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Dual task interference in psychogenic tremor

Authors

  • Hatice Kumru MD,

    Corresponding author
    1. Institute Guttmann, Badalona, Barcelona, Spain
    2. Unitat d'EMG, Servei de Neurologia, Hospital Clinic, Centro de Investigación Biomédica August Pi i Sunyer (IDIBAPS), Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain
    • Hospital de Neurorehabilitación Instituto Guttmann, Camí de Can Rutí s/n, 08916 Badalona (Barcelona), Spain
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  • Maaike Begeman MD,

    1. Unitat d'EMG, Servei de Neurologia, Hospital Clinic, Centro de Investigación Biomédica August Pi i Sunyer (IDIBAPS), Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain
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  • Eduardo Tolosa MD,

    1. Unitat d'EMG, Servei de Neurologia, Hospital Clinic, Centro de Investigación Biomédica August Pi i Sunyer (IDIBAPS), Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain
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  • Josep Valls-Sole MD

    1. Unitat d'EMG, Servei de Neurologia, Hospital Clinic, Centro de Investigación Biomédica August Pi i Sunyer (IDIBAPS), Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain
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Abstract

Psychogenic tremor (PT) is visually indistinguishable from voluntarily mimicked tremor. Healthy volunteers have difficulties with carrying out simultaneously two tasks due to the phenomenon known as dual task interference. Therefore, performing voluntary rhythmic movements would be a burden for carrying out fast ballistic movements with the contralateral hand. We hypothesized that, similarly to healthy volunteers performing rhythmic movements, patients with PT should show the effects of dual task interference, and this may distinguish them from patients with other types of tremor. We studied 6 patients with PT, 9 with Parkinson's disease (PD) and predominantly unilateral tremor, 11 with essential tremor (ET), and 10 normal volunteers (NV) mimicking tremor. They were requested to perform a unilateral simple reaction time task (SRT) to a visual imperative signal in two different conditions: at rest (rSRT) and during contralateral hand tremor (tSRT). Reaction time was significantly longer in tSRT than in rSRT in PT and in NV groups (P < 0.01 for both groups). However, no significant differences were observed between rSRT and tSRT in PD and ET. The delay of unilateral tSRT with respect to rSRT suggests an effect of tremorlike oscillatory movements on reaction time that is consistent with the concept of dual-task interference in NV or PT patients but not in PD or ET. These observations may be useful in the evaluation of psychogenic movement disorders. © 2007 Movement Disorder Society

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