**5. References**


< http://www.biomedsearch.com/nih/Essential-tremor-clinical-characteristics/ 10854348.html >.

	- [13] Bhidayasiri, R. Differential diagnosis of common tremor syndromes. Postgraduate Medical Journal, v. 81, n. 962, p. 756-762, December 1, 2005 2005. Disponível em: < http://pmj.bmj.com/content/81/962/756.abstract >.

Human Tremor: Origins, Detection and Quantification 21

[25] Bain, P. G. et al. Assessing tremor severity. Journal of Neurology, Neurosurgery & Psychiatry, v. 56, n. 8, p. 868-873, August 1, 1993 1993. Disponível em: <

[26] Raethjen, J. et al. Determinants of physiologic tremor in a large normal population. Clinical Neurophysiology, v. 111, n. 10, p. 1825-1837, 2000. ISSN 1388-2457. Disponível

[27] Elble, R. J. Characteristics of physiologic tremor in young and elderly adults. Clinical Neurophysiology, v. 114, n. 4, p. 624-635, 2003. ISSN 1388-2457. Disponível em: <

[28] Morrison, S.; Mills, P.; Barrett, R. Differences in multiple segment tremor dynamics between young and elderly persons. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, v. 61, n. 9, p. 982-990, 2006. Disponível em: <

[29] Salarian, A. et al. Quantification of tremor and bradykinesia in Parkinson's disease using a novel ambulatory monitoring system. IEEE Transactions on Biomedical

[30] Uhríková, Z. et al. Validation of a new tool for automatic assessment of tremor frequency from video recordings. Journal of Neuroscience Methods, v. 198, n. 1, p. 110-

[31] Kuncel, A. M. et al. Tremor reduction and modeled neural activity during cycling thalamic deep brain stimulation. Clinical Neurophysiology, v. 123, n. 5, p. 1044-1052,

[32] Tsipouras, M. G. et al. An automated methodology for levodopa-induced dyskinesia: Assessment based on gyroscope and accelerometer signals. Artificial Intelligence in

[33] Hilliard, J. D.; Frysinger, R. C.; Elias, W. J. Effective subthalamic nucleus deep brain stimulation sites may differ for tremor, bradykinesia and gait disturbances in Parkinson's disease. Stereotact Funct Neurosurg, v. 89, n. 6, p. 357-364, 2011. ISSN 1011- 6125. Disponível em: < http://pubget.com/paper/22104373 http://gateway.proquest.com/

2004&res\_id=xri:pqd&rft\_val\_fmt=info:ofi:fmt:kev:mtx:journal&genre=article&jtitle=Ste reotactic and Functional Neurosurgery&issn=1011-61251423-0372&atitle=Effective subthalamic nucleus deep brain stimulation sites may differ for tremor, bradykinesia and gait disturbances in Parkinson's disease.&date=2011-01-01&volume=89&issue=

[34] Veluvolu, K. C.; Ang, W. T. Estimation of Physiological Tremor from Accelerometers for Real-Time Applications. Sensors, v. 11, n. 3, p. 3020-3036, 2011. ISSN 1424-8220.

em: < http://www.sciencedirect.com/science/article/B6VNP-419BFX0-J/2/

http://www.sciencedirect.com/science/article/B6VNP-47XWVJ4-

Engineering, v. 54, n. 2, p. 313-322, 2007. ISSN 0018-9294.

http://biomed.gerontologyjournals.org/cgi/content/abstract/61/9/982 >.

< http://www.sciencedirect.com/science/article/pii/S0165027011001294 >.

< http://www.sciencedirect.com/science/article/pii/S1388245711006250 >.

Medicine, v. 55, n. 2, p. 127-135, 2012. ISSN 0933-3657. Disponível em: < http://www.sciencedirect.com/science/article/pii/S0933365712000322 >.

6&spage=357 http://dx.doi.org/10.1159/000331269 >.

Disponível em: < http://www.mdpi.com/1424-8220/11/3/3020 >.

http://jnnp.bmj.com/content/56/8/868.abstract >.

ee6af8163265c25d3ac795c893aa454e >.

3/2/e2bb859ab434ea2b5c91345ae114f7d2 >.

113, 2011. ISSN 0165-0270. Disponível em:

2012. ISSN 1388-2457. Disponível em:

openurl?ctx\_ver=Z39.88-


[25] Bain, P. G. et al. Assessing tremor severity. Journal of Neurology, Neurosurgery & Psychiatry, v. 56, n. 8, p. 868-873, August 1, 1993 1993. Disponível em: < http://jnnp.bmj.com/content/56/8/868.abstract >.

20 Practical Applications in Biomedical Engineering

&nrm=iso >.

http://pmj.bmj.com/content/81/962/756.abstract >.

3, p. 248-256, March 1, 1980 1980. Disponível em: < http://jnnp.bmj.com/content/43/3/248.abstract >.

56, p. 320-323, 1998. ISSN 0004-282X. Disponível em:

8257. Disponível em: < http://dx.doi.org/10.1002/mds.10248 >.

http://dx.doi.org/10.1002/mds.21198 >.

assn.org/cgi/content/abstract/63/4/584 >.

9942-56-7-noc8137 >.

[13] Bhidayasiri, R. Differential diagnosis of common tremor syndromes. Postgraduate Medical Journal, v. 81, n. 962, p. 756-762, December 1, 2005 2005. Disponível em: <

[14] Young, R. R.; Hagbarth, K. E. Physiological tremor enhanced by manoeuvres affecting the segmental stretch reflex. Journal of Neurology, Neurosurgery & Psychiatry, v. 43, n.

[15] Mattos, J. P. D. Diagnóstico diferencial dos tremores. Arquivos de Neuro-Psiquiatria, v.

< http://www.scielo.br/scielo.php?script=sci\_arttext&pid=S0004-282X1998000200027

[16] Goetz, C. G. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Movement Disorders, v. 22, n. 1, p. 41-47, 2007. ISSN 1531-8257. Disponível em: <

[17] Ramaker, C. et al. Systematic evaluation of rating scales for impairment and disability in Parkinson's disease. Movement Disorders, v. 17, n. 5, p. 867-876, 2002. ISSN 1531-

[18] Greffard, S. et al. Motor Score of the Unified Parkinson Disease Rating Scale as a Good Predictor of Lewy Body-Associated Neuronal Loss in the Substantia Nigra. Arch Neurol, v. 63, n. 4, p. 584-588, April 1, 2006 2006. Disponível em: < http://archneur.ama-

[19] Louis, E. D. et al. A teaching videotape for the assessment of essential tremor. Movement Disorders, v. 16, n. 1, p. 89-93, 2001. ISSN 1531-8257. Disponível em: <

http://dx.doi.org/10.1002/1531-8257(200101)16:1<89::AID-MDS1001>3.0.CO;2-L >. [20] Louis Ed, W. K. J. A. S. M. P. S. L. Y. Q. A. H. Validity of a performance-based test of function in essential tremor. Archives of Neurology, v. 56, n. 7, p. 841-846, 1999. ISSN 0003-9942. Disponível em: < http://dx.doi.org/10-1001/pubs.Arch Neurol.-ISSN-0003-

[21] Stacy, M. A. et al. Assessment of interrater and intrarater reliability of the Fahn–Tolosa– Marin Tremor Rating Scale in essential tremor. Movement Disorders, v. 22, n. 6, p. 833- 838, 2007. ISSN 1531-8257. Disponível em: < http://dx.doi.org/10.1002/mds.21412 >. [22] Mostile, G. et al. Correlation between Kinesia system assessments and clinical tremor scores in patients with essential tremor. Movement Disorders, v. 25, n. 12, p. 1938-1943,

2010. ISSN 1531-8257. Disponível em: < http://dx.doi.org/10.1002/mds.23201 >. [23] Goetz, C. G. et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations The Movement Disorder Society Task Force on rating scales for Parkinson's disease. Movement Disorders, v. 19, n. 9, p. 1020-1028,

2004. ISSN 1531-8257. Disponível em: < http://dx.doi.org/10.1002/mds.20213 >. [24] Goulart, F.; Pereira, L. X. Main scales for Parkinson's disease assessment: use in physical

therapy. Fisioterapia e Pesquisa, v. 2, n. 1, p. 49-56, 2004.


< http://www.sciencedirect.com/science/article/pii/S0165027011001294 >.

[31] Kuncel, A. M. et al. Tremor reduction and modeled neural activity during cycling thalamic deep brain stimulation. Clinical Neurophysiology, v. 123, n. 5, p. 1044-1052, 2012. ISSN 1388-2457. Disponível em:

< http://www.sciencedirect.com/science/article/pii/S1388245711006250 >.


2004&res\_id=xri:pqd&rft\_val\_fmt=info:ofi:fmt:kev:mtx:journal&genre=article&jtitle=Ste reotactic and Functional Neurosurgery&issn=1011-61251423-0372&atitle=Effective subthalamic nucleus deep brain stimulation sites may differ for tremor, bradykinesia and gait disturbances in Parkinson's disease.&date=2011-01-01&volume=89&issue= 6&spage=357 http://dx.doi.org/10.1159/000331269 >.

[34] Veluvolu, K. C.; Ang, W. T. Estimation of Physiological Tremor from Accelerometers for Real-Time Applications. Sensors, v. 11, n. 3, p. 3020-3036, 2011. ISSN 1424-8220. Disponível em: < http://www.mdpi.com/1424-8220/11/3/3020 >.

	- [35] Sanchez-Ramos, J. et al. Quantitative Analysis of Tremors in Welders. International Journal of Environmental Research and Public Health, v. 8, n. 5, p. 1478-1490, 2011. ISSN 1660-4601. Disponível em: < http://www.mdpi.com/1660-4601/8/5/1478 >.

Human Tremor: Origins, Detection and Quantification 23

[45] Blesic, S. et al. Scaling analysis of bilateral hand tremor movements in essential tremor patients. Journal of Neural Transmission, v. 118, n. 8, p. 1227-1234, 2011. ISSN 0300-

[46] Latt, W. T.; Veluvolu, K. C.; Ang, W. T. Drift-Free Position Estimation of Periodic or Quasi-Periodic Motion Using Inertial Sensors. Sensors, v. 11, n. 6, p. 5931-5951, 2011.

[48] Mergl, R. et al. Digitized analysis of handwriting and drawing movements in healthy subjects: methods, results and perspectives. Journal of Neuroscience Methods, v. 90, n.

[49] Louis, E. D. et al. Is essential tremor symmetric?: observational data from a communitybased study of essential tremor. Archives of Neurology, v. 55, n. 12, p. 1553-1559, 1998.

[51] Elble, R. J. et al. Quantification of essential tremor in writing and drawing. Movement

[52] Miralles, F.; Tarongí, S.; Espino, A. Quantification of the drawing of an Archimedes spiral through the analysis of its digitized picture. Journal of Neuroscience Methods, v.

[53] Liu, X. et al. Quantifying drug-induced dyskinesias in the arms using digitised spiraldrawing tasks. Journal of Neuroscience Methods, v. 144, n. 1, p. 47-52, 2005. ISSN 0165- 0270. Disponível em: < http://www.sciencedirect.com/science/article/B6T04-4DX27FD-

[54] Rudzińska M, I. A., Banaszkiewicz K, Bukowczan S, Marona M, Szczudlik A Quantitative tremor measurement with the computerized analysis of spiral drawing.

[55] Elble, R. J. et al. Tremor amplitude is logarithmically related to 4- and 5-point tremor

[56] Ulmanová, O. et al. Tremor magnitude: a single index to assess writing and drawing in essential tremor. Parkinsonism & Related Disorders, v. 13, n. 4, p. 250-253, 2007. ISSN 1353-8020. Disponível em: < http://www.sciencedirect.com/science/article/B6TB9-

Polish Journal Of Neurology And Neurosurgery, v. 41, n. 6, p. 510-516, 2007.

rating scales. Brain, v. 129, n. 10, p. 2660-2666, 2006. Disponível em: < http://brain.oxfordjournals.org/cgi/content/abstract/129/10/2660 >.

Disponível em: < http://archneur.ama-assn.org/cgi/content/abstract/55/12/1553 >. [50] Feys, P. et al. Digitised spirography as an evaluation tool for intention tremor in multiple sclerosis. Journal of Neuroscience Methods, v. 160, n. 2, p. 309-316, 2007. ISSN 0165-0270. Disponível em: < http://www.sciencedirect.com/science/article/B6T04-

ISSN 1424-8220. Disponível em: < http://www.mdpi.com/1424-8220/11/6/5931 >. [47] Popovi\, L. Z. et al. Adaptive band-pass filter (ABPF) for tremor extraction from inertial sensor data. Comput. Methods Prog. Biomed., v. 99, n. 3, p. 298-305, 2010. ISSN 0169-

9564. Disponível em: < http://dx.doi.org/10.1007/s00702-011-0581-1 >.

< http://www.sciencedirect.com/science/article/B6T04-3XBTV5W-7/2/

Disorders, v. 11, n. 1, p. 70-78, 1996. ISSN 1531-8257. Disponível em:

< http://www.sciencedirect.com/science/article/B6T04-4H68NGJ-1/2/

2, p. 157-169, 1999. ISSN 0165-0270. Disponível em:

4MC71C5-1/2/cc55be9051d4ab74e620ece8a142903e >.

152, n. 1-2, p. 18-31, 2006. ISSN 0165-0270. Disponível em:

< http://dx.doi.org/10.1002/mds.870110113 >.

0934969b75770f9c6452893d336e093d >.

3/2/eacac6a2698f8a2b30d47c0d858d3356 >.

4K7FJPP-4/2/e4e3eba11bec47a0d2e67de3a85c6ef4 >.

9e2366c4d50d9aaadb2e8c877f27da34 >.

2607.

	- < http://pubget.com/paper/21459111

http://gateway.proquest.com/openurl?ctx\_ver=Z39.88-

2004&res\_id=xri:pqd&rft\_val\_fmt=info:ofi:fmt:kev:mtx:journal&genre=article&jtitle=Jou rnal of Neuroscience Methods&issn=0165-02701872-678X&atitle=Kinematic

optimization of deep brain stimulation across multiple motor symptoms in Parkinson's disease&date=2011-03-31&volume=198&issue=2&spage=280

http://www.sciencedirect.com/science/article/pii/S0165-0270(11)00167-1 >.


< http://www.sciencedirect.com/science/article/pii/S036192300600061X >.


[45] Blesic, S. et al. Scaling analysis of bilateral hand tremor movements in essential tremor patients. Journal of Neural Transmission, v. 118, n. 8, p. 1227-1234, 2011. ISSN 0300- 9564. Disponível em: < http://dx.doi.org/10.1007/s00702-011-0581-1 >.

22 Practical Applications in Biomedical Engineering

em: < http://dx.doi.org/10.1007/BF02349979 >.

< http://dx.doi.org/10.1007/s004220050440 >.

4b5ec662a94e4eae13b0ef5cc9180537 >.

ISSN 0165-0270. Disponível em: < http://pubget.com/paper/21459111

9230. Disponível em:

[35] Sanchez-Ramos, J. et al. Quantitative Analysis of Tremors in Welders. International Journal of Environmental Research and Public Health, v. 8, n. 5, p. 1478-1490, 2011.

[37] Timmer, J. et al. Cross-spectral analysis of physiological tremor and muscle activity.

[38] Milanov, I. Electromyographic differentiation of tremors. Clinical Neurophysiology, v.

[39] Giuffrida, J. P. et al. Clinically deployable Kinesia™ technology for automated tremor assessment. Movement Disorders, v. 24, n. 5, p. 723-730, 2009. ISSN 1531-8257.

[40] Mera, T. et al. Kinematic optimization of deep brain stimulation across multiple motor symptoms in Parkinson's disease. J Neurosci Methods, v. 198, n. 2, p. 280-286, 2011.

2004&res\_id=xri:pqd&rft\_val\_fmt=info:ofi:fmt:kev:mtx:journal&genre=article&jtitle=Jou

optimization of deep brain stimulation across multiple motor symptoms in Parkinson's

[41] Barroso Júnior, M. C. et al. A telemedicine instrument for remote evaluation of tremor: design and initial applications in fatigue and patients with Parkinson's disease.

[42] Ghassemi, M. et al. Bradykinesia in patients with Parkinson's disease having levodopainduced dyskinesias. Brain Research Bulletin, v. 69, n. 5, p. 512-518, 2006. ISSN 0361-

[43] Albert, M. V.; Kording, K. P. Determining posture from physiological tremor. Experimental brain research. Experimentelle Hirnforschung. Experimentation cerebrale,

[44] Riviere, C. N.; Reich, S. G.; Thakor, N. V. Adaptive Fourier modeling for quantification of tremor. Journal of Neuroscience Methods, v. 74, n. 1, p. 77-87, 1997. ISSN 0165-0270. Disponível em: < http://www.sciencedirect.com/science/article/B6T04-3TCVRT9-

rnal of Neuroscience Methods&issn=0165-02701872-678X&atitle=Kinematic

http://www.sciencedirect.com/science/article/pii/S0165-0270(11)00167-1 >.

< http://www.sciencedirect.com/science/article/pii/S036192300600061X >.

Biological Cybernetics, v. 78, n. 5, p. 359-368, 1998. Disponível em:

< http://www.sciencedirect.com/science/article/B6VNP-43RJ9D3-7/2/

112, n. 9, p. 1626-1632, 2001. ISSN 1388-2457. Disponível em:

Disponível em: < http://dx.doi.org/10.1002/mds.22445 >.

http://gateway.proquest.com/openurl?ctx\_ver=Z39.88-

< http://ukpmc.ac.uk/abstract/MED/21306628 >.

v. 215, n. 3-4, p. 247-255, 2011. Disponível em: < http://ukpmc.ac.uk/abstract/MED/21997329 >.

T/2/6f12090ac184c878343120cd13881b90 >.

disease&date=2011-03-31&volume=198&issue=2&spage=280

Biomedical engineering online, v. 10, p. 14, 2011. Disponível em:

ISSN 1660-4601. Disponível em: < http://www.mdpi.com/1660-4601/8/5/1478 >. [36] Tong, K.; Mak, A.; Ip, W. Command control for functional electrical stimulation hand grasp systems using miniature accelerometers and gyroscopes. Medical and Biological Engineering and Computing, v. 41, n. 6, p. 710-717, 2003. ISSN 0140-0118. Disponível

	- [57] Pullman, S. L. Spiral analysis: a new technique for measuring tremor with a digitizing tablet. Movement Disorders, v. 13, n. 3, p. 85-89, 1998. ISSN 1531-8257. Disponível em: < http://dx.doi.org/10.1002/mds.870131315 >.

**Chapter 2** 

© 2012 Zgallai, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

© 2012 Zgallai, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This chapter investigates the application of digital signal processing techniques to ECG signals. The first few sections of this chapter are devoted to definitions and properties of cumulants, their spectra, and associated statistics. This is followed by describing the structural properties of the third-order cumulants of an adult male's chest ECG, maternal chest ECG, transabdominally-measured ECG, as well as fetal ECG signal using scalpelectrode. The non-linearity and non-stationarity of ECG signals are investigated using the bispectrum and bicoherence squared. The third-order cumulants, bispectra, and bicoherence squared of some noise components, namely, the baseline wander, electromyographic (EMG), and motion artefact noise isolated from the MIT/BIH databases are analysed. Finally,

Adequate knowledge of the higher-order statistics (HOS) of both the maternal and fetal ECG signals must be acquired in order to pave the way for fetal QRS-complex identification and detection. There are several motivations behind using higher-order statistics in processing

i. ECG signals are predominantly non-Gaussian (Rizk et al., 1995; Rizk and Zgallai, 1999), and exhibit quadratic and higher-order non-linearities supported by third- and fourthorder statistics, respectively. It is worth mentioning that, in general, the third-order

ii. The maternal and fetal QRS-complex bispectral contours do not overlap with that of the baseline wander and that of the EMG above –20 dB normalised to the peak of the

cumulants can support linear non-Gaussian, and non-linear signals.

**Second- and Third-Order Statistical** 

**Non-Gaussianity of Adult and Fetal** 

**ECG Signals and Noise** 

Additional information is available at the end of the chapter

concluding remarks are discussed and summarised.

ECG signals. These motivations are:

Walid A. Zgallai

**1. Introduction** 

http://dx.doi.org/10.5772/52575

**Characterization of Non-Linearity and** 


< http://dx.doi.org/10.1002/1531-8257(200011)15:6<1084::AID-MDS1005>3.0.CO;2-Y >.

[63] Sturman, M. M.; Vaillancourt, D. E.; Corcos, D. M. Effects of aging on the regularity of physiological tremor. Journal of Neurophysiology, v. 93, p. 3064-3074, 2005. ISSN 0022- 3077. Disponível em: < http://jn.physiology.org/cgi/content/full/93/6/3064 >.

**Chapter 2** 
