{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:29:26Z","timestamp":1787729366126,"version":"build-2784847793"},"reference-count":12,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,3,18]]},"published-print":{"date-parts":[[2014,4]]},"abstract":"\n Objective<\/jats:title>\n Few studies have attempted to estimate the rate of decline over time in essential tremor (ET). The study objectives were to: (1) measure change, deriving a single summary measure for the entire group, and relate it to a commonly used clinical rating scale (ie, yearly change in points on that scale); (2) to assess change as a function of baseline clinical characteristics and (3) to answer the basic clinical question\u2014is change perceptible\/obvious during the follow-up of ET cases?<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Prospective collection of longitudinal data on ET cases enrolled in a study of the environmental epidemiology of ET at Columbia University Medical Center (2000\u20132008).<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n 116 unselected ET cases.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Each case underwent the same evaluation at baseline and during one follow-up visit (mean follow-up interval (range)=5.8 (1.4\u201312.4) years).<\/jats:p>\n <\/jats:sec>\n \n Primary and secondary outcome measures<\/jats:title>\n We assessed tremor during a commonly affected daily activity\u2014drawing (ie, spirography), quantifying tremor using a simple, standardised 10-point rating scale developed by Bain and Findley.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The Bain and Findley spiral score increased at an average rate of 0.12\u00b10.23 points per year (maximum=1 point\/year). In cases who had been followed for \u22655\u2005years, the change was obvious\u2014a blinded neurologist was able to correctly order their spirals (baseline vs follow-up) in three-fourth of cases. The rate of change was higher in cases with versus without familial ET (p=0.01).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Tremor in ET is slowly progressive; yet in the majority of cases, a clear difference in handwritten spirals was visible with a follow-up interval of five or more years. There may be differences between familial and non-familial ET in the rate of progression. These clinical data are intended to aid in the prognostic discussions that treating physicians have with their patients with ET.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2013-004626","type":"journal-article","created":{"date-parts":[[2014,4,10]],"date-time":"2014-04-10T22:45:41Z","timestamp":1397169941000},"page":"e004626","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Shaky drawing: what is the rate of decline during prospective follow-up of essential tremor?"],"prefix":"10.1136","volume":"4","author":[{"given":"Elan D","family":"Louis","sequence":"first","affiliation":[{"name":"GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA"},{"name":"Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA"},{"name":"Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Michalec","sequence":"additional","affiliation":[{"name":"GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Art","family":"Gillman","sequence":"additional","affiliation":[{"name":"GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,4,10]]},"reference":[{"key":"2025121512061867000_4.4.e004626.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60544-3"},{"key":"2025121512061867000_4.4.e004626.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2005.086579"},{"key":"2025121512061867000_4.4.e004626.3","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1212\/WNL.55.10.1547","article-title":"Essential tremor frequency decreases with time","volume":"55","author":"Elble","year":"2000","journal-title":"Neurology"},{"key":"2025121512061867000_4.4.e004626.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2010.229740"},{"key":"2025121512061867000_4.4.e004626.5","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1212\/01.WNL.0000099075.19951.8C","article-title":"Prevalence of essential tremor: door-to-door neurologic exams in Mersin Province, Turkey","volume":"61","author":"Dogu","year":"2003","journal-title":"Neurology"},{"key":"2025121512061867000_4.4.e004626.6","doi-asserted-by":"crossref","unstructured":"Bain P Findley LJ . Assessing tremor severity. London: Smith-Gordon, 1993.","DOI":"10.1136\/jnnp.56.8.868"},{"key":"2025121512061867000_4.4.e004626.7","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1212\/01.WNL.0000038385.60538.19","article-title":"Elevation of blood beta-carboline alkaloids in essential tremor","volume":"59","author":"Louis","year":"2002","journal-title":"Neurology"},{"key":"2025121512061867000_4.4.e004626.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuro.2007.12.001"},{"key":"2025121512061867000_4.4.e004626.9","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1002\/mds.20754","article-title":"Betel quid: its tremor-producing effects in residents of Araihazar, Bangladesh","volume":"21","author":"Hafeman","year":"2006","journal-title":"Mov Disord"},{"key":"2025121512061867000_4.4.e004626.10","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870130215"},{"key":"2025121512061867000_4.4.e004626.11","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1159\/000109681","article-title":"The Washington Heights-Inwood Genetic Study of Essential Tremor: methodologic issues in essential-tremor research","volume":"16","author":"Louis","year":"1997","journal-title":"Neuroepidemiology"},{"key":"2025121512061867000_4.4.e004626.12","doi-asserted-by":"publisher","DOI":"10.1159\/000111584"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2013-004626","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:06:24Z","timestamp":1765829184000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2013-004626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,4,10]]},"published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1136\/bmjopen-2013-004626"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2013-004626","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4]]}}}