Louis Elan D, Machado Duarte G
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA.
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.
Parkinsonism Relat Disord. 2015 Jul;21(7):729-35. doi: 10.1016/j.parkreldis.2015.04.019. Epub 2015 Apr 24.
Tremor-related quality of life is a multi-dimensional concept that reflects the physical, emotional and other health effects of tremor. Curiously, tremor-related quality of life has never been directly compared in patients with the two major tremor disorders, essential tremor (ET) and Parkinson's disease (PD). We performed a head-to-head comparison of ET with PD patients.
The Quality of Life in Essential Tremor (QUEST) questionnaire was administered to 103 ET and 103 matched PD patients enrolled in a clinical-epidemiological study in New York.
The QUEST total score and QUEST physical subscore were higher in ET than PD patients (both p < 0.05). In relative terms, ET patients reported significantly more impairment than PD patients in multiple areas; PD patients reported more impairment than ET patients in one area (all p ≤ 0.02). In absolute terms, tremor impacted on many aspects of quality of life in both diseases, including physical and psychosocial, and in one-third or more of PD patients, tremor sometimes, frequently or always interfered with numerous physical activities, including writing, using a typewriter/computer, fixing small things, dressing, eating, and holding reading material.
Tremor is a clinical entity that can have numerous effects on patients. While there were relative differences between the two major tremor disorders, ET and PD, in absolute terms, tremor impacted on several domains of quality of life, from physical to psychosocial, in a large proportion of ET and PD patients. Attempts to judge the efficacy of treatments for tremor, whether pharmacological or surgical, should consider its broad impact.
与震颤相关的生活质量是一个多维度概念，反映了震颤对身体、情感及其他健康方面的影响。奇怪的是，从未对两种主要震颤疾病，即特发性震颤（ET）和帕金森病（PD）患者的与震颤相关的生活质量进行过直接比较。我们对ET患者和PD患者进行了直接对比。
对纽约一项临床流行病学研究中纳入的103例ET患者和103例匹配的PD患者进行特发性震颤生活质量（QUEST）问卷调查。
ET患者的QUEST总分和QUEST身体亚评分高于PD患者（均p<0.05）。相对而言，ET患者在多个领域报告的功能损害明显多于PD患者；PD患者在一个领域报告的功能损害多于ET患者（均p≤0.02）。绝对而言，震颤影响了两种疾病生活质量的许多方面，包括身体和心理社会方面，并且在三分之一或更多的PD患者中，震颤有时、经常或总是干扰许多身体活动，包括书写、使用打字机/电脑、修理小物件、穿衣、进食和拿取阅读材料。
震颤是一种可对患者产生多种影响的临床病症。虽然两种主要震颤疾病ET和PD之间存在相对差异，但绝对而言，震颤在很大比例的ET和PD患者中影响了从身体到心理社会等多个生活质量领域。判断震颤治疗（无论是药物治疗还是手术治疗）的疗效时应考虑其广泛影响。
