The bereitschaftspotential in jerky movement disorders
- Sandra M A van der Salm1,
- Marina A J Tijssen1,2,
- Johannes H T M Koelman1,
- Anne-Fleur van Rootselaar1
- 1Department of Neurology and Clinical Neurophysiology, Academic Medical Center, Amsterdam, The Netherlands
- 2Department of Neurology, University Medical Center Groningen (UMCG), The Netherlands
- Correspondence to Dr Anne-Fleur van Rootselaar, Department of Clinical Neurophysiology, Academic Medical Centre, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands;
Contributors All authors (SvdS, MT, JK and A-FvR) made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data. They all participated in drafting the article or revising it critically for important intellectual content and fully comply with and approve of the version to be published.
- Received 26 April 2012
- Revised 2 July 2012
- Accepted 1 August 2012
- Published Online First 5 September 2012
Objective To assess the diagnostic value of the bereitschaftspotential (BP) in jerky movement disorders.
Methods A cross-sectional case series of 48 patients with psychogenic jerks, Gilles de la Tourette syndrome (GTS) or myoclonus was investigated. We measured the BP prior to the spontaneous jerk and voluntary wrist extension. In addition, the various jerky movements were imitated by 25 healthy subjects.
Results For patients with psychogenic jerks, we observed significantly more BPs; however, the BP was not identified prior to self-paced wrist extensions in 59% of cases. In contrast, none of the patients with the clinical diagnosis of myoclonus had a BP prior to their jerks but did have a BP prior to intentional wrist extension. In GTS, we demonstrated a BP in a minority of cases preceding motor tics and with a shorter duration in comparison with patients with psychogenic jerks. In healthy control subjects, a BP was found preceding all movements in all cases. The absence of a BP prior to intended wrist extension had a sensitivity of 0.59, specificity of 0.98 and positive likelihood ratio of 25 for the diagnosis of psychogenic jerks.
Conclusions We demonstrate that the BP can aid in the differentiation of jerky movements. Patients with psychogenic jerks significantly more often have a BP prior to their jerks and with a significantly earlier onset compared with GTS patients. A novel finding of our study is the absence of a BP prior to intentional movements for patients with psychogenic jerks. Validation in a prospective cohort is needed.
Funding This work was supported by an AMC PhD stipend for SvdS.
Competing interests None.
Patient consent Our article does not contain personal medical information about any identifiable living individual. Patients gave written informed consent (in Dutch) to participate in the study.
Ethics approval Provided by the medical ethics committee AMC Amsterdam.
Provenance and peer review Not commissioned; externally peer reviewed.