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Abstract Details

Quantitative motion analysis and clinical characteristics of Holmes tremor as compared to other tremor types
Movement Disorders
S32 - Movement Disorders: Dystonia and Tremor Disorders (4:54 PM-5:06 PM)
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HT is a rare complex, irregular tremor consisting of rest, postural, and action components. This typically arises from neurologic insult to the brainstem, thalamus, or cerebellum.

To assess whether 3D motion capture data can differentiate Holmes tremor (HT) from more common tremors.

We performed a cross-sectional study of N=436 patients assessed with quantitative motion capture between 2014 and 2020 (N=436). Patients with HT (N=11), Parkinson’s disease (PD), and essential tremor (ET) were identified. After aggregating data for analysis and excluding cases with incomplete kinematic data, N=193 patients (N=10 Holmes, N=110 PD, N=73 ET) were available.

Standard ~1-hour full body motion capture session protocols generated data including peak tremor amplitude (TA), tremor frequency (TF), and tremor constancy (TC) during rest, posture, or action.  ANOVA analyses assessed differences across HT, PD, and ET.

HT patients were predominantly female (63.6%) with an average age of 60 ± 11 y.  Comparison patients were closely matched on sex (P=0.99) and age (P=0.66).

Among HT patients, most tremor occurred at rest (40%), followed by action (36%) and postural tasks (24%). Both PD and ET patients trended towards more postural and less action tremor (41% and 18%, respectively, P=0.07). Among HT patients, average TF was 3.2 ± 0.9 Hz, average TA was 62 ± 37 mm, and average TC was 66 ± 23 %. ANOVAs identified significant differences across groups in TA (P<0.001) and TF (P<0.001). Both PD and ET exhibited smaller TAs (11 ± 18 mm, PD; 16 ± 13 mm, ET), and faster TFs (3.3 ± 1.3 Hz, PD; 4.2 ± 1.1 Hz, ET).

Quantitative description of tremor characteristics may be useful in the differential diagnosis and management of tremor disorders including HT.

Authors/Disclosures
Sally Iwamoto
PRESENTER
Dr. Williams has nothing to disclose.
Johnathan McKay (Emory University) Dr. McKay has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biocircuit Technologies. The institution of Dr. McKay has received research support from NIH. The institution of Dr. McKay has received research support from the McCamish Foundation.
No disclosure on file
No disclosure on file
Anh-Thu Vu (Drexel University College of Medicine) Dr. Vu has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Tucker Law Group, P.A..
Richa Tripathi (Emory University) Dr. Tripathi has nothing to disclose.
Stewart Factor (Emory University School of Medicine) Dr. Factor has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Factor has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Factor has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. The institution of Dr. Factor has received research support from Biohaven. The institution of Dr. Factor has received research support from Voyager. The institution of Dr. Factor has received research support from Neurocrine. The institution of Dr. Factor has received research support from Supernus. The institution of Dr. Factor has received research support from Prelinia. The institution of Dr. Factor has received research support from Medtronics. The institution of Dr. Factor has received research support from Boston Scientific. The institution of Dr. Factor has received research support from Sun Pharmaceuticals Advanced Research Company. The institution of Dr. Factor has received research support from Aspen. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care.
Christine Esper (Emory Brain Health Center) Dr. Esper has received research support from Centers for Disease Control and Prevention. Dr. Esper has received publishing royalties from a publication relating to health care.