Mild cognitive impairment, dementia and risk of mortality in essential tremor: A longitudinal prospective study of elders

Delgado, Nikki; Hernandez, Daniella Iglesias; Radler, Keith; Huey, Edward D.; Cosentino, Stephanie; Louis, Elan D.

doi:10.1016/j.jns.2021.117563

Cited by 12 publications

(23 citation statements)

References 58 publications

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“…Increased tremor severity over time may also depend on the higher prevalence of rest tremor observed in advanced disease stages [ 12 ]. The progression of non‐motor symptoms in ET is even less understood [ 7 , 13 , 14 , 15 , 16 ]. Regarding demographic and clinical factors possibly influencing ET progression, it has been shown that female patients have a higher risk of manifesting or developing head and voice tremor over time [ 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal study of clinical and neurophysiological features in essential tremor

Angelini

Paparella

Biase

et al. 2022

Euro J of Neurology

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Background and purpose Essential tremor (ET) is a common and heterogeneous disorder characterized by postural/kinetic tremor of the upper limbs and other body segments and by non‐motor symptoms, including cognitive and psychiatric abnormalities. Only a limited number of longitudinal studies have comprehensively and simultaneously investigated motor and non‐motor symptom progression in ET. Possible soft signs that configure the ET‐plus diagnosis are also under‐investigated in follow‐up studies. We aimed to longitudinally investigate the progression of ET manifestations by means of clinical and neurophysiological evaluation. Methods Thirty‐seven ET patients underwent evaluation at baseline (T0) and at follow‐up (T1; mean interval ± SD = 39.89 ± 9.83 months). The assessment included the clinical and kinematic evaluation of tremor and voluntary movement execution, as well as the investigation of cognitive and psychiatric disorders. Results A higher percentage of patients showed tremor in multiple body segments and rest tremor at T1 as compared to T0 (all p‐values < 0.01). At T1, the kinematic analysis revealed reduced finger‐tapping movement amplitude and velocity as compared to T0 (both p‐values < 0.001). The prevalence of cognitive and psychiatric disorders did not change between T0 and T1. Female sex, absence of family history, and rest tremor at baseline were identified as predictive factors of worse disease progression. Conclusions ET progression is characterized by the spread of tremor in multiple body segments and by the emergence of soft signs. We also identified possible predictors of disease worsening. The results contribute to a better understanding of ET classification and pathophysiology.

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Section: Introductionmentioning

confidence: 99%

Longitudinal study of clinical and neurophysiological features in essential tremor

Angelini

Paparella

Biase

et al. 2022

Euro J of Neurology

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“…ET is one of the most common movement disorders among adults characterized by a kinetic tremor. Furthermore, additional clinical characteristics have been associated with the disorder, including ataxic gait and non-motor symptoms like depression, mild cognitive impairment, and dementia [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Differentiating Parkinson’s Disease from Essential Tremor Using Transcranial Sonography: A Systematic Review and Meta-Analysis

Heim

Peball

Hammermeister

et al. 2022

JPD

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Background: Essential tremor (ET) and the tremor of Parkinson’s disease (PD) are the most common tremors encountered in clinical practice. Especially in early disease stages, discrimination between the tremors of ET and PD can be challenging. Objective: The aim of this study was to evaluate the diagnostic accuracy of transcranial sonography (TCS) of the substantia nigra echogenicity for differential diagnosis of PD versus ET. Methods: A systematic PubMed search identified 512 studies. Sensitivity and specificity of substantia nigra hyperechogenicity was estimated. Data synthesis was carried applying a random effects bivariate binomial model. To assess study quality and risk of bias, the QUADAS-2 tool was used. Results: Eighteen studies were suitable for analysis including 1,264 PD and 824 ET patients. The meta analysis showed a pooled sensitivity and specificity for TCS in the differential diagnosis of PD versus ET of 84.6% (95% CI, 79.4–88.6%) and 83.9% (95% CI, 78.4–88.2%), respectively. Furthermore, we found similar results in sensitivity and specificity comparing TCS and DaTSCAN in a subgroup-analysis of three studies using both diagnostic tools including 107 patients with PD and 62 patients with ET. The QUADAS-2 toolbox revealed a high risk of bias regarding the methodological quality of patient selection. Conclusion: Substantia nigra hyperechogenicity yield high diagnostic accuracy for the discrimination of PD from ET. TCS is a low cost, widely available, non-invasive marker without radiation Therefore, a diagnostic algorithm based on presence or absence of substantia nigra hyperechogenicity is highly warranted.

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“…Patients were enrolled in an ongoing, prospective, longitudinal study of cognitive performance (Clinical Pathological Study of Cognitive Impairment in Essential Tremor, National Institute of Neurological Disorders and Stroke R01 NS086736). 12 They learned about the study from an online study website and mailings from the International Essential Tremor Foundation. Recruitment materials described the study as one designed to follow ET patients year after year to pinpoint the changes taking place as the disorder progresses.…”

Section: Overviewmentioning

confidence: 99%

“…11 Their risk of mortality doubles compared to that of their counterparts without dementia. 12 Data on the rates of development of cognitive impairment in ET are essential for prognosis, planning, and potential treatment of cognitive impairment in patients with ET.…”

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confidence: 99%

Prevalence of and Annual Conversion Rates to Mild Cognitive Impairment and Dementia: Prospective, Longitudinal Study of an Essential Tremor Cohort

Ghanem,

Berry,

Burkes

et al. 2024

Annals of Neurology

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ObjectiveDespite recent attention to cognitive impairment in essential tremor, few studies examine rates of conversion to diagnoses of mild cognitive impairment and dementia. Development of dementia in essential tremor is associated with loss of functional ability and a doubling of mortality rate. This prospective, longitudinal study comprehensively reports the prevalence and incidence of, and the annual rates of conversion to, mild cognitive impairment and dementia in an essential tremor cohort.MethodsPatients underwent detailed cognitive assessments and were assigned diagnoses of normal cognition, mild cognitive impairment, or dementia. There were 222 patients at baseline (mean age = 79.3 ± 9.7 years), and 177 patients participated in follow‐up evaluations at 18, 36, 54, and 72 months (mean years of observation = 5.1 ± 1.7). Data were compared to those of historical controls and Parkinson disease patients.ResultsThe cumulative prevalence of dementia and average annual conversion rate of mild cognitive impairment to dementia were 18.5% and 12.2%, nearly three times higher than rates in the general population, and approximately one half the magnitude of those reported for Parkinson disease patients. The cumulative prevalence of mild cognitive impairment (26.6%) was almost double that of the general population, but less than that in Parkinson disease populations.InterpretationWe present the most complete exposition of the longitudinal trajectory of cognitive impairment in an essential tremor cohort yet presented. The prevalence of and conversion rates to dementia in essential tremor fall between those associated with the natural course of aging and the more pronounced rates observed in Parkinson disease. ANN NEUROL 2024

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Mild cognitive impairment, dementia and risk of mortality in essential tremor: A longitudinal prospective study of elders

Cited by 12 publications

References 58 publications

Longitudinal study of clinical and neurophysiological features in essential tremor

Longitudinal study of clinical and neurophysiological features in essential tremor

Differentiating Parkinson’s Disease from Essential Tremor Using Transcranial Sonography: A Systematic Review and Meta-Analysis

Prevalence of and Annual Conversion Rates to Mild Cognitive Impairment and Dementia: Prospective, Longitudinal Study of an Essential Tremor Cohort

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