Rest tremor in Parkinson's disease: Body distribution and time of appearance

To assess body distribution and timing of appearance of rest tremor in Parkinson's disease. Information was obtained by a computerized database containing historical information collected at the first visit and data collected during the subsequent follow-up visits. Information on rest tremor developed during the follow-up could be therefore obtained by our own observation in a proportion of patients. Among 289 patients, rest tremor was reported at disease onset in 65.4% of cases and detected at last follow-up examination in 74.4% of patients. Analysis of patients who did not report rest tremor at disease onset indicated that 26% of such patients (9% in the overall population) manifested rest tremor over the disease course. Rest tremor spread to new sites in 39% of patients who manifested rest tremor at disease onset. Regardless of tremor presentation at disease onset or during the follow-up, upper limb was the most frequent tremor localization. Over the follow-up, rest tremor developed faster in the upper limb than in other body sites. The risk of developing rest tremor during the follow-up was not affected by sex, side of motor symptom onset and site of tremor presentation. However, age of disease onset >63years was associated with an increased risk of rest tremor spread. This study provides new information about body distribution and timing of rest tremor appearance during the course of early stages of Parkinson's disease that may help clinicians in patients' counselling. •We studied body distribution and time of appearance of rest tremor in a large parkinsonian population.•Rest tremor was reported by 65.4% of patients at disease onset.•Rest tremor was described in 74.4% of patients on last follow-up examination.•Rest tremor involved the upper limb more frequently than other body sites.•During the follow-up, rest tremor developed faster in the upper limb than in other body sites.