Sengul Yildizhan, Sengul Hakan S, Sural Müge Kocak, Bakim Bahadir, Forta Hulki
Department of Neurology, Erzurum Regional Training and Research Hospital, Cat Yolu, Palandoken, Erzurum, Turkey,
Acta Neurol Belg. 2015 Sep;115(3):289-94. doi: 10.1007/s13760-014-0408-6. Epub 2014 Dec 21.
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.
在过去十年中，我们对特发性震颤（ET）作为一种纯粹的运动系统疾病的看法开始发生变化。鉴于最近对用于表征帕金森病（PD）的非运动症状（NMSs）的研究，这些症状也已被纳入ET的定义中。越来越多的证据表明，ET可能并不像我们之前认为的那样良性且单一症状。本研究的目的是评估ET中的非运动症状，并将其与PD进行比较。我们研究了37例ET患者和23例PD患者。使用Fahn-Tolosa-Marin震颤评定量表（FTM-TRS）评估ET患者的震颤频率。使用统一帕金森病评定量表（UPDRS）-III和Hoehn-Yahr量表对PD患者的运动症状进行评分。使用蒙特利尔认知评估（MoCA）测试评估认知功能。使用非运动症状问卷（NMSQuest）评估NMSs。在ET组中，最常见的NMSs是遗忘、悲伤情绪、夜尿症、尿急和注意力不集中。ET组的NMSQuest平均得分为8.43±4.14，PD组为14.06±5.44（p值<0.001）。然而，除了NMSQuest中的12个项目外，逐一比较项目时它们之间没有统计学差异。ET组的MoCA总分平均为17.81±4.56，PD组为17.08±4.08（p值0.675）。MoCA亚组得分没有显著差异。评估ET中的非运动症状可能有助于我们理解ET的这一新兴定义。本研究为这一新概念提供了证据。
