title: Is median nerve enlargement at the wrist associated with tremor in Parkinson disease?
abstract: OBJECTIVE
  Tremor is one of the cardinal features of Parkinson disease (PD) and may cause cumulative trauma-related injury to nerves of the hands. The aim of this study was to assess the electrodiagnostic and sonographic features of patients with PD and to assess the effect of tremor in PD on the median nerve.
  
  
  METHODS
  We studied 31 hands of healthy control participants (n = 16; mean age ± SD, 60.25 ± 14.67 years) and 81 hands of patients with PD (n = 42; 64.95 ± 11.13 years). Motor symptoms were measured by the Unified Parkinson's Disease Rating Scale III. Median nerve conduction studies and sonographic cross-sectional area measurements were performed in all participants.
  
  
  RESULTS
  The median nerve cross-sectional area in patients with PD (10.71 ± 2.79 mm(2)) was significantly larger than that in the control group (7.40 ± 1.05 mm(2); P < .05). However, there was no significant difference in median nerve electrodiagnostic findings between the PD and control groups. The median nerve cross-sectional area was associated with the severity of the tremor but not with the Unified Parkinson's Disease Rating Scale motor score.
  
  
  CONCLUSIONS
  Tremor in PD is associated with median nerve enlargement but not with impairment of median nerve conduction.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (S.N.Y., H.J.K., J.S.Y.); Department of Physical Medicine and Rehabilitation, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea (S.J.W.); and Department of Neurology, Korea University College of Medicine, Seoul, Korea (W.-K.S., S.B.K.).
authors.forename: Seung Nam
authors.initials: SN
authors.lastname: Yang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (S.N.Y., H.J.K., J.S.Y.); Department of Physical Medicine and Rehabilitation, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea (S.J.W.); and Department of Neurology, Korea University College of Medicine, Seoul, Korea (W.-K.S., S.B.K.).
authors.forename: Hyo Jeong
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (S.N.Y., H.J.K., J.S.Y.); Department of Physical Medicine and Rehabilitation, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea (S.J.W.); and Department of Neurology, Korea University College of Medicine, Seoul, Korea (W.-K.S., S.B.K.). parkinson@korea.ac.kr rehab46@korea.ac.kr.
authors.forename: Joon Shik
authors.initials: JS
authors.lastname: Yoon
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (S.N.Y., H.J.K., J.S.Y.); Department of Physical Medicine and Rehabilitation, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea (S.J.W.); and Department of Neurology, Korea University College of Medicine, Seoul, Korea (W.-K.S., S.B.K.).
authors.forename: Sun Jae
authors.initials: SJ
authors.lastname: Won
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (S.N.Y., H.J.K., J.S.Y.); Department of Physical Medicine and Rehabilitation, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea (S.J.W.); and Department of Neurology, Korea University College of Medicine, Seoul, Korea (W.-K.S., S.B.K.).
authors.forename: Woo-Keun
authors.initials: WK
authors.lastname: Seo
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (S.N.Y., H.J.K., J.S.Y.); Department of Physical Medicine and Rehabilitation, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea (S.J.W.); and Department of Neurology, Korea University College of Medicine, Seoul, Korea (W.-K.S., S.B.K.). parkinson@korea.ac.kr rehab46@korea.ac.kr.
authors.forename: Seong Beom
authors.initials: SB
authors.lastname: Koh
mesh_terms: D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014202:Tremor / Q000150:complications* / Q000175:diagnosis*; D014463:Ultrasonography / Q000379:methods; D014953:Wrist / Q000000981:diagnostic imaging
keywords: Parkinson disease; median nerve; musculoskeletal ultrasound; sonography; tremor