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Bayesian Interpretation of Essential Tremor Plus

Essential tremor (ET) plus is a new tremor classification that was introduced in 2018 by a task force of the International Parkinson and Movement Disorder Society. Patients with ET plus meet the criteria for ET but have one or more additional systemic or neurologic signs of uncertain significance or...

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Autor principal: Elble, Rodger J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurological Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926770/
https://www.ncbi.nlm.nih.gov/pubmed/35274833
http://dx.doi.org/10.3988/jcn.2022.18.2.127
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author Elble, Rodger J.
author_facet Elble, Rodger J.
author_sort Elble, Rodger J.
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description Essential tremor (ET) plus is a new tremor classification that was introduced in 2018 by a task force of the International Parkinson and Movement Disorder Society. Patients with ET plus meet the criteria for ET but have one or more additional systemic or neurologic signs of uncertain significance or relevance to tremor (“soft signs”). Soft signs are not sufficient to diagnose another tremor syndrome or movement disorder, and soft signs in ET plus are known to have poor interrater reliability and low diagnostic sensitivity and specificity. Therefore, the clinical significance of ET plus must be interpreted probabilistically when judging whether a patient is more likely to have ET or a combined tremor syndrome, such as dystonic tremor. Such a probabilistic interpretation is possible with Bayesian analysis. This review presents a Bayesian analysis of ET plus in patients suspected of having ET versus a dystonic tremor syndrome, which is the most common differential diagnosis in patients referred for ET. Bayesian analysis of soft signs provides an estimate of the probability that a patient with possible ET is more likely to have an alternative diagnosis. ET plus is a distinct tremor classification and should not be viewed as a subtype of ET. ET plus covers a more-comprehensive phenotyping of people with possible ET, and the clinical interpretation of ET plus is enhanced with Bayesian analysis of associated soft signs.
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spelling pubmed-89267702022-03-24 Bayesian Interpretation of Essential Tremor Plus Elble, Rodger J. J Clin Neurol Review Essential tremor (ET) plus is a new tremor classification that was introduced in 2018 by a task force of the International Parkinson and Movement Disorder Society. Patients with ET plus meet the criteria for ET but have one or more additional systemic or neurologic signs of uncertain significance or relevance to tremor (“soft signs”). Soft signs are not sufficient to diagnose another tremor syndrome or movement disorder, and soft signs in ET plus are known to have poor interrater reliability and low diagnostic sensitivity and specificity. Therefore, the clinical significance of ET plus must be interpreted probabilistically when judging whether a patient is more likely to have ET or a combined tremor syndrome, such as dystonic tremor. Such a probabilistic interpretation is possible with Bayesian analysis. This review presents a Bayesian analysis of ET plus in patients suspected of having ET versus a dystonic tremor syndrome, which is the most common differential diagnosis in patients referred for ET. Bayesian analysis of soft signs provides an estimate of the probability that a patient with possible ET is more likely to have an alternative diagnosis. ET plus is a distinct tremor classification and should not be viewed as a subtype of ET. ET plus covers a more-comprehensive phenotyping of people with possible ET, and the clinical interpretation of ET plus is enhanced with Bayesian analysis of associated soft signs. Korean Neurological Association 2022-03 2022-02-25 /pmc/articles/PMC8926770/ /pubmed/35274833 http://dx.doi.org/10.3988/jcn.2022.18.2.127 Text en Copyright © 2022 Korean Neurological Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Elble, Rodger J.
Bayesian Interpretation of Essential Tremor Plus
title Bayesian Interpretation of Essential Tremor Plus
title_full Bayesian Interpretation of Essential Tremor Plus
title_fullStr Bayesian Interpretation of Essential Tremor Plus
title_full_unstemmed Bayesian Interpretation of Essential Tremor Plus
title_short Bayesian Interpretation of Essential Tremor Plus
title_sort bayesian interpretation of essential tremor plus
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926770/
https://www.ncbi.nlm.nih.gov/pubmed/35274833
http://dx.doi.org/10.3988/jcn.2022.18.2.127
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