![]() ![]() Nevertheless, the digitizing tablet is a robust method of quantifying tremor that can be used in lieu of or in combination with clinical ratings.Įssential tremor minimum detectable change rating scale spirography.The Fahn-Tolosa-Marin Clinical Rating Scale for Tremor (FTM) has been used in large trials for essential tremor (ET), but its anchors for ratings from 0 to 4 of upper limb tremor are probably too low for patients with severe tremor (tremor amplitude >4 cm grade 4). The minimum detectable change for the tablet and FTM were 51% and 67% of the initial assessment.ĭigitizing tablets are much more precise than clinical ratings, but this advantage is mitigated by the natural variability in tremor. ![]() Log 10 tremor amplitude ( T) and FTM were strongly correlated (log T=αFTM + β, α≈0.6, β≈-1.27, r=0.94). Test-retest intraclass correlations (ICCs) (two-way random single measures, absolute agreement) were excellent for the FTM ratings (ICC 0.90, 95% CI 0.76-0.96) and tablet (ICC 0.97, 95% CI 0.91-0.99). The mean peak-to-peak tremor displacement (cm) in the four spirals and mean FTM ratings were compared statistically. Tremor in each digitized drawing was computed with spectral analysis in an independent laboratory, blinded to the clinical ratings. The drawings were simultaneously digitized with a digitizing tablet. The large and small spirals of FTM were drawn with each hand on two consecutive days by 14 men and four women (age 60☘.7 years ) with mild to severe essential tremor. We performed the first blinded comparison of Fahn-Tolosa-Marín (FTM) ratings and tablet measures of essential tremor to determine if a digitizing tablet is better than 0-4 ratings in detecting changes in essential tremor that exceed random variability in tremor amplitude. Drawing Archimedes spirals is a popular and valid method of assessing action tremor in the upper limbs. ![]()
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