Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX.
Tremor Other Hyperkinet Mov (N Y). 2021 Mar 29;11:12. doi: 10.5334/tohm.581.
Patients with essential tremor were initially considered to have isolated tremor, but additional motor and non-motor features have been increasingly recognized. The term "essential tremor plus" was adopted by the Task Force on Tremor of the International Parkinson and Movement Disorder Society to describe essential tremor patients with additional neurologic signs.
To characterize essential tremor patients and their phenotypes in a movement disorders clinic population in the context of the new tremor classification.
Demographic, clinical, historical, treatment, and diagnostic data were retrospectively collected on 300 patients diagnosed by movement disorder experts with essential tremor. Patients were classified as having essential tremor, essential tremor plus, or essential tremor-Parkinson's disease combination, and features between these groups were compared.
Of the 300 patients, 20.7% were classified as isolated essential tremor, 53.3% as essential tremor plus, and 26.0% as essential tremor-Parkinson's disease. There was no significant difference in the duration of tremor symptoms. Essential tremor plus patients were more likely to have dystonia, tandem gait abnormalities, head tremor and greater tremor severity. Essential tremor-Parkinson's disease patients were more likely to have RBD symptoms. There was no significant difference in cognitive impairment between essential tremor plus and essential tremor-Parkinson's disease patients.
Additional motor and non-motor features, including parkinsonism, are common in patients with essential tremor. Further studies are needed to clarify essential tremor phenotypes and to provide insights into possible subtypes.
300 patients with essential tremor from a movement disorders clinic were re-classified based on the Movement Disorder Society Consensus Statement on the Classification of Tremors. Additional motor and non-motor features, including parkinsonism, were common, and only 20.7% of patients remained classified as isolated essential tremor.
最初，人们认为特发性震颤患者仅有孤立性震颤，但越来越多的研究发现其存在多种运动和非运动症状。国际帕金森病和运动障碍协会震颤特遣队采用“特发性震颤附加症”这一术语来描述伴有其他神经系统体征的特发性震颤患者。
在新的震颤分类框架下，对运动障碍门诊患者中特发性震颤患者及其表型进行特征描述。
回顾性收集 300 例经运动障碍专家诊断为特发性震颤患者的人口统计学、临床、病史、治疗和诊断数据。根据震颤特发性震颤共识声明对患者进行分类，分为特发性震颤、特发性震颤附加症和特发性震颤-帕金森病组合，并比较这些组之间的特征。
300 例患者中，20.7%为孤立性特发性震颤，53.3%为特发性震颤附加症，26.0%为特发性震颤-帕金森病组合。震颤症状持续时间无显著差异。特发性震颤附加症患者更易出现肌张力障碍、步态共济失调、头部震颤和更严重的震颤。特发性震颤-帕金森病患者更易出现 RBD 症状。特发性震颤附加症和特发性震颤-帕金森病患者的认知障碍无显著差异。
特发性震颤患者常伴有其他运动和非运动症状，包括帕金森病。需要进一步研究以明确特发性震颤的表型，并为可能的亚型提供见解。
根据运动障碍协会震颤共识声明，对来自运动障碍门诊的 300 例特发性震颤患者进行重新分类。除震颤外，还存在多种运动和非运动症状，包括帕金森病，仅有 20.7%的患者仍被归类为孤立性特发性震颤。
