Tremors in Early Parkinsonʼs Disease

We examined 50 untreated parkinsonian patients with a complaint of tremor for the presence of a resting, postural, or kinetic tremor. Tremors were recorded by an accelerometer to determine amplitude and frequency. A postural tremor was present in 92% and a resting tremor in 76%. The amplitude of postural tremor was greater than resting tremor in 50%, the same in 25%, and less in 25%. The average tremor frequency of resting and postural tremor was not significantly different. Carbidopa/levodopa reduced testing tremor in 58% and postural tremor in 46% of patients. The dopamine agonist naxoglide (PHNO) reduced resting tremor in 77% and postural tremor in 70% of patients. Postural tremor was not worsened by either drug. It is concluded that tremors in both the resting and postural positions are an integral part of the symptoms of Parkinson's disease and that both tremors have a similar frequency and pharmacological responsiveness in the early phases of the disease.