Non-Motor Symptoms of Essential Tremor Are Independent of Tremor Severity and Have an Impact on Quality of Life

Abstract

Background: Several publications have focused on accompanying non-motor symptoms (NMS) in essential tremor (ET) patients; however, it remains unclear if NMS are an intrinsic part of the disease or secondary phenomena. We present the results of several neuropsychiatric tests and their impact on quality of life (QoL) in community-dwelling patients with ET. Methods: Participants were recruited via a newspaper article about ET published in the local media and on the internet. All participants completed several standard neuropsychiatric tests, including those that assess QoL. To compare differences between cases and controls, Student's t-tests with Bonferroni-Holm post hoc tests were performed. Spearman's correlation coefficients were also calculated. Results: We enrolled 110 patients with definite or probable ET. Highly significant changes were observed for apathy, anxiety, and cognition and negatively impacted QoL. Most aberrations were independent of tremor severity and duration. Discussion: The significant neuropsychiatric deficits and reduced QoL demonstrate a degree of illness that appears to be a non-motor phenotype rather than a secondary effect of ET. In the future, NMS should carefully be explored in ET patients as they may have an impact on QoL and treatment.

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

“…Based on a score of above 8 on the KDS-II, demoralization was found to have a prevalence of 13.3% in ET in our cohort. Demoralization was not associated with tremor severity, similar to that which is seen in studies of depression in ET, [15][16][17][18][19][20][21] where tremor severity did not positively correlate with depression. 13 Rather, as expected, demoralization was associated with related constructs including high levels of subjective incompetence and low levels of resilience.…”

“…16 These data suggest that depressive symptoms may not be a mere consequence of tremor in ET, but rather a separable comorbid entity or a marker of a certain premorbid tendency. [15][16][17][18][19][20][21] Demoralization, another manifestation of psychological distress, has been well-described in various chronic illnesses, and is characterized by feelings of helplessness, hopelessness, a sense of bewilderment, and an inability to cope in stressful situations. [22][23][24][25] Though demoralization can be associated with depression, they are distinct psychological phenomena with independent prognostic implications.…”

Probable REM-Sleep Behavior Disorder and Dysautonomic Symptoms in Essential Tremor

“…Also, the patients were recruited from our outpatient clinic (where more severe ET is encountered). Although it is not likely that tremor severity is related with autonomic dysfunction or RBD, 6 we cannot exclude the possibility of selection bias. We used a structured interview to minimize possible bias due to different people performing the telephone interviews.…”

Cost-minimisation model of magnetic resonance-guided focussed ultrasound therapy compared to unilateral deep brain stimulation for essential tremor treatment in Japan

“…ET is a chronic and progressive neurological disease that commonly manifests as bilateral tremors in the upper limbs, and is associated with considerable physical and psychosocial burden [2, 3]. Many patients struggle with everyday tasks such as writing, dressing and/or eating and have a diminished health-related quality of life (HRQoL) [3, 4]. The condition may also result in decreased productivity, and in premature retirement for those suffering from its symptoms [5].…”