Fig 1.
CONSORT flow diagram displaying the progress of the study’s design.
Table 1.
ET participant demographics and baseline UPDRS, QUEST and FTM parts A to C scores.
Fig 2.
Sample kinematic data showing (A) presence of tremor in the wrist, elbow and shoulder joints and (B) the ideal injection parameters determined using the kinematics with the injector’s best clinical judgement. (A) Total tremor severity (plot 1) is displayed in angular RMS amplitude and the percent distribution of tremulous movement (plot 2) by 3 DOFs in the wrist and by 2 DOFs in the shoulder joint. Error bars indicate standard deviation over three trials. (B) Injector’s interpretation of the kinematic results showing selection of total dose allocated to wrist, elbow and shoulder muscle groups based on tremor severity and the muscles selected based on the amount of tremor present in each degree of freedom that each arm joint moves in.
Table 2.
Total injected dosage and number of muscles injected as determined by injector across all participants.
Table 3.
Mean injected dosage per arm muscle treated at each treatment time-point.
Fig 3.
IncobotulinumtoxinA treatments significantly reduced severity of tremor and provided functional benefit for fine and gross motor tasks with mild muscle weakness in treated muscles.
(A) Tremor severity, FTM part A sub-category score (max: /4 per task), significantly decreased. (B) Handwriting, spiral and line writing tasks showed significant improvement, signified by FTM part B summed score, and functional disability, FTM part C summed score (max: /4 per category, 8 categories in total), was significantly reduced. (C) Quality of life, measured by QUEST tallied 30-items (max: /4 per item), significantly increased. (D) Angular RMS tremor amplitude (primary y-axis) and hand and finger acceleration values (secondary y-axis) at each arm joint was averaged per time-point. Significant reductions in wrist and shoulder tremor amplitudes resembled change in hand and finger acceleration values. (E) Angular wrist tremor RMS amplitude for each scripted-task was significantly reduced. (F) Maximal grip strength (blue) was significantly reduced, but did not impair function, and perceived muscle weakness (red) yielded no significant change at injection visits. All plotted values are means for all participants per each time-point. Asterisks represented statistical significant change (p<0.05) compared to baseline. Error bars represent standard deviation of population.