Daniele Belvisi1, Antonella Conte2, Matteo Bologna3, Maria Carmela Bloise4, Antonio Suppa5, Alessandra Formica6, Matteo Costanzo7, Pierluigi Cardone8, Giovanni Fabbrini9, Alfredo Berardelli10. 1. Neuromed Institute IRCCS, Via Atinense 18, 86077, Pozzilli (IS), Italy. Electronic address: daniele.belvisi@uniroma1.it. 2. Neuromed Institute IRCCS, Via Atinense 18, 86077, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: antonella.conte@uniroma1.it. 3. Neuromed Institute IRCCS, Via Atinense 18, 86077, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: matteo.bologna@uniroma1.it. 4. Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: bloise.mc@gmail.com. 5. Neuromed Institute IRCCS, Via Atinense 18, 86077, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: antonio.suppa@uniroma1.it. 6. Neuromed Institute IRCCS, Via Atinense 18, 86077, Pozzilli (IS), Italy. Electronic address: alessandraformica@yahoo.it. 7. Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: matteo_cos90@hotmail.it. 8. Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: pierluigicardone91@gmail.com. 9. Neuromed Institute IRCCS, Via Atinense 18, 86077, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: giovanni.fabbrini@uniroma1.it. 10. Neuromed Institute IRCCS, Via Atinense 18, 86077, Pozzilli (IS), Italy; Department of Neurology and Psychiatry, "Sapienza" University of Rome, Viale dell'Università 30, 00185 Rome, Italy. Electronic address: alfredo.berardelli@uniroma1.it.
Abstract
INTRODUCTION: Re-emergent tremor (RET) is a postural tremor that appears after a variable delay in patients with Parkinson's disease (PD). The aim of the present study was to evaluate the occurrence and the clinical characteristics of RET in a population of patients with PD. METHODS: We consecutively assessed 210 patients with PD. We collected the patients' demographic and clinical data. RET was clinically characterized in terms of latency, severity and body side affected. We also investigated a possible relationship with motor and non-motor symptoms and differences in the clinical features in patients with and without RET. RESULTS: RET was present in 42/210 patients. The mean latency of RET was 9.20 ± 6.8 seconds. Mean severity was 2.4 ± 1.9. RET was unilateral in 21 patients. Patients with RET had less severe speech, posture and gait disorders and upper limb and global bradykinesia than patients without RET. Similar findings were observed when we compared patients with RET with patients with tremor at rest associated with action tremor, patients with isolated action tremor and patients with no tremor. By contrast, patients with RET tremor did not clinically differ from those with isolated tremor at rest. CONCLUSION: Our results suggest that patients with RET and patients with isolated tremor at rest represent the same clinical subtype, whereas patients with action tremor (whether isolated or associated with tremor at rest) might belong to a distinct subtype that is clinically worse. Patients with RET represents a benign subtype of PD, even within the tremor-dominant phenotype.
INTRODUCTION: Re-emergent tremor (RET) is a postural tremor that appears after a variable delay in patients with Parkinson's disease (PD). The aim of the present study was to evaluate the occurrence and the clinical characteristics of RET in a population of patients with PD. METHODS: We consecutively assessed 210 patients with PD. We collected the patients' demographic and clinical data. RET was clinically characterized in terms of latency, severity and body side affected. We also investigated a possible relationship with motor and non-motor symptoms and differences in the clinical features in patients with and without RET. RESULTS: RET was present in 42/210 patients. The mean latency of RET was 9.20 ± 6.8 seconds. Mean severity was 2.4 ± 1.9. RET was unilateral in 21 patients. Patients with RET had less severe speech, posture and gait disorders and upper limb and global bradykinesia than patients without RET. Similar findings were observed when we compared patients with RET with patients with tremor at rest associated with action tremor, patients with isolated action tremor and patients with no tremor. By contrast, patients with RET tremor did not clinically differ from those with isolated tremor at rest. CONCLUSION: Our results suggest that patients with RET and patients with isolated tremor at rest represent the same clinical subtype, whereas patients with action tremor (whether isolated or associated with tremor at rest) might belong to a distinct subtype that is clinically worse. Patients with RET represents a benign subtype of PD, even within the tremor-dominant phenotype.
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