Abdominal Tremor in Parkinson's Disease

A 66-year-old male visited our clinic with a 1-year history of walking difficulty and stomach shaking while lying down. Examination revealed very mild right-arm akinesia, bilateral leg rest tremor, and tremor in his abdominal muscles (see Video; Fig. 1A,B). Abnormal 123I-ioflupane single-photon emission CT (SPECT; Fig. 1C) and 123I-metaiodobenzylguanidine scintigraphy (heart-to-mediastinum ratio: 1.89) supported the diagnosis of Parkinson's disease (PD). Pramipexole was prescribed up to 3 mg/day, and his symptoms, including abdominal tremor, improved. Abdominal tremor is a rare symptom in PD. In addition, this might indicate that the presence of striatum somatotopy found in macaque monkeys are also present in humans.1 (1) Research Project: A. Conception, B. Organization, C. Execution; (2) Manuscript: A. Writing of the First Draft, B. Review and Critique. N.T.: 1A, 1B, 1C T.H.: 1A, 2B S.T.: 2B A.I.: 1A, 1B, 1C, 2A Funding Sources and Conflicts of Interest: The authors report no sources of funding and no conflicts of interest. Financial Disclosures for previous 12 months: Dr. Hayashi received an endowed chair from Janssen Pharmaceuticals. Dr. Iwata received research funding from Eisai Inc and Daiichi-Sankyo; received honoraria from serving on the scientific advisory board of the International Parkinson and Movement Disorder Society; and received an endowed chair from Janssen Pharmaceuticals. A video accompanying this article is available in the supporting information here. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.