Udwani Sachin K, Desai Soaham D
Department of Neurology, Shree Krishna Hospital, Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India.
Ann Indian Acad Neurol. 2024 Mar-Apr;27(2):122-130. doi: 10.4103/aian.aian_36_24. Epub 2024 Apr 27.
Non-parkinsonian tremors represent a heterogeneous spectrum of movement disorders where knowledge gaps persist regarding epidemiology, pathophysiology, and clinical burden. This scoping review aimed to systematically consolidate literature on these disorders in India across the domains of prevalence, biological mechanisms, psychiatric comorbidity, disability impact, and quality of life. A systematic search was undertaken across databases to identify studies on non-parkinsonian tremors in India. Extracted data were synthesized descriptively under themes spanning reported prevalence estimates and variability, proposed biological processes, psychiatric symptom rates, stigma perceptions, and quality-of-life deficits. Methodological appraisal was undertaken. Twenty-nine studies reported prevalence estimates displaying wide variability from 0.09% to 22% for essential tremor, partly attributable to definitional inconsistencies. Proposed pathologic processes centered on cerebellar dysfunction, neurotransmitter disturbances, and genetic risks. Nine studies revealed variable anxiety (6.8%-90%) and depression (3.4%-60%) rates among essential tremor patients, while two indicated perceived stigma. Five studies unanimously concurred significant quality of life impairment in essential tremors. Evidence of dystonic tremor, functional tremor, and other tremors was limited. This review exposed critical knowledge gaps and methodological limitations, while systematically evaluating the Indian literature on non-parkinsonian tremors concerning epidemiology, mechanisms, and clinical burden. Large-scale collaborative research applying standardized diagnostic criteria is imperative to determine contemporary prevalence statistics and comprehensively characterize the multifaceted disability footprint to inform patient-centric models optimizing diagnosis and holistic care.
非帕金森氏震颤代表了一系列异质性的运动障碍,在流行病学、病理生理学和临床负担方面仍存在知识空白。本范围综述旨在系统整合印度关于这些疾病在患病率、生物学机制、精神疾病共病、残疾影响和生活质量等领域的文献。对多个数据库进行了系统检索,以识别印度关于非帕金森氏震颤的研究。提取的数据在以下主题下进行了描述性综合:报告的患病率估计及其变异性、提出的生物学过程、精神症状发生率、耻辱感认知以及生活质量缺陷。进行了方法学评估。29项研究报告了患病率估计,原发性震颤的患病率从0.09%到22%显示出很大的变异性,部分原因是定义不一致。提出的病理过程集中在小脑功能障碍、神经递质紊乱和遗传风险上。9项研究显示原发性震颤患者中焦虑(6.8%-90%)和抑郁(3.4%-60%)的发生率各不相同,而两项研究表明存在耻辱感。5项研究一致认为原发性震颤患者的生活质量有显著损害。关于肌张力障碍性震颤、功能性震颤和其他震颤的证据有限。本综述揭示了关键的知识空白和方法学局限性,同时系统评估了印度关于非帕金森氏震颤的流行病学、机制和临床负担的文献。应用标准化诊断标准进行大规模合作研究对于确定当代患病率统计数据并全面描述多方面的残疾情况以指导以患者为中心的模型优化诊断和整体护理至关重要。