Li Mingqiang, He Runcheng, Zhou Xun, Wang Yuzheng, Sun Qiying, Wang Chunyu, Zeng Sheng, Lei Lifang, Wu Heng, Yi Shanqing, Wen Jun, Xu Qian, Guo Jifeng, Tang Beisha
Department of Neurology, Multi-Omics Research Center for Brain Disorders, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
The First Affiliated Hospital, Clinical Research Center for Immune-Related Encephalopathy of Hunan Province, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Brain Behav. 2025 Feb;15(2):e70288. doi: 10.1002/brb3.70288.
Distinguishing between essential tremor (ET) and tremor-dominant Parkinson's disease (PD-TD) can be challenging due to overlapping motor symptoms. This study aims to investigate the differences in nonmotor symptoms (NMS) between ET and PD-TD patients to provide additional evidence for differentiating these two conditions.
This retrospective study included 1656 participants, comprising 558 PD-TD patients, 584 ET patients, and 514 controls. ET patients were assessed using the Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS), while PD-TD patients were evaluated based on the Unified Parkinson's Disease Rating Scale (UPDRS). All participants were assessed for NMS using the Nonmotor Symptoms Scale (NMSS).
The composite NMSS score for the PD-TD group was significantly higher than that for the ET group and the control group (23.44 ± 20.20 vs. 12.60 ± 14.89 vs. 9.37 ± 12.44, p < 0.001). Compared to ET patients, PD-TD patients had an increased risk of all NMS, especially in hyposmia (OR = 7.70, 95% CI: 5.11-11.62). The NMSS score, urinary symptoms, and hyposmia may play a role in differentiating ET from PD-TD. The area under the curve (AUC) is 0.766 (95% CI: 0.739-0.793), with a sensitivity of 80.8% and specificity of 58.6%. When family history is included in the analysis, the AUC increases to 0.819 (95% CI: 0.795-0.843), with sensitivity improving to 82.4% and specificity to 68.2%.
The study reveals significant differences in NMS between ET and PD-TD. Compared to patients with ET, those with PD-TD exhibit more frequent and severe NMS. NMS and family history are helpful in differentiating between ET and PD-TD.
由于运动症状重叠，区分特发性震颤（ET）和震颤为主型帕金森病（PD - TD）具有挑战性。本研究旨在调查ET和PD - TD患者非运动症状（NMS）的差异，为区分这两种疾病提供额外证据。
这项回顾性研究纳入了1656名参与者，包括558名PD - TD患者、584名ET患者和514名对照。ET患者使用震颤研究组特发性震颤评定量表（TETRAS）进行评估，而PD - TD患者则根据统一帕金森病评定量表（UPDRS）进行评估。所有参与者使用非运动症状量表（NMSS）评估NMS。
PD - TD组的NMSS综合评分显著高于ET组和对照组（23.44±20.20 vs. 12.60±14.89 vs. 9.37±12.44，p < 0.001）。与ET患者相比，PD - TD患者所有NMS的风险均增加，尤其是嗅觉减退（比值比 = 7.70，95%置信区间：5.11 - 11.62）。NMSS评分、泌尿系统症状和嗅觉减退可能在区分ET和PD - TD中起作用。曲线下面积（AUC）为0.766（95%置信区间：0.739 - 0.793），敏感性为80.8%，特异性为58.6%。当分析中纳入家族史时，AUC增加到0.819（95%置信区间：0.795 - 0.843），敏感性提高到82.4%，特异性提高到68.2%。
该研究揭示了ET和PD - TD在NMS方面的显著差异。与ET患者相比，PD - TD患者表现出更频繁、更严重的NMS。NMS和家族史有助于区分ET和PD - TD。
