title: Continuous in-home monitoring of essential tremor.
abstract: BACKGROUND
  Essential tremor (ET) is typically measured in the clinic with subjective tremor rating scales which require the presence of a clinician for scoring and are not appropriate for measuring severity throughout the day. Motion sensors can accurately rate tremor severity during a set of predefined tasks in a laboratory.
  
  
  METHODS
  We evaluated the ability of motion sensors to quantify tremor during unconstrained activities at home. 20 ET subjects wore a wireless sensor continuously for up to 10 h daily on two days and completed hourly standardized tremor assessments involving pre-defined tasks. Mathematical models were used to predict tremor rating scores from the sensor data.
  
  
  RESULTS
  At home tremor scores from hourly standardized assessments correlated with at home tremor scores estimated during unconstrained activities immediately following the standardized assessments. The hourly standardized assessments did not significantly fluctuate throughout the day, while fluctuations in the continuous assessments tended to follow changes in voluntary activity level. Both types of tremor ratings (standardized and continuous) showed high day-to-day test-retest reliability with intraclass correlation coefficients ranging from 0.67 to 0.90 for continuous ratings and 0.77 to 0.95 for standardized ratings.
  
  
  CONCLUSIONS
  Results demonstrate the feasibility of continuous monitoring of tremor severity at home, which should provide clinicians with a measure of the temporal pattern of tremor in the context of daily life and serve as a useful tool for the evaluation of novel anti-tremor medications in clinical trials.
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, OH, USA. Electronic address: cpulliam@glneurotech.com.
authors.forename: C L
authors.initials: CL
authors.lastname: Pulliam
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Eichenseer
authors.affiliation: Rush University Medical Center, Chicago, IL, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Goetz
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: O
authors.initials: O
authors.lastname: Waln
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Hunter
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Jankovic
authors.affiliation: University of Florida, Gainesville, FL, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Vaillancourt
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, OH, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Giuffrida
authors.affiliation: Great Lakes NeuroTechnologies, Cleveland, OH, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Heldman
mesh_terms: D061725:Accelerometry / Q000295:instrumentation / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D020329:Essential Tremor / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*
keywords: Accelerometer; Ambulatory monitoring; Essential tremor; Gyroscope; Kinesia