By autocorrelation decay 64%, by mean harmonic peak power 94% (Parkinson's disease > essential tremor) of patients with a definite clinical diagnosis, and 11 of 12 clinically unclear patients were classified correctly. Conclusions: Mean harmonic power is a useful measure to separate clinically difficult cases of advanced essential tremor from tremulous Parkinson's disease.

Original languageEnglish
Pages (from-to)1548-1552
Number of pages5
JournalMovement Disorders
Issue number8
Publication statusPublished - Jul 2011


  • Accelerometry
  • Differential diagnosis
  • Essential tremor
  • Parkinsonian tremor

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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