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A comparison between rate of nonmotor symptom development in essential tremor and Parkinson’s disease

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Abstract

In the last decade our perspective on essential tremor (ET) as a pure motor system disorder has begun to change. By virtue of recent studies of nonmotor symptoms (NMSs) that are used to characterize Parkinson’s disease (PD), these symptoms have also been added to the definition of ET. There is increasing evidence to suggest that ET might not be as benign and monosymptomatic as we previously thought. The aim of this study was to evaluate nonmotor symptoms in ET, and to compare them with PD. We studied 37 ET and 23 PD patients. Tremor rate was evaluated using the Fahn–Tolosa–Marin tremor rating scale (FTM-TRS) in ET patients. The patients with PD were scored for motor symptoms using the unified Parkinson’s disease rating scale (UPDRS)-III and the Hoehn–Yahr scale. Cognitive functions were assessed with the Montreal Cognitive Assessment (MoCA) test. NMSs were evaluated with the nonmotor symptoms questionnaire (NMSQuest). In the ET group, the most common NMSs were forgetting things, feeling sad, nocturia, urgency, and difficulty concentrating. The mean NMSQuest score was 8.43 ± 4.14 in the ET group and 14.06 ± 5.44 in the PD group (p value <0.001). However, except for 12 items in NMSQuest, in comparing items one by one there was no statistical difference between them. The mean MoCA total score was 17.81 ± 4.56 in the ET group and 17.08 ± 4.08 in the PD group (p value 0.675). There were no significant differences in MoCA subgroup scores. Evaluation of nonmotor symptoms in ET may help us to understand this emerging definition of ET. This study contributes evidence toward this new concept.

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References

  1. Bonuccelli U (2012) Essential tremor is a neurodegenerative disease. J Neural Transm 119:1383–1387. doi:10.1007/s00702-012-0878-8

    Article  PubMed  Google Scholar 

  2. Deuschl G, Elble R (2009) Essential tremor–neurodegenerative or non-degenerative disease towards a working definition of ET. Mov Disord 24(14):2033–2041. doi:10.1002/mds.22755

    Article  PubMed  Google Scholar 

  3. Bermejo-Pareja F (2011) Essential tremor–a neurodegenerative disorder associated with cognitive defects? Nat Rev Neurol 7:273–282. doi:10.1038/nrneurol.2011.44

    Article  PubMed  Google Scholar 

  4. Bermejo-Pareja F, Puertas-Martín V (2012) Cognitive features of essential tremor: a review of the clinical aspects and possible mechanistic underpinnings. Tremor Other Hyperkinet Mov 2. pii:02-74-541-1

  5. Rajput AH, Rozdilsky B, Ang L, Rajput A (1991) Clinicopathologic observations in essential tremor: report of six cases. Neurology 41:1422–1424

    Article  CAS  PubMed  Google Scholar 

  6. Louis ED, Faust PL, Vonsattel JP, Honig LS, Rajput A, Robinson CA, Rajput A, Pahwa R, Lyons KE, Ross GW, Borden S, Moskowitz CB, Lawton A, Hernandez N (2007) Neuropathological changes in essential tremor: 33 cases compared with 21 controls. Brain 130:3297–3307

    Article  PubMed  Google Scholar 

  7. Louis ED (2010) Essential tremor: evolving clinicopathological concepts in an era of intensive post-mortem enquiry. Lancet Neurol 9:613–622. doi:10.1016/S1474-4422(10)70090-9

    Article  PubMed  Google Scholar 

  8. Benito-León J, Louis ED (2006) Essential tremor: emerging views of a common disorder. Nat Clin Pract Neurol 2(12):666–678

    Article  PubMed  Google Scholar 

  9. Chaudhuri KR, Buxton-Thomas M, Dhawan V, Peng R, Meilak C, Brooks DJ (2005) Long duration asymmetrical postural tremor is likely to predict development of Parkinson’s disease and not essential tremor: clinical follow up study of 13 cases. J Neurol Neurosurg Psychiatry 76(1):115–117

    Article  PubMed Central  PubMed  Google Scholar 

  10. Labiano-Fontcuberta A, Benito-León J (2012) Essential tremor and Parkinson’s disease: are they associated? Rev Neurol 55(8):479–489

    PubMed  Google Scholar 

  11. Chaudhuri KR, Healy DG, Schapira AH (2006) National Institute for Clinical Excellence. Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol 5:235–245

    Article  PubMed  Google Scholar 

  12. Chandran V, Pal PK (2012) Essential tremor: beyond the motor features. Parkinsonism Relat Disord 18:407–413. doi:10.1016/j.parkreldis.2011.12.003

    Article  PubMed  Google Scholar 

  13. Chandran V, Pal PK, Reddy JY, Thennarasu K, Yadav R, Shivashankar N (2012) Non-motor features in essential tremor. Acta Neurol Scand 125(5):332–337. doi:10.1111/j.1600-0404.2011.01573.x

    Article  CAS  PubMed  Google Scholar 

  14. Kim JS, Song IU, Shim YS, Park JW, Yoo JY, Kim YI, Lee KS (2009) Cognitive impairment in essential tremor without dementia. J Clin Neurol 5:81–84. doi:10.3988/jcn.2009.5.2.81

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Janicki SC, Cosentino S, Louis ED (2013) The cognitive side of essential tremor: what are the therapeutic implications? Ther Adv Neurol Disord 6:353–368. doi:10.1177/1756285613489591

    Article  PubMed Central  PubMed  Google Scholar 

  16. Louis ED (2010) Essential tremor as a neuropsychiatric disorder. J Neurol Sci 15(289):144–148. doi:10.1016/j.jns.2009.08.029

    Article  Google Scholar 

  17. Elble RJ (2000) Diagnostic criteria for essential tremor and differential diagnosis. Neurology 54:2–6

    Article  Google Scholar 

  18. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Stacy MA, Elble RJ, Ondo WG, Wu SC (2007) Hulihan J; TRS study group. Assessment of interrater and intrarater reliability of Fahn-Tolosa-Marin Tremor Rating Scale in essential tremor. Mov Disord 30(22):833–838

    Article  Google Scholar 

  20. Ozdilek B, Kenangil G (2014) Validation of the Turkish Version of the Montreal Cognitive Assessment Scale (MoCA-TR) in patients with Parkinson’s disease. Clin Neuropsychol 28:333–343. doi:10.1080/13854046.2014.881554

    Article  PubMed  Google Scholar 

  21. Pendlebury ST, Mariz J, Bull L, Mehta Z, Rothwell PM (2012) MoCA, ACE-R, and MMSE versus the National institute of neurological disorders and Stroke-Canadian stroke network vascular cognitive impairment harmonization standards neuropsychological battery after TIA and stroke. Stroke 43:464–469. doi:10.1161/STROKEAHA.111.633586

    Article  PubMed  Google Scholar 

  22. http://www.mocatest.org/pdf_files/test/MOCA-Test-Turkish.pdf

  23. Storch A, Odin P, Trender-Gerhard I, Fuchs G, Reifschneider G, Ray Chaudhuri K, Jost WH, Ebersbach G (2010) Non-motor Symptoms Questionnaire and Scale for Parkinson’s disease. Cross-cultural adaptation into the German language. Nervenarzt 81:980–985. doi:10.1007/s00115-010-3010-z

    Article  CAS  PubMed  Google Scholar 

  24. Romenets SR, Wolfson C, Galatas C, Pelletier A, Altman R, Wadup L, Postuma RB (2011) Validation of the non-motor symptoms questionnaire (NMS-Quest). Parkinsonism Relat Disord 18:54–58. doi:10.1016/j.parkreldis.2011.08.013

    Article  PubMed  Google Scholar 

  25. https://www.parkinsons.org.uk/sites/default/files/publications/download/english/nms_questionnaire.pdf

  26. Chaudhuri KR, Martinez-Martin P, Schapira AH, Stocchi F, Sethi K, Odin P, Brown RG, Koller W, Barone P, MacPhee G, Kelly L, Rabey M, MacMahon D, Thomas S, Ondo W, Rye D, Forbes A, Tluk S, Dhawan V, Bowron A, Williams AJ, Olanow CW (2006) International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson’s disease: the NMSQuest study. Mov Disord 21:916–923

    Article  PubMed  Google Scholar 

  27. Gasparini M, Bonifati V, Fabrizio E, Fabbrini G, Brusa L, Lenzi GL, Meca G (2001) Frontal lobe dysfunction in essential tremor: preliminary study. J Neurol 248:399–402

    Article  CAS  PubMed  Google Scholar 

  28. Lombardi WJ, Woolston DJ, Roberts JW, Gross RE (2001) Cognitive deficits in patients with essential tremor. Neurology 57:785–790

    Article  CAS  PubMed  Google Scholar 

  29. Lacritz LH, Dewey R Jr, Giller C, Cullum CM (2002) Cognitive functioning in individuals with “benign” essential tremor. J Int Neuropsychol Soc 8(125–9):25

    Google Scholar 

  30. Tröster AI, Woods SP, Fields JA, Lyons KE, Pahwa R, Higginson CI, Koller WC (2002) Neuropsychological deficits in essential tremor: an expression of cerebello-thalamo-cortical pathophysiology? Eur J Neurol 9:143–151

    Article  PubMed  Google Scholar 

  31. Sahin HA, Terzi M, Uçak S, Yapici O, Basoglu T, Onar M (2006) Frontal functions in young patients with essential tremor: a case comparison study. J Neuropsychiatry Clin Neurosci 18:64–72

    Article  PubMed  Google Scholar 

  32. Benito-León J, Louis ED, Bermejo-Pareja F; Neurological Disorders in Central Spain (NEDICES) Study Group (2006) Population-based case-control study of cognitive function in essential tremor. Neurology 66(69–74):27

    Google Scholar 

  33. Louis ED, Benito-León J, Vega-Quiroga S, Bermejo-Pareja F; Neurological Disorders in Central Spain (NEDICES) Study Group (2010) Cognitive and motor functional activity in non-demented community-dwelling essential tremor cases. J Neurol Neurosurg Psychiatry 81:997–1001. doi:10.1136/jnnp.2009.202838

    Article  Google Scholar 

  34. Kim JS, Song IU, Shim YS, Park JW, Yoo JY, Kim YI, Lee KS (2010) Impact of tremor severity on cognition in elderly patients with essential tremor. Neurocase 16:50–58. doi:10.1080/13554790903193216

    Article  CAS  PubMed  Google Scholar 

  35. Bermejo-Pareja F, Louis ED, Benito-León J; Neurological Disorders in Central Spain (NEDICES) Study Group (2007) Risk of incident dementia in essential tremor: a population-based study. Mov Disord 22:1573–1580

    Article  Google Scholar 

  36. Giorelli M, Bagnoli J, Consiglio L, Lopane M, Zimatore GB, Zizza D, Difazio P (2014) Do non-motor symptoms in Parkinson’s disease differ from essential tremor before initial diagnosis? A clinical and scintigraphic study. Parkinsonism Relat Disord 20:17–21. doi:10.1016/j.parkreldis.2013.09.004

    Article  PubMed  Google Scholar 

  37. Lageman SK, Cash TV, Mickens MN (2014) Patient-reported needs, non-motor symptoms, and quality of life in essential tremor and Parkinson’s disease. Tremor Other Hyperkinet Mov 5(4):240. doi:10.7916/D8RF5S4J

    Google Scholar 

  38. Louis ED, Benito-León J, Bermejo- Pajera F, Neurological Disorders in Central Spain (NEDICES) Study Group (2007) Self-reported depression and anti-depressant medication use in essential tremor: cross-sectional and prospective analyses in a population-based study. Eur J Neurol 14:1138–1146

    Article  Google Scholar 

  39. Giorelli M, Bagnoli J, Consiglio L, Difazio P, Zizza D, Zimatore GB (2014) Change in non-motor Symptoms in Parkinson’s disease and essential tremor patients: A One-year Follow-up Study. Tremor Other Hyperkinet Mov 14(4):216. doi:10.7916/D82J68TH

    Google Scholar 

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Acknowledgments

We thank Dr. Murat Terzi for his valuable contribution. There was no funding source in this study.

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The authors declare that there is no conflict of interest.

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Correspondence to Yildizhan Sengul.

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Sengul, Y., Sengul, H.S., Sural, M.K. et al. A comparison between rate of nonmotor symptom development in essential tremor and Parkinson’s disease. Acta Neurol Belg 115, 289–294 (2015). https://doi.org/10.1007/s13760-014-0408-6

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