Contralateral Spread of Asymmetrical Tremor in Parkinson's Disease
Bibliographic record
Abstract
BACKGROUND: Parkinsonian tremor usually starts asymmetrically. The mid-term prognosis of this lateralized tremor is unknown, as is the development of tremor in the contralateral arm. OBJECTIVE: To investigate the occurrence of contralateral tremor in the Parkinson's Progression Marker Initiative database, with data available for 7 years. METHODS: Tremor requiring treatment (TRT) was defined as any rest, postural or kinetic tremor with amplitude >1 cm (MDS-UPDRS score ≥2) as this criterion is commonly accepted as an insufficiently treated tremor. Tremor was analyzed by side mainly in the off-medication state. RESULTS: At baseline, 348 (87.7%) of the 397 patients with Parkinson's disease had tremor at least on one side of the body. 183 (46%) had only mild tremors but 165 (41.6%) had TRT. 159 patients (40.1%) had lateralized TRT and six (1.6%) had bilateral TRT. Among patients with asymmetrical TRT, 40 patients (25.2%) developed contralateral TRT at 3 years, 49 patients (30.8%) at 5 years, and 61 patients (38.4%) at 7 years. The side more affected by tremor was also more affected by other cardinal signs. In 159 patients with initially asymmetrical TRT, tremor severity did not increase on the more tremulous side over the 7-year period. However, there was an increase in tremor on the contralateral side. This was associated with a clear increase in bradykinesia and rigidity on both sides. CONCLUSION: The study findings may prove beneficial in counseling patients with TRT, and may also provide an explanation as to why the worsening of tremor is not correlated with overall disease progression.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".