Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Acta Neurol Scand. 2020 Jul;142(1):74-82. doi: 10.1111/ane.13242. Epub 2020 Mar 26.
There have been few comprehensive scale studies on the non-motor symptoms (NMS) of patients with essential tremor (ET) with head tremor (ETh) and those with ET without head tremor (ETol). We aimed to explore the motor symptoms and NMS of these two subgroups.
We enrolled 199 patients with ET (125, ETol; 74 ETh) and 132 healthy controls. We evaluated motor symptoms using the Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and NMS using the Non-Motor Symptom Scale (NMSS). We compared NMSS scores and the prevalence of each NMS between the patient subgroups. Finally, we conducted a logistic regression analysis of the correlation between head tremor and NMS severity, as well as other determinants.
There were no significant between-subgroup differences in demographic characteristics. Further, they presented similar tremor clinical manifestation; however, the ETh subgroup showed a higher prevalence of rest tremor, feeling of sadness, forgetting things or events, and swallowing difficulty, as well as TRS scores, compared with the ETol subgroup. Both patient subgroups showed high scores and prevalence (>50%) in difficulty falling asleep. Logistic regression analysis indicated age as a tremor severity determinant; further, head tremor and tremor severity were NMS determinants.
Both patient subgroups presented various NMS including sleep disturbances, cognitive deficits, and affective disorders. The ETh subgroup showed a high prevalence of certain NMS aspects including memory and affective disorder; further, they had aggravated NMS. ET with both upper limb tremor and head tremor may be regarded as a more severe clinical subtype.
针对头部震颤（ETh）伴震颤和不伴头部震颤（ETol）的原发性震颤（ET）患者的非运动症状（NMS），鲜有全面的量表研究。我们旨在探讨这两个亚组的运动症状和 NMS。
我们纳入了 199 例 ET 患者（125 例 ETol；74 例 ETh）和 132 例健康对照者。我们使用 Fahn-Tolosa-Marin 震颤评定量表（TRS）评估运动症状，使用非运动症状量表（NMSS）评估 NMS。我们比较了患者亚组之间的 NMSS 评分和每个 NMS 的发生率。最后，我们进行了逻辑回归分析，以评估头部震颤与 NMS 严重程度以及其他决定因素之间的相关性。
亚组间在人口统计学特征方面无显著差异。进一步，它们表现出相似的震颤临床表现；然而，ETh 亚组与 ETol 亚组相比，静止性震颤、悲伤感、健忘或遗忘事情和吞咽困难的发生率更高，TRS 评分也更高。两个患者亚组均表现出较高的入睡困难评分和发生率（>50%）。逻辑回归分析表明年龄是震颤严重程度的决定因素；进一步，头部震颤和震颤严重程度是 NMS 的决定因素。
两个患者亚组均表现出多种 NMS，包括睡眠障碍、认知缺陷和情感障碍。ETh 亚组表现出某些 NMS 方面（如记忆和情感障碍）的高发生率，并且这些 NMS 更为严重。同时伴有上肢震颤和头部震颤的 ET 可能被视为更为严重的临床亚型。
