Background: Tremor occurs in approximately 70% of patients with Parkinson’s disease (PD) and occurs mostly at rest. Since it’s rarely present with action, the tremor doesn’t often result in much motor disability. The abnormalities in PD are typically asymmetric, with either their dominant or non-dominant hand being preferentially affected. Patients frequently report considerable psychosocial disability associated with the presence of tremor, which has received little attention in the research literature. Therefore, we wish to assess the psychological burden of rest tremor and to determine whether patient-reported disability of tremor was more prominent in patients whose tremor was present on their dominant side.
Methods: Cohort study of patients with PD, examining patient reporting of the severity of tremor and psychosocial impact, and physician objective measurement of tremor.
Study population will be derived from patients attending a tertiary specialist PD clinic at Galway University Hospital. 20-25 patients will be recruited to participate during the course of their routine clinical outpatient appointment. The study’s being submitted for consideration by the Galway University Hospital Ethics in clinical Research committee. Patients will be provided with a patient Information Sheet and asked to sign a written informed consent form.
Inclusion criteria includes patients with idiopathic PD with a Hoehn & Yahr disease rating scale score of < 3. Exclusion criteria includes patients with atypical Parkinsonism and comorbidity which affects motor limb function or causes significant cognitive impairment.
Assessments: Cerebral dominance assessed using the Edinburgh Handedness Questionnaire. Motor symptoms assessed using the MDS-UPDRS scale Part II and III. The primary outcome measure will be the comparison of patient-reported tremor severity (UPDRS-Part II) with motor examination of tremor (UPDRS Part III) among left and right hand dominant patients. Tremor severity also assessed using a commercially available inertial sensor. A quality of Life Questionnaire will be completed (PDQ-39).