Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

Cersonsky, Tess E.K.; Kellner, Sarah; Morgan, Sarah; Cosentino, Stephanie; Koo, Brian B.; Figueiredo, John M. de; Louis, Elan D.

doi:10.1017/s1092852918001633

Cited by 12 publications

(12 citation statements)

References 71 publications

(133 reference statements)

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“…However, there are some controversial findings. Other studies have reported that demoralization (ie, depression) or cognitive deficits are not related to tremor severity, indicating that they are separate comorbid entities 38 . Additionally, Matteo et al 8 reported a high prevalence of axis I disorders in patients with ETh, indicating that ET manifests psychiatric disorders, especially axis I disorders.…”

Section: Discussionmentioning

confidence: 97%

Distinct non‐motor features of essential tremor with head tremor patients

Peng

et al. 2020

Acta Neurol Scand

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Background There have been few comprehensive scale studies on the non‐motor symptoms (NMS) of patients with essential tremor (ET) with head tremor (ETh) and those with ET without head tremor (ETol). We aimed to explore the motor symptoms and NMS of these two subgroups. Methods We enrolled 199 patients with ET (125, ETol; 74 ETh) and 132 healthy controls. We evaluated motor symptoms using the Fahn‐Tolosa‐Marin Tremor Rating Scale (TRS) and NMS using the Non‐Motor Symptom Scale (NMSS). We compared NMSS scores and the prevalence of each NMS between the patient subgroups. Finally, we conducted a logistic regression analysis of the correlation between head tremor and NMS severity, as well as other determinants. Results There were no significant between‐subgroup differences in demographic characteristics. Further, they presented similar tremor clinical manifestation; however, the ETh subgroup showed a higher prevalence of rest tremor, feeling of sadness, forgetting things or events, and swallowing difficulty, as well as TRS scores, compared with the ETol subgroup. Both patient subgroups showed high scores and prevalence (>50%) in difficulty falling asleep. Logistic regression analysis indicated age as a tremor severity determinant; further, head tremor and tremor severity were NMS determinants. Conclusion Both patient subgroups presented various NMS including sleep disturbances, cognitive deficits, and affective disorders. The ETh subgroup showed a high prevalence of certain NMS aspects including memory and affective disorder; further, they had aggravated NMS. ET with both upper limb tremor and head tremor may be regarded as a more severe clinical subtype.

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Section: Discussionmentioning

confidence: 97%

Distinct non‐motor features of essential tremor with head tremor patients

Peng

et al. 2020

Acta Neurol Scand

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“…The disease can be either a component of different neurodegenerative diseases or an isolated disease. (18) The molecular mechanism of ET is still unclear because there is no specific diagnostic marker for ET. The disease has clinical similarities with some diseases such as dystonia and Parkinson's disease (PD) and can also be seen together with other neurological diseases such as restless leg syndrome.…”

Section: Discussionmentioning

confidence: 99%

Propranolol significantly reduced DNA polymerase β expression in patients with essential tremor

et al. 2021

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Background Essential tremor (ET) is the most common movement disorder. Propranolol is a first-line medication for ET. We aimed to evaluate the effect of propranolol on the expression of poly (ADP-ribose) polymerase 1 (PARP1) and DNA polymerase beta (POLB) genes, which are known to be related to neurodegenerative diseases, in patients with ET. MethodsThirty-five healthy volunteers and thirty-five patients followed up with essential tremors were included in a non-randomized control experimental study. Expressions of PARP1 and POLB genes were compared between the control group and the patient group. In addition, pre- and post-treatment gene expression levels and Fahn-Tolosa-Marin tremor scale values of the patient group were compared after 8 weeks of propranolol treatment. The Wilcoxon rank and Mann Whitney U tests were used to analyze the data. ResultsAt baseline, PARP1 expression was significantly lower in the ET group than in the control group. (p<0.001). POLB gene expression was significantly higher in the pre-treatment ET group than in the controls (p<0.05). There was no significant difference in PARP1 expression levels before and after 8 weeks of propranolol treatment. POLB gene expression was significantly higher in the pre-treatment group than in the post-treatment group (p<0.001). ConclusionPropranolol significantly decreased POLB gene expression but there was no significant difference in PARP1 gene expression levels in the patient group, after 8 weeks of propranolol treatment.

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“…One-way ANOVA results (GRF corrected with a voxellevel P < 0.01 and a cluster-level P < 0.05, gray matter mask, estimated smoothing kernel with FWHM: 6 × 6 × 4 mm3 and cluster size > 405 mm 3 ) showed ReHo changes in the prefrontal cortices, anterior cingulate cortices, motor cortices, insular cortices, superior parietal lobules, superior temporal cortices, cuneus and cerebellum among the three groups (Fig. S1).…”

Section: Local Fc Changes Among the Three Groupsmentioning

confidence: 99%

“…S1). Figure 1 shows the post hoc two-sample t-test results (GRF corrected with a voxel-level P < 0.001 and a cluster-level P < 0.05, ANOVA results as mask, estimated smoothing kernel with FWHM: 6 × 6 × 4 mm 3 and cluster size > 432 mm 3 ). Compared with the HCs, the depressed ET patients had increased ReHo in the bilateral precentral cortices, supplementary motor cortices, superior and middle prefrontal cortices, anterior cingulate cortices, insular cortices, superior parietal lobules, cuneus and right superior temporal cortex, and decreased ReHo in the bilateral cerebellum lobules IV-V, cerebellum lobules VI, cerebellum lobules VIII, cerebellum lobules IX, cerebellum lobules crus 1 and left superior temporal cortex.…”

Section: Local Fc Changes Among the Three Groupsmentioning

confidence: 99%

“…Essential tremor (ET) has been gradually accepted as a heterogeneous disorder; in addition to the characteristic upper limb action tremor, ET has been linked to a variety of other motor and non-motor symptoms [1,2] . In recent years, psychiatric and affective disturbances, particularly depression with ET, have been constantly studied and reported [3,4]. However, it remains unclear whether depression in ET is associated with brain activity changes, such as depression in Parkinson's disease (PD), or is merely a secondary mental phenomenon due to disabling tremor.…”

Section: Introductionmentioning

confidence: 99%

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Altered local and matrix functional connectivity in depressed essential tremor patients

Duan

Zhou

et al. 2021

BMC Neurol

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Background Depression in essential tremor (ET) has been constantly studied and reported, while the associated brain activity changes remain unclear. Recently, regional homogeneity (ReHo), a voxel-wise local functional connectivity (FC) analysis of resting-state functional magnetic resonance imaging, has provided a promising way to observe spontaneous brain activity. Methods Local FC analyses were performed in forty-one depressed ET patients, 49 non-depressed ET patients and 43 healthy controls (HCs), and then matrix FC and clinical depression severity correlation analyses were further performed to reveal spontaneous neural activity changes in depressed ET patients. Results Compared with the non-depressed ET patients, the depressed ET patients showed decreased ReHo in the bilateral cerebellum lobules IX, and increased ReHo in the bilateral anterior cingulate cortices and middle prefrontal cortices. Twenty-five significant changes of ReHo clusters were observed in the depressed ET patients compared with the HCs, and matrix FC analysis further revealed that inter-ROI FC differences were also observed in the frontal-cerebellar-anterior cingulate cortex pathway. Correlation analyses showed that clinical depression severity was positively correlated with the inter-ROI FC values between the anterior cingulate cortex and bilateral middle prefrontal cortices and was negatively correlated with the inter-ROI FC values of the anterior cingulate cortex and bilateral cerebellum lobules IX. Conclusion Our findings revealed local and inter-ROI FC differences in frontal-cerebellar-anterior cingulate cortex circuits in depressed ET patients, and among these regions, the cerebellum lobules IX, middle prefrontal cortices and anterior cingulate cortices could function as pathogenic structures underlying depression in ET patients.

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Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity

Cited by 12 publications

References 71 publications

Distinct non‐motor features of essential tremor with head tremor patients

Distinct non‐motor features of essential tremor with head tremor patients

Propranolol significantly reduced DNA polymerase β expression in patients with essential tremor

Altered local and matrix functional connectivity in depressed essential tremor patients

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