Koneru Vindhya, Ondo William G
Department of Neurology Houston Methodist Neurological Institute, Houston Methodist Hospital Houston Texas USA.
Department of Neurology Weill Cornell Medical College New York USA.
Mov Disord Clin Pract. 2020 Nov 17;8(1):111-113. doi: 10.1002/mdc3.13109. eCollection 2021 Jan.
Parkinson's Disease (PD) can present with dystonia or essential tremor but task specific tremor (TST) preceding PD has been only rarely reported. The relationship between TST and PD is unclear. We report a series of 12 patients with TST who later developed PD.
Patients with TST and PD were identified from our database. Records and imaging were reviewed and descriptive statistics presented. Twelve patients were identified. All 11 patients who had TST of arm developed rest tremor ipsilateral to the TST arm. DaTscan showed reduced dopaminergic uptake in all 11 patients who were scanned. The TST improved with STN and VIM DBS (3/12) and partially to dopaminergic medications (N = 3) and trihexyphenidyl (N = 2).
Rest tremor consistently occurring ipsilateral to TST, positive DaTscan, and partial response to dopaminergic medications but not to ET medications suggests TST is a precursor to PD in this population rather than chance occurrence.
帕金森病（PD）可伴有肌张力障碍或特发性震颤，但PD之前出现的任务特异性震颤（TST）仅有极少报道。TST与PD之间的关系尚不清楚。我们报告了一系列12例后来发展为PD的TST患者。
从我们的数据库中识别出患有TST和PD的患者。回顾了记录和影像学资料并给出描述性统计结果。共识别出12例患者。所有11例出现手臂TST的患者在TST手臂同侧出现静止性震颤。DaTscan显示，在所有接受扫描的11例患者中多巴胺能摄取减少。TST在接受丘脑底核（STN）和丘脑腹中间核（VIM）深部脑刺激（DBS）治疗的患者中得到改善（3/12），部分患者对多巴胺能药物（N = 3）和苯海索（N = 2）有反应。
TST同侧持续出现静止性震颤、DaTscan阳性以及对多巴胺能药物而非特发性震颤药物有部分反应，提示在该人群中TST是PD的前驱症状而非偶然发生。
