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; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Parkinsonism Relat Disord. 2019 Jun;63:10-19. doi: 10.1016/j.parkreldis.2019.02.038. Epub 2019 Mar 1.
Although the hallmark feature of essential tremor (ET) is tremor, there is growing appreciation that cognitive impairment also occurs, including increased prevalence of mild cognitive impairment (MCI) and increased prevalence and incidence of dementia. With emerging knowledge of ET-cognitive impairment, come fundamental questions regarding its course, bases, predictors and clinical outcomes. Studies in the general population and in Parkinson's disease (PD), a related movement disorder, offer a starting point from which to begin filling these clinically important knowledge gaps.
A PubMed search (June 2018) identified articles for this review.
Much of our knowledge of cognitive impairment in ET is of the static condition (e.g., prevalence of cognitive impairment in ET), with nearly no information on its bases, predictors and dynamics (i.e., course, and clinical outcomes). In PD, where such data have been published, rates of cognitive decline and conversion to MCI/dementia are higher than in the general population. Predictors of cognitive change in PD and the general population have also been identified, yet they only partially overlap one another.
The predictors and dynamics of cognitive impairment have been investigated fairly extensively in the general population, to a somewhat lesser extent in PD, and are emerging only now in ET. We suggest that longitudinal studies specific to ET are needed, and we outline variables to be considered in these investigations. Increased knowledge of ET-cognitive impairment will facilitate meaningful counseling of patients and their families.
尽管特发性震颤（ET）的标志特征是震颤，但人们越来越认识到认知障碍也会发生，包括轻度认知障碍（MCI）的患病率增加，以及痴呆症的患病率和发病率增加。随着对 ET-认知障碍的认识不断提高，出现了关于其病程、基础、预测因素和临床结果的基本问题。在一般人群和帕金森病（PD）中的研究为填补这些具有重要临床意义的知识空白提供了起点。
通过 PubMed 搜索（2018 年 6 月）确定了本综述的文章。
我们对 ET 认知障碍的大部分了解都是静态的（例如，ET 认知障碍的患病率），几乎没有关于其基础、预测因素和动态（即病程和临床结果）的信息。在已经发表了这些数据的 PD 中，认知下降和转化为 MCI/痴呆的速度高于一般人群。PD 和一般人群中认知变化的预测因素也已被确定，但它们彼此只有部分重叠。
认知障碍的预测因素和动态在一般人群中已经得到了相当广泛的研究，在 PD 中则稍逊一筹，而在 ET 中才刚刚出现。我们建议需要针对 ET 进行纵向研究，并概述了这些研究中需要考虑的变量。增加对 ET-认知障碍的了解将有助于对患者及其家属进行有意义的咨询。
