Continuous in-home monitoring of essential tremor

• Published in: Parkinsonism & related disorders 2014-01, Vol.20 (1), p.37-40
• Main Authors: Pulliam, C.L, Eichenseer, S.R, Goetz, C.G, Waln, O, Hunter, C.B, Jankovic, J, Vaillancourt, D.E, Giuffrida, J.P, Heldman, D.A
• Format: Article
• Language: English
• Subjects: Accelerometer; Accelerometry - instrumentation; Accelerometry - methods; Aged; Aged, 80 and over; Ambulatory monitoring; Biomechanical Phenomena; Essential tremor; Essential Tremor - diagnosis; Feasibility Studies; Female; Gyroscope; Humans; Kinesia; Male; Middle Aged; Monitoring, Ambulatory - instrumentation; Monitoring, Ambulatory - methods; Neurology
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2013.09.009

Abstract Background Essential tremor (ET) is typically measured in the clinic with subjective tremor rating scales which require the presence of a clinician for scoring and are not appropriate for measuring severity throughout the day. Motion sensors can accurately rate tremor severity during a set of predefined tasks in a laboratory. Methods We evaluated the ability of motion sensors to quantify tremor during unconstrained activities at home. 20 ET subjects wore a wireless sensor continuously for up to 10 h daily on two days and completed hourly standardized tremor assessments involving pre-defined tasks. Mathematical models were used to predict tremor rating scores from the sensor data. Results At home tremor scores from hourly standardized assessments correlated with at home tremor scores estimated during unconstrained activities immediately following the standardized assessments. The hourly standardized assessments did not significantly fluctuate throughout the day, while fluctuations in the continuous assessments tended to follow changes in voluntary activity level. Both types of tremor ratings (standardized and continuous) showed high day-to-day test-retest reliability with intraclass correlation coefficients ranging from 0.67 to 0.90 for continuous ratings and 0.77 to 0.95 for standardized ratings. Conclusions Results demonstrate the feasibility of continuous monitoring of tremor severity at home, which should provide clinicians with a measure of the temporal pattern of tremor in the context of daily life and serve as a useful tool for the evaluation of novel anti-tremor medications in clinical trials.