How Many People in the United States Have Essential Tremor? Deriving a Population Estimate Based on Epidemiological Data

Louis, Elan D.; Ottman, Ruth

doi:10.7916/d8tt4p4b

Cited by 62 publications

(9 citation statements)

References 31 publications

(44 reference statements)

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“…Eligibility criteria for confirmed ET required ET diagnosis with two relevant prescriptions or an additional diagnosis for unspecified tremor, which may have limited the number of identified patients with ET. Although stricter eligibility criteria attempted to ensure the presence of ET diagnosis and avoid potential misclassifications, the criteria most likely resulted in an underestimation of the number of patients with ET compared to established prevalence estimates [ 4 , 5 ]. Additionally, because the database only captured data from 2015 to 2019, it is possible that some patients in the post-diagnosis subset received their initial ET diagnosis outside the study period.…”

Section: Discussionmentioning

confidence: 99%

“…It is typically marked by tremor in the upper limbs, but may also involve the head, voice, lower limbs, and trunk [ 1 – 3 ]. In the USA, it is projected that approximately 7 million people have ET, representing more than 2% of the total population [ 4 , 5 ]. ET prevalence increases with age, affecting 0.8% of people aged 18–30 years, and slightly more than 8% of people aged 85 years or older [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The Hidden Burden of Disease and Treatment Experiences of Patients with Essential Tremor: A Retrospective Claims Data Analysis

et al. 2022

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Introduction Essential tremor (ET) affects approximately 7 million people in the USA, yet public recognition of the disease and its impact remain low. Methods A retrospective observational study examined US claims data from 2015 to 2019 using the Compile database. ET diagnoses were captured using longitudinal data from 2015 to 2019 and for the year 2019, with diagnosis estimates extrapolated to the general US population. Confirmed ET was identified by an ET diagnosis code with at least two relevant prescriptions or by two diagnosis codes for ET and unspecified tremor at least 90 days apart. Comorbidity and treatment use data were extracted, and medication compliance and 2-year treatment persistence were assessed as measures of treatment adherence. Results A total of 1,336,183 patients with ET diagnoses codes were identified from 2015 through 2019, corresponding to 2,226,971 projected US diagnoses. In 2019, 128,263 patients had a confirmed ET diagnosis, corresponding to 213,772 projected US confirmed diagnoses. Of these, 96% had at least one comorbidity, and 64% received at least one pharmacologic treatment. Propranolol (24%) and primidone (20%) comprised the most common ET prescriptions. Two-year medication discontinuation rates were approximately 40%. Conclusion Our findings revealed that 1 million people were diagnosed and sought treatment for ET in the USA from 2015 to 2019. Projected population estimates of approximately 2 million people diagnosed suggest a further 1 million remain untreated. Our findings highlight the complexity of patient care in ET, complicated by delayed diagnoses, multiple comorbidities, and lack of effective and tolerable therapies that can mitigate treatment adherence limitations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Hidden Burden of Disease and Treatment Experiences of Patients with Essential Tremor: A Retrospective Claims Data Analysis

et al. 2022

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“…Essential tremor (ET), which affects roughly 2% of the population, is the commonest cause of tremor in neurological practice 1 , 2 . Research into the disorder depends strongly on objective methods to characterise the tremor and to measure its severity.…”

Section: Introductionmentioning

confidence: 99%

Wearable sensors during drawing tasks to measure the severity of essential tremor

Ali

Arjunan

Peters

et al. 2022

Sci Rep

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Commonly used methods to assess the severity of essential tremor (ET) are based on clinical observation and lack objectivity. This study proposes the use of wearable accelerometer sensors for the quantitative assessment of ET. Acceleration data was recorded by inertial measurement unit (IMU) sensors during sketching of Archimedes spirals in 17 ET participants and 18 healthy controls. IMUs were placed at three points (dorsum of hand, posterior forearm, posterior upper arm) of each participant’s dominant arm. Movement disorder neurologists who were blinded to clinical information scored ET patients on the Fahn–Tolosa–Marin rating scale (FTM) and conducted phenotyping according to the recent Consensus Statement on the Classification of Tremors. The ratio of power spectral density of acceleration data in 4–12 Hz to 0.5–4 Hz bands and the total duration of the action were inputs to a support vector machine that was trained to classify the ET subtype. Regression analysis was performed to determine the relationship of acceleration and temporal data with the FTM scores. The results show that the sensor located on the forearm had the best classification and regression results, with accuracy of 85.71% for binary classification of ET versus control. There was a moderate to good correlation (r2 = 0.561) between FTM and a combination of power spectral density ratio and task time. However, the system could not accurately differentiate ET phenotypes according to the Consensus classification scheme. Potential applications of machine-based assessment of ET using wearable sensors include clinical trials and remote monitoring of patients.

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“…There is no gold standard assessment method for identifying tremors 11 and many methods have been used in the literature, such as electromyography, video recordings, and inertial sensor recordings 12 – 22 .…”

Section: Introductionmentioning

confidence: 99%

The hand tremor spectrum is modified by the inertial sensor mass during lightweight wearable and smartphone-based assessment in healthy young subjects

Santos

Monteiro

et al. 2022

Sci Rep

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Tremors are common disorders characterized by an involuntary and relatively rhythmic oscillation that can occur in any part of the body and may be physiological or associated with some pathological condition. It is known that the mass loading can change the power spectral distribution of the tremor. Nowadays, many instruments have been used in the evaluation of tremors with bult-in inertial sensors, such as smartphones and wearables, which can significantly differ in the device mass. The aim of this study was to compare the quantification of hand tremor using Fourier spectral techniques obtained from readings of accelerometers built-in a lightweight handheld device and a commercial smartphone in healthy young subjects. We recruited 28 healthy right-handed subjects with ages ranging from 18 to 40 years. We tested hand tremors at rest and postural conditions using lightweight wearable device (5.7 g) and smartphone (169 g). Comparing both devices at resting tremor, we found with smartphone the power distribution of peak ranging 5 and 12 Hz in both hands. With wearable, the result was similar but less evident. When comparing both devices in postural tremor, there were significant differences in both frequency ranges in peak frequency and peak amplitude in both hands. Our main findings show that in resting condition the hand tremor spectrum had a higher peak amplitude in the 5–12 Hz range when the tremor was recorded with smartphones, and in postural condition there was a significantly (p < 0.05) higher peak power spectrum and peak frequency in the dominant hand tremors recorded with smartphones compared to those obtained with lightweight wearable device. Devices having different masses can alter the features of the hand tremor spectrum and their mutual comparisons can be prejudiced.

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How Many People in the United States Have Essential Tremor? Deriving a Population Estimate Based on Epidemiological Data

Cited by 62 publications

References 31 publications

The Hidden Burden of Disease and Treatment Experiences of Patients with Essential Tremor: A Retrospective Claims Data Analysis

The Hidden Burden of Disease and Treatment Experiences of Patients with Essential Tremor: A Retrospective Claims Data Analysis

Wearable sensors during drawing tasks to measure the severity of essential tremor

The hand tremor spectrum is modified by the inertial sensor mass during lightweight wearable and smartphone-based assessment in healthy young subjects

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