Okusa Shohei, Tezuka Toshiki, Nihei Yoshihiro, Nakahara Jin, Seki Morinobu
Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
Parkinson's Disease Center, Keio University Hospital, Tokyo, Japan.
Tremor Other Hyperkinet Mov (N Y). 2025 May 7;15:21. doi: 10.5334/tohm.1006. eCollection 2025.
Essential tremor (ET) is primarily characterized by action tremor, but is also associated with various non-motor symptoms (NMS). However, the diagnostic relevance of NMS in ET remains unclear. This study aimed to compare NMS and motor symptoms of ET with those of Parkinson's disease-tremor dominant type (PD-TDT) and healthy controls (HCs) and to identify the presence and diagnostic relevance of NMS.
Twenty-three ET patients, 23 PD-TDT patients, and 22 HCs were enrolled. Diagnoses of ET and PD were confirmed using Movement Disorder Society (MDS) criteria and Dopamine transporter single-photon emission computed tomography. Motor symptoms, NMS and quality of life (QOL) were evaluated using validated scales, including the Clinical Rating Scale for Tremor (CRST), MDS-Unified Parkinson's Disease Rating Scale (UPDRS), Non-Motor Symptoms Scale for Parkinson's Disease (NMSS), Odor Stick Identification Test for Japanese (OSIT-J), and Quality of Life in Essential Tremor Questionnaire (QUEST).
ET patients had significantly higher NMSS total scores and MDS-UPDRS part IB scores than HCs, with more severe sleep disturbances, fatigue, and urinary problems. CRST scores were significantly correlated with QUEST scores. Logistic regression identified CRST Part B and OSIT-J as key factors distinguishing ET from PD-TDT, with 87% sensitivity and 90% specificity.
ET patients showed more severe NMS than HCs. Differentiating ET from PD-TDT requires motor and sensory assessments, highlighting the diagnostic relevance of NMS. Comprehensive evaluation is essential for accurate diagnosis and management of ET.
特发性震颤（ET）主要以动作性震颤为特征，但也与各种非运动症状（NMS）相关。然而，NMS在ET中的诊断相关性仍不明确。本研究旨在比较ET患者与帕金森病震颤为主型（PD-TDT）患者及健康对照（HCs）的NMS和运动症状，并确定NMS的存在及其诊断相关性。
纳入23例ET患者、23例PD-TDT患者和22例HCs。采用运动障碍协会（MDS）标准和多巴胺转运体单光子发射计算机断层扫描确诊ET和PD。使用经过验证的量表评估运动症状、NMS和生活质量（QOL），包括震颤临床评分量表（CRST）、MDS统一帕金森病评定量表（UPDRS）、帕金森病非运动症状量表（NMSS）、日本嗅觉棒识别测试（OSIT-J）和特发性震颤生活质量问卷（QUEST）。
ET患者的NMSS总分和MDS-UPDRS第IB部分得分显著高于HCs，睡眠障碍、疲劳和泌尿系统问题更严重。CRST评分与QUEST评分显著相关。逻辑回归分析确定CRST B部分和OSIT-J是区分ET与PD-TDT的关键因素，敏感性为87%，特异性为90%。
ET患者的NMS比HCs更严重。区分ET与PD-TDT需要进行运动和感觉评估，突出了NMS的诊断相关性。全面评估对于ET的准确诊断和管理至关重要。
