Is tremor a biomarker? I have read quite a few definitions of biomarker and some mention proteins and other internal processes. Wikipedia says, "More generally a biomarker is anything that can be used as an indicator of a particular disease state or some other physiological state of an organism."

Happy New Year!

So is tremor both biomarker and symptom, do symptoms and biomarkers over lap as understanding of a condition grows? Is a biomarker just a symptom of an underlying biomarker that is closer to the source of the problem?

Link

Identifying biomarkers will be transformative to the PD community, allowing scientists to objectively diagnose, monitor and predict the disease. Currently, there is no way to definitively diagnose Parkinson's disease in a living person. Instead, a diagnosis is based on the presence of clinical symptoms including resting tremor, rigidity, and bradykinesia (slow movement).

Robert,

It is my understanding that biomarkers precede clinical symptoms such as tremor. The goal is to establish a common set of markers to nab people early on before motor symptoms start. I think two of the more common predictors are anosmia or deficit in recognizing certains smells like pickles. Seriously, they use a scratch and sniff test. The other which holds a little more weight is REM Sleep Disorder; this is where people act out their dreams. If you experience both you are doomed:


Combination of 'idiopathic' REM sleep behaviour disorder and olfactory dysfunction as possible indicator for alpha-synucleinopathy demonstrated by dopamine transporter FP-CIT-SPECT

What I find alarming is that many of us will not have these markers. I, for one have an intact sniffer and do not have or never have had REM sleep disorder, so what does that say?

Further, I have read that the onset of PD is rapid and closely linked to a causative; this would be pre-motor phase. The progression of PD is not necessarily linked to cause. This strongly correlates to the flu pandemic of 1918. The flu can cause brain damage resulting in PD but the symptoms which are basically a sign of progression show years later. This happened with survivors of that flu...they awakened years later to PD motor symptoms. I guess I fail to see how biomarkers matter at this point when the damage is done early on; there are no symptoms, and any number of things possibly cause it. How do they know if biomarkers appear early enough to halt or reverse anything? I think it is a laudable goal but the cart is way before the horse, imho.

Laura

As I see it, although it is an important symptom, tremor is a difficult to use biomarker. This is because it varies so much from second to second, it's difficult to avoid the act of measuring from affecting the tremor, and it has so many facets: areas affected, frequency, amplitude, direction, etc.. That said, if you could overcome the pollution problem and you average over a suitable period, a day, say, I think you would get useful results.

Although it falls far short of meeting these ends, you might like to use my attempt at a tremor measurement tool:

http://www.parkinsonsmeasurement.org/toolBox/tremor.htm

All you need to do is to put a finger on the pressure pad of a laptop, and it will measure the finger's movement. Unfortunately, it only gives reasonable results for some tremors. I'll be grateful for any advice on how to make it more sensitive.

John

Hi...

My dad has got the following problems but none is sure what disease it it...
He is unable to swallow foods, unable to speak, no balance in the body, slow movement, unable to move the eye balls. Few doctors were telling that it is PD and he is being medicated for PD. Yesterday I took him to another doc and he was telling that it not PD since he couldnt observe any tremors with my dad. Could some one help me what exactly would be the symptoms for PD or with the mentioned symptoms is he affected with PD? Your suggestion will help my dad to recover from this state. Please help.

But, interestingly, i had a slight tremor before diagnosis and i have an internal chaos that makes it difficult for anyone unfamiliar with me to take an EKG.

Does everyone have trouble with internal readings due to internal tremor? I sometimes have a tremor under my chin. I think there is a possibility that internal tremor could be a biomarker. I wonder if there is anything of this nature showing up in the FOXhunt?

I too have very little tremor, and also vibrate inside like a motor that never stops.

John

Hello Shahul, and welcome to the forum.

There are a lot of well informed people here, but I guess your post is in the middles of a thread about an issue that isn't quite what you are asking about. Diagnosis of Pd is quite difficult which is why people on this thread are talking about bio-markers.

Some of your dad's problems do have things that are similar to PD, but some of them are not usually found in early PD. There are however a number of conditions that are similar to Pd and have sometimes been included under the PD label. Not everybody with PD has a tremor, some figures reckon that as many as 30% do not have it. Some people with no visible tremor have an internal vibration sensation that is often called an internal tremor. Others have intermittent shakiness that is not the same as the classic PD tremor. So as you can see nothing is clear cut.

You do not say how old your dad is, or how long he has had symptoms, or what medications he is on and how they have/have not helped him. I suggest that you start a new thread, to ask the question again, and outline some of these things. For instance if your dad is responsive to PD meds that might be an indication. If he is not perhaps he might have another PD related condition. Or he may have something else altogether. If he is elderly then you are likely to want some kind of resolution of what is wrong fairly soon, and his condition sounds difficult. Ask again and maybe others will have more suggestions.

You also do not say where your dad lives. If he is in the US a neurologist who is a movement disorder specialist will be the best to ascertain if he has PD, in the UK and elsewhere a neurologist who specializes in PD may be able to help.

Best wishes as you try to find out what you are dealing with, and please ask any questions you think are relevant.

Lindy