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Comparing Essential Tremor with and without Soft Dystonic Signs and Tremor Combined with Dystonia: The TITAN Study.

Authors :
Erro, Roberto
Lazzeri, Giulia
Terranova, Carmen
Paparella, Giulia
Gigante, Angelo Fabio
De Micco, Rosa
Magistrelli, Luca
Di Biasio, Francesca
Valentino, Francesca
Moschella, Vincenzo
Pilotto, Andrea
Esposito, Marcello
Olivola, Enrica
Malaguti, Maria Chiara
Ceravolo, Roberto
Dallocchio, Carlo
Spagnolo, Francesca
Nicoletti, Alessandra
De Rosa, Anna
Di Giacopo, Raffaella
Source :
Movement Disorders Clinical Practice; Jun2024, Vol. 11 Issue 6, p645-654, 10p
Publication Year :
2024

Abstract

Background: Tremor disorders remain as clinical diagnoses and the rate of misdiagnosis between the commonest non‐parkinsonian tremors is relatively high. Objectives: To compare the clinical features of Essential Tremor without other features (pure ET), ET plus soft dystonic signs (ET + DS), and tremor combined with dystonia (TwD). Methods: We compared the clinical features of patients with pure ET, ET + DS, and TwD enrolled in The ITAlian tremor Network (TITAN). Linear regression models were performed to determine factors associated with health status and quality of life. Results: Three‐hundred‐eighty‐three patients were included. Sex distribution was significantly different between the groups with males being more represented in pure ET and females in TwD. The initial site of tremor was different between the groups with about 40% of TwD having head tremor and ET + DS unilateral upper limb tremor at onset. This pattern mirrored the distribution of overt dystonia and soft dystonic signs at examination. Sensory trick, task‐specificity, and position‐dependence were more common, but not exclusive, to TwD. Pure ET patients showed the lowest degree of alcohol responsiveness and ET + DS the highest. Midline tremor was more commonly encountered and more severe in TwD than in the other groups. Regression analyses demonstrated that tremor severity, sex, age, and to a lesser degree the variable "group", independently predicted health status and quality of life, suggesting the existence of other determinants beyond tremor. Conclusions: Pure ET and TwD manifest with a phenotypic overlap, which calls for the identification of diagnostic biomarkers. ET + DS shared features with both syndromes, suggesting intra‐group heterogeneity. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
23301619
Volume :
11
Issue :
6
Database :
Complementary Index
Journal :
Movement Disorders Clinical Practice
Publication Type :
Academic Journal
Accession number :
177626431
Full Text :
https://doi.org/10.1002/mdc3.14026