Validation of Digital Spiral Analysis in Pediatric Tremor

Background/Purpose: Essential tremor (ET) is one of the most common pediatric movement disorders. Assessing tremor severity can be done using various methods such as tremor-rating scales and visual spiral analysis. Digital spiral analysis (DSA) is a relatively new method that has only been used in adults so far. In this study in pediatric patients, severity of ET was assessed using DSA as well as longer-established exams. The aim of the study was to validate DSA as an instrument for further studies in pediatric tremor.

Methods: Data acquisition took place at the Department of Pediatric and Adolescent Medicine, Medical University Vienna, in 2013. Eight patients, aged 6 to 19 years, with previously diagnosed essential tremor, were included. Descriptive analysis and correlation analysis using Spearman’s statistics of the data acquired in digital spiral analysis as well as clinical assessment, video documentation, standardized tremor rating scales, and visual spiral analysis was performed.

Results: Mean scores in digital spiral analysis correlated significantly with visual spiral scores (p < 0.037). Correlation of individual spiral scores was also significant (p < 0.0001). A correlation between digital scores and simple tremor rating could not be shown.

Conclusion: The main limitation of this study was the small sample size. Nevertheless, DSA was shown to be a valid assessment method for ET in childhood. With further studies including more patients and/or different kinds of tremor, DSA might give a possibility to assess tremor severity in pediatric patients in a quick and consistent way without extensive training needed.