EMG Tremor Analysis Of Parkinson’s And Essential Tremor

Background: There is still no effective and reliable method to distinguish essential tremor and Parkinson’s tremor, most relying on clinical features 。The typical Parkinson’s tremor is resting tremor with 4~7Hz, but it will disappear with autonomous movement. The core characteristics of essential patients is 4-12 Hz kinetic tremor and postural tremor. The tremor on arms will be weaken or disappear when the patient is walking. This is a representative mixture tremor of kinetic and postural tremor. The Parkinson tremor has a lot of similarities with t he essential tremor, it is difficult to distinguish in the early disease. In recent years, an examination for tremor patients- tremor analysis, receives wide attention from scholars at home and abroad. This examination mainly combines surface EMG with acceleration technology, in order to get the data of tremor frequency, amplitude and the EMG burst mode, to help the differential diagnosis of Parkinson’s and essential tremor. The advantage of EMG is that loading the measurement settings is not required, and the measurement is easy.Objective: The aim of this study was to compare the similarities and differences between the Parkinson and essential tremor, to explore the clinical similarities and differences with the data of frequency/ amplitude/ EMG burst mode from the tremor EMG analysis.Methods: Collect the patients examined in the first hospital of Ji Ling University from June 2015 to January 2016. a total of 24 Parkinson’s tremor cases were selected, including 19 male patients, 5 female patients, aging from 42-84 years old; a total of 13 essential tremor patients were selected, including 2 male patients, 11 female patients, aging from 24 to 77 years old. The Danish Keypoint electromyography and the accelerator were used to collect the Neurophysiological parameters of Resting tremor and postural tremor from the Parkinson’s and essential tremor patients. The Neurophysiological parameters included average frequency, peak frequency, amplitude and EMG burst mode. The aim of the comparison among the neurophysiological parameters was to find whether there was a statistical difference.Result1. The average frequency of resting tremor was slightly lower than that of the postural tremor in PD patients, which was(5.21 + 1.11) Hz and(6.18 + 1.28) Hz, with statistical difference(Z =-2.861, P = 0.004, P < 0.01);2. The average frequency of resting tremor was higher than that of the postural tremor in ET patients, which was(7.01 + 1.77) Hz and(6.03 + 1.26) Hz, with statistical difference(Z =-2.273, P = 0.023, P > 0.01);3. There was no significant difference between the mean frequency and peak frequency of the PD and ET patients with resting tremor or postural tremor.4. There was no linear correlation between the mean frequency and the amplitude of PD patients and ET patients.5. There was no significant difference between the amplitude of PD patients and ET patients;6. EMG burst mode: The EMG burst mode of PD patients and ET patients include synchronous and alternate burst mode.Conclusions1. The average frequency of resting tremor was less than that of postural tremor in patients with Parkinson. The average frequency of resting tremor was greater than that of postural tremor in essential tremor. This conclusion can be used to differentiate these two diseases.2. There was no correlation between the average frequency and amplitude of PD and ET patients. There was a Statistical difference between the amplitude of resting tremor and postural tremor in PD patients. There was no statistical difference between the amplitude of resting tremor and postural tremor in patients with ET. There was no significant difference between the amplitude of PD and ET patients. So the amplitude cannot be used to distinguish these two diseases.3. The EMG burst mode of tremor: the EMG burst mode of PD patients and ET patients both have synchronous and alternate burst mode. The EMG burst mode was unable to distinguish these two diseases temporarily.EMG tremor analysis was based on the electrophysiological characteristics, with a sensitivity and objectivity. Compared with some tremor scales, the advantage of it was to exclude the impact of subjective factors. EMG tremor analysis would play a greater role of tremor disease mechanism research and differential diagnosis in the future.