Tremor and other hyperkinetic movements
Clinical and Electrophysiological Heterogeneity of Orthostatic Tremor: An Individual Patient Data Analysis
By D'Souza L, Niharika BR, Benito-León J and 6 others.
Abstract
Background
Orthostatic tremor (OT) is traditionally classified using tremor frequency and the presence of associated neurological signs. However, increasing reports of overlapping frequencies, fluctuating electrophysiological profiles, and diverse clinical associations indicate that current classification systems may not fully capture the clinical heterogeneity of OT.
Methods
A systematic review of PubMed/MEDLINE from inception to February 2026 identified case reports, case series, and original studies reporting electromyography-confirmed OT with individual patient data. Demographic, clinical, electrophysiological, and data on associated conditions were extracted. Cases were classified according to the 2018 Movement Disorder Society criteria and separately grouped as isolated or non-isolated OT. Associations between tremor frequency and clinical phenotype were assessed using receiver operating characteristic analysis and multivariable logistic regression.