Evidence map›Paper›PMID 40956636›Full record

ArticleMovement disorders clinical practice2026

Contralateral Spread of Asymmetrical Tremor in Parkinson's Disease.

Jacopo Pasquini, Nicola Pavese, Roberto Ceravolo, Rick C Helmich, Günther Deuschl

Abstract read
In one paragraph

Article in Movement disorders clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jacopo PasquiniDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.ORCID https://orcid.org/0000-0003-1856-2995
Nicola PaveseTranslational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0002-6801-6194
Roberto CeravoloDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.ORCID https://orcid.org/0000-0003-1412-9406
Rick C HelmichDonders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.ORCID https://orcid.org/0000-0003-4035-6573
Günther DeuschlDepartment of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel Campus, and Christian-Albrechts-University, Kiel, Germany.ORCID https://orcid.org/0000-0002-4176-9196

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundParkinsonian tremor usually starts asymmetrically. The mid-term prognosis of this lateralized tremor is unknown, as is the development of tremor in the contralateral arm.

objectiveTo investigate the occurrence of contralateral tremor in the Parkinson's Progression Marker Initiative database, with data available for 7 years.

methodsTremor requiring treatment (TRT) was defined as any rest, postural or kinetic tremor with amplitude >1 cm (MDS-UPDRS score ≥2) as this criterion is commonly accepted as an insufficiently treated tremor. Tremor was analyzed by side mainly in the off-medication state.

resultsAt baseline, 348 (87.7%) of the 397 patients with Parkinson's disease had tremor at least on one side of the body. 183 (46%) had only mild tremors but 165 (41.6%) had TRT. 159 patients (40.1%) had lateralized TRT and six (1.6%) had bilateral TRT. Among patients with asymmetrical TRT, 40 patients (25.2%) developed contralateral TRT at 3 years, 49 patients (30.8%) at 5 years, and 61 patients (38.4%) at 7 years. The side more affected by tremor was also more affected by other cardinal signs. In 159 patients with initially asymmetrical TRT, tremor severity did not increase on the more tremulous side over the 7-year period. However, there was an increase in tremor on the contralateral side. This was associated with a clear increase in bradykinesia and rigidity on both sides.

conclusionThe study findings may prove beneficial in counseling patients with TRT, and may also provide an explanation as to why the worsening of tremor is not correlated with overall disease progression.

Indexed as

Functional LateralityParkinson DiseaseTremorAgedDisease ProgressionFemaleHumansMaleMiddle AgedSeverity of Illness Indexclinical assessmentdisease progressionlaterality of tremorParkinson's diseasetremor

Identifiers

PMID40956636
PMCPMC13042382

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