Elan D Louis1, Adina Wise2, Roy N Alcalay3, Ashwini K Rao4, Pam Factor-Litvak5. 1. Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA. Electronic address: elan.louis@yale.edu. 2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA. 3. Program in Physical Therapy, Department of Rehabilitation & Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA. 4. Program in Physical Therapy, Department of Rehabilitation & Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA; G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA. 5. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Abstract
BACKGROUND: Surprisingly little has been written about the combined clinical entity, essential tremor-Parkinson's disease (ET-PD), which is the result of a double disease hit. We carefully quantified tremor burden using a wide range of measures (tremor severity, tremor-related disability, tremor-related quality of life) and furthermore, studied additional motor and non-motor features in ET-PD. METHODS: In this prospective, clinical-epidemiological study, we performed a standardized, structured clinical evaluation of 27 ET-PD patients, comparing them to age-matched samples of 35 PD and 109 ET patients. RESULTS: The number of hours/day shaking was lowest in PD (median=3.0), intermediate in ET (median=10.0) and highest in ET-PD (median=14.0) (p<0.001). All measures of mobility and balance (Berg Balance test, Activities-specific Balance Confidence Scale, Timed Up and Go test) worsened across groups in a stepwise manner from ET to PD to ET-PD (p<0.05). Mini-mental state test scores worsened (p=0.002) and daytime sleepiness increased (p=0.002) across groups from ET to PD to ET-PD. CONCLUSIONS: The ET-PD patient seems to be more than just a PD patient with a little more kinetic tremor. Aside from a significantly greater tremor burden, ET-PD patients exhibited more cognitive and sleep problems and more mobility and balance problems than patients with isolated PD.
BACKGROUND: Surprisingly little has been written about the combined clinical entity, essential tremor-Parkinson's disease (ET-PD), which is the result of a double disease hit. We carefully quantified tremor burden using a wide range of measures (tremor severity, tremor-related disability, tremor-related quality of life) and furthermore, studied additional motor and non-motor features in ET-PD. METHODS: In this prospective, clinical-epidemiological study, we performed a standardized, structured clinical evaluation of 27 ET-PDpatients, comparing them to age-matched samples of 35 PD and 109 ET patients. RESULTS: The number of hours/day shaking was lowest in PD (median=3.0), intermediate in ET (median=10.0) and highest in ET-PD (median=14.0) (p<0.001). All measures of mobility and balance (Berg Balance test, Activities-specific Balance Confidence Scale, Timed Up and Go test) worsened across groups in a stepwise manner from ET to PD to ET-PD (p<0.05). Mini-mental state test scores worsened (p=0.002) and daytime sleepiness increased (p=0.002) across groups from ET to PD to ET-PD. CONCLUSIONS: The ET-PDpatient seems to be more than just a PDpatient with a little more kinetic tremor. Aside from a significantly greater tremor burden, ET-PDpatients exhibited more cognitive and sleep problems and more mobility and balance problems than patients with isolated PD.
Authors: Joe R Nocera; Elizabeth L Stegemöller; Irene A Malaty; Michael S Okun; Michael Marsiske; Chris J Hass Journal: Arch Phys Med Rehabil Date: 2013-03-06 Impact factor: 3.966
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Authors: Elan D Louis; Daniella Iglesias-Hernandez; Nora C Hernandez; Xena Flowers; Sheng-Han Kuo; Jean Paul G Vonsattel; Phyllis L Faust Journal: J Neuropathol Exp Neurol Date: 2022-09-19 Impact factor: 3.148