What is the functional significance of nondominant arm tremor in essential tremor?

Authors

  • Elan D. Louis MD, MSc,

    Corresponding author
    1. GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    3. Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    4. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
    • Unit 198, Neurological Institute, 710 West 168th Street, New York, NY, 10032, USA

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  • Marina Gerbin MPH,

    1. GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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  • Mary M. Mullaney MS

    1. GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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  • Potential conflict of interest: The authors report no conflicts of interest.

Abstract

Tremor in the dominant arm is often the focus of clinical attention in essential tremor (ET) yet many daily activities require both arms. The functional relevance of nondominant arm tremor has rarely been studied. In 181 right-handed patients with ET, action tremor in each arm was rated using a clinical rating scale. Tremor disability was self-reported and a performance-based test of function was administered. Independently of tremor on the right, greater tremor severity on the left was associated with greater self-reported disability (P = 0.02) and greater performance-based dysfunction (P < 0.001). In 5.0% of patients, tremor was largely restricted to the nondominant arm. Nondominant arm tremor, independent of dominant arm tremor, had a significant functional correlate, contributing to both greater perceived and greater observable functional difficulty. In 5% of patients, tremor in the nondominant arm was the likely motivator for seeking care, which is another indication of its functional significance. © 2010 Movement Disorder Society.

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