Abstract
To investigate the characteristics of tremor in patients with dopamine-resistant and
dopamine-responsive tremor in Parkinson's disease (PD). Methods: This study is a retrospective analysis. A
total of 197 PD patients with at least one limb exhibiting resting or postural tremor were included. All patients
underwent an acute levodopa challenge test and tremor analysis. Patients with a tremor improvement score of
less than 5 points were classified as dopamine-resistant (116 cases), while those with a tremor improvement
score of 5 points or more were classified as dopamine-responsive (81 cases). The tremor patterns and frequencies
in the resting, postural, intentional, and object-holding states were compared between the two groups. Results:
Compared to the dopamine-resistant group, the dopamine-responsive group had a higher baseline Unified
Parkinson’s Disease Rating Scale Part III (UPDRS-III) total score and tremor total score, longer disease
duration, and higher levodopa equivalent dose (all P<0.05). The maximum improvement rate and improvement
value of tremor during the acute levodopa challenge test were also greater in the dopamine-responsive group
(both P<0.05). There were statistically significant differences in the distribution of tremor muscle contraction
patterns and frequencies between the two groups in the upper limb intentional tremor and upper limb
object-holding state (P<0.05). Additionally, there were statistically significant differences in the distribution of
tremor muscle contraction patterns and frequencies between the two groups in the lower limb resting and postural tremor states (P<0.05).
Conclusion: The tremor of PD exhibits heterogeneity in its response to levodopa. Different responsive types show variations in the
distribution of tremor muscle contraction patterns and frequencies under different conditions. Tremor analysis can provide objective and
practical evidence for the differentiation and treatment of various dopamine-responsive types of Parkinson's tremor.
Key words
Parkinson's disease
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Classification and Electrophysiological Features of Parkinson's Disease Tremor Based on
Dopamine Reactivity[J]. Neural Injury and Functional Reconstruction. 2025, 20(4): 197-202
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