Non‐motor symptoms are associated with midline tremor in essential tremor

Abstract

including cognition deficiency, psychiatry symptoms, sleep disruption, and sensory abnormalities, has recently been reported in ET syndrome. 2 Besides, accumulating evidence on different etiologies, pathophysiologies, and clinical features has demonstrated the heterogeneity of ET syndrome, even giving rise to a new placeholder, ET-plus. 2,3 Due to such heterogeneity, its disease sub-types should be extensively studied to understand the inherent mechanisms of ET syndrome.

Phenotypic Features of Isolated Essential Tremor, Essential Tremor Plus, and Essential Tremor-Parkinson’s Disease in a Movement Disorders Clinic

“…Essential tremor was defined as an Axis 1 tremor syndrome with "isolated tremor syndrome of bilateral upper limb action tremor" of "at least 3 years' duration" in the "absence of other neurological signs, such as dystonia, ataxia, or parkinsonism". "Essential tremor plus" was adopted to describe tremor with the characteristics of ET as well as "additional neurological signs of uncertain significance" [1], in order to accommodate the additional movement disorders and non-motor symptoms increasingly described in ET patients [2][3][4][5][6][7][8].…”

Essential tremor patients experience significant burden beyond tremor: A systematic literature review

“…Studies also reported that ET patients performed lower on certain sub-scores from the MMSE and MoCA including attention/calculation, construction, orientation, language, recall, visuospatial/executive, and abstraction (23,38,42). In a crosssectional study from China, 42% of patients with ET reported experiencing impaired concentration, while 60 and 27% of patients reported difficulties remembering things or events and remembering to do things, respectively (46). Patients with ET with midline tremor reported experiencing more impairment related to concentrating, remembering to do things, and remembering things or events compared to patients without midline tremor as assessed by the attention/memory domain of the NMSS (46).…”

“…Cognitive impairment was reported in a total of 26 studies across the US (11,(24)(25)(26)(27)(28)(29)(31)(32)(33)(34)(35)(36)(37)(38), Europe (23,39,40,48), 46,47), and Africa (45). The mean patient ages ranged from 25 to 87 years across included studies; eight publications assessed cognitive impairment specifically in older populations with mean patient ages >80 years (24,25,29,32,33,(36)(37)(38).…”

“…The mean patient ages ranged from 25 to 87 years across included studies; eight publications assessed cognitive impairment specifically in older populations with mean patient ages >80 years (24,25,29,32,33,(36)(37)(38). Cognitive impairment was measured using a variety of scales, including versions of the Folstein Mini Mental State Examination (MMSE), including the MMSE, MMSE-37, and modified MMSE (11,24,26,(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44); the Montreal Cognitive Assessment (MoCA) (23, 25-29, 31, 32, 42, 44, 45); the Clinical Dementia Rating Scale (CDR) (25,26,29,31,32); the Frontal Assessment Battery (FAB) (35,44,48); the Parkinson Neuropsychometric Dementia Assessment (PANDA) (48); and the attention/memory domain of the Non-Motor Symptoms Scale (NMSS) (42,(45)(46)(47). Modified versions of these instruments were used to accommodate low education levels or to differentiate cognitive functioning across varying stages of dementia (36,(38)(39)(40).…”

“…In a crosssectional study from China, 42% of patients with ET reported experiencing impaired concentration, while 60 and 27% of patients reported difficulties remembering things or events and remembering to do things, respectively (46). Patients with ET with midline tremor reported experiencing more impairment related to concentrating, remembering to do things, and remembering things or events compared to patients without midline tremor as assessed by the attention/memory domain of the NMSS (46). Similarly, patients with ET with head tremor reported more difficulty remembering to do things compared to ET patients without head tremor (47).…”