Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain.
Neurology. 2013 Jul 2;81(1):60-6. doi: 10.1212/WNL.0b013e318297ef2b. Epub 2013 May 22.
To characterize the rate of cognitive decline during the premotor phase of essential tremor (ET) in comparison to prevalent ET cases and controls.
In this population-based, prospective study of people aged 65 years and older (Neurological Disorders in Central Spain), a 37-item version of the Mini-Mental State Examination was administered at 2 visits (baseline and follow-up, approximately 3 years later). We compared the rate of cognitive decline in 3 groups: prevalent ET cases (i.e., participants diagnosed with ET at baseline and at follow-up), "premotor" ET cases (i.e., participants diagnosed with incident ET at follow-up, but not at baseline), and controls (i.e., participants not diagnosed with ET at baseline or follow-up).
The 2,375 participants included 135 prevalent ET cases, 56 premotor ET cases, and 2,184 controls. During the follow-up period of 3.4 ± 0.5 years (mean ± SD), the 37-item version of the Mini-Mental State Examination declined by 0.7 ± 3.3 points (0.2 ± 1.0 points/year) in prevalent ET cases, 1.1 ± 3.5 points (0.3 ± 1.0 points/year) in premotor ET cases, and 0.1 ± 3.9 points (0.0 ± 1.2 points/year) in controls (p = 0.014). The difference between premotor ET cases and controls was significant (p = 0.046), as was the difference between prevalent ET cases and controls (p = 0.027).
In this prospective cohort, cognitive test scores in premotor and prevalent ET cases declined at a faster rate than in elders without this disease. A decline in global cognitive function may occur in a premotor phase of ET.
与普遍震颤（ET）病例和对照组相比，描绘 ET 运动前期认知下降的速度。
在这项基于人群的前瞻性研究中，对 65 岁及以上的人群（西班牙中部神经紊乱）进行了 37 项简易精神状态检查的测试，该测试在两次就诊时进行（基线和随访，大约 3 年后）。我们比较了 3 组人群的认知下降速度：普遍 ET 病例（即，在基线和随访时被诊断为 ET 的参与者）、“运动前期”ET 病例（即，在随访时被诊断为新发 ET 的参与者，但在基线时未被诊断）和对照组（即，在基线或随访时均未被诊断为 ET 的参与者）。
2375 名参与者包括 135 例普遍 ET 病例、56 例运动前期 ET 病例和 2184 例对照组。在 3.4±0.5 年的随访期间（平均值±标准差），37 项简易精神状态检查在普遍 ET 病例中下降了 0.7±3.3 分（0.2±1.0 分/年），在运动前期 ET 病例中下降了 1.1±3.5 分（0.3±1.0 分/年），在对照组中下降了 0.1±3.9 分（0.0±1.2 分/年）（p=0.014）。运动前期 ET 病例与对照组之间的差异具有统计学意义（p=0.046），普遍 ET 病例与对照组之间的差异也具有统计学意义（p=0.027）。
在这项前瞻性队列研究中，运动前期和普遍 ET 病例的认知测试分数下降速度快于没有这种疾病的老年人。在 ET 的运动前期可能会出现整体认知功能下降。
