Assessment of movement time in patients with essential tremor

Background We have observed mild bradykinesia in essential tremor (ET) patients, which do not satisfy the criteria of Parkinson's disease (PD). Objective To compare the mean movement time for repetitive movements around distal and proximal joints in ET patients with normal controls by using a simple test paradigm. Patients and methods Seventeen patients with ET and 14 control subjects were instructed to tap with the index finger sequentially on push-button microswitches. Movement times around metacarpophalangeal, wrist, elbow, and shoulder joints of the right side were tested. The data collected were stored on a computer and the time elapsed between sequential taps on two keys (ms) and number of taps on the left key for 15 seconds were evaluated offline. Results Movement times of the patients with ET were not found to be significantly different from those of the controls at all joints tested despite slight prolongation for movements around the shoulder joint. Conclusion The simple test paradigm we have used showed that there is no difference in the movement time for repetitive movements around four joints of the upper extremity between patients with ET and normal control subjects. The slightly prolonged movement time around the shoulder joint noted in patients with ET may be ascribed to tremor, not bradykinesia. Tremor may cause these patients to pay more attention to the performance of goal-directed finger movements and consequently prolong movement time slightly or it may simply delay the time elapsed to reach the goal in the absence of overt intention tremor

Value of Diffusion Weighted Magnetic Resonance Imaging in Differentiation of Benign and Malignant Adrenal Lesions

Objective: Diffusion weighted imaging (DWI) is a functional magnetic resonance imaging (MRI) technique that explores the random motion of water molecules in the body. Although DWI has been widely applied in the evaluation of intracranial disorders, there is growing interest for its use in detection and characterization of abdominal masses. In this study, the efficiency of DWI in distinguishing benign adrenal focal lesions from malignant ones is investigated. Material and Methods: Sixty six adrenal focal lesions in 56 patients were included in the study. The lesions were characterized with dynamic adrenal computed tomography and/or adrenal MRI if there was not a histopathological result or radiological follow up. DWI was performed for these lesions and apparent diffusion coefficient (ADC) values were measured by using three different b values (b=500 sec/mm2, b=750 sec/mm2, b=1000 sec/mm2). Results: The mean ADC values of 39 benign lesions were 1.54 x 10-3 mm2/sec for b=500 sec/mm2, 1.01x 10-3 mm2/sec for b=750 sec/mm2 and 0.77 x 10-3 mm2/sec for b=1000 sec/mm2. The mean ADC values of 27 malignant lesions were found to be 1.69x 10-3 mm2/sec, 1.14 x 10-3 mm2/sec and 0.86 x 10-3 mm2/sec for b=500 sec/mm2, b=750 sec/mm2, b=1000 sec/mm2, respectively. There was not any statistically significant difference between ADC values of benign and malignant lesions for all three b values (p<0.05). Conclusion: According to this study, DWI did not seem to be an effective radiological method for differentiating benign and malignant adrenal lesions; but for a more accurate decision, studies with improved and high resolution images, standardized techniques parameters and larger number of lesions may be needed. [Cukurova Med J 2013; 38(4.000): 734-743