{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:27:03Z","timestamp":1781260023050,"version":"3.54.1"},"reference-count":66,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Unilateral or very asymmetric upper limb tremors with a jerky appearance are poorly investigated. Their clinical classification is an unsolved problem because their classification as essential tremor versus dystonic tremor is uncertain. To avoid misclassification as essential tremor or premature classification as dystonic tremor, the term indeterminate tremor was suggested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to characterize this tremor subgroup electrophysiologically and evaluate whether diagnostically meaningful electrophysiological differences exist compared to patients with essential tremor and dystonic tremor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 29 healthy subjects and 64 patients with tremor: 26 with dystonic tremor, 23 with essential tremor, and 15 patients with upper limb tremor resembling essential tremor but was unusually asymmetric and jerky (indeterminate tremor). We investigated the somatosensory temporal discrimination threshold, the short\u2010interval intracortical inhibition, and the cortical plasticity by paired associative stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Somatosensory temporal discrimination threshold was significantly increased in patients with dystonic tremor and indeterminate tremor, but it was normal in the essential tremor patients and healthy controls. Significant differences in short\u2010interval intracortical inhibition and paired associative stimulation were not found among the three patient groups and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results indicate that indeterminate tremor, as defined in this study, shares electrophysiological similarities with dystonic tremor rather than essential tremor. Therefore, we propose that indeterminate tremor should be considered as a separate clinical entity from essential tremor and that it might be dystonic in nature. Somatosensory temporal discrimination appears to be a useful tool in tremor classification. \u00a9 2019 International Parkinson and Movement Disorder Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.27880","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T23:14:27Z","timestamp":1573686867000},"page":"306-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Temporal Discrimination is Altered in Patients With Isolated Asymmetric and Jerky Upper Limb Tremor"],"prefix":"10.1002","volume":"35","author":[{"given":"Felix","family":"G\u00f6vert","sequence":"first","affiliation":[{"name":"Department of Neurology University Hospital Schleswig\u2010Holstein, Christian\u2010Albrechts\u2010University  Kiel Germany"},{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos","family":"Becktepe","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Schleswig\u2010Holstein, Christian\u2010Albrechts\u2010University  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Balint","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"},{"name":"Department of Neurology University Hospital Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Rocchi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Brugger","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"},{"name":"Department of Neurology Kantonsspital St. Gallen  St. Gallen Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Garrido","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"},{"name":"Movement Disorders Unit, Neurology Service, Hospital Cl\u00ednic, Institut d'investigacions Biom\u00e8diques August Pi i Sunyer, Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Schleswig\u2010Holstein, Christian\u2010Albrechts\u2010University  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricci","family":"Hannah","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1367-6467","authenticated-orcid":false,"given":"John","family":"Rothwell","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodger","family":"Elble","sequence":"additional","affiliation":[{"name":"Department of Neurology Southern Illinois University School of Medicine  Springfield Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-9196","authenticated-orcid":false,"given":"G\u00fcnther","family":"Deuschl","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Schleswig\u2010Holstein, Christian\u2010Albrechts\u2010University  Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8185-286X","authenticated-orcid":false,"given":"Kailash","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences Queen Square Institute of Neurology, University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","first-page":"2","article-title":"Consensus statement of the Movement Disorder Society on tremor","volume":"13","author":"Deuschl G","year":"1998","journal-title":"Ad Hoc Scientific Committee. 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