Abstract
Introduction Topography of tremor manifestations is poorly investigated in essential tremor. The present study explores the prevalence and clinical correlates of head and/or voice tremor in essential tremor. Methods Out of a prospectively designed registry of 972 patients, 884 patients with definite and probable essential tremor had complete information on tremor localization. Demographic and clinical characteristics were compared among four subgroups: group A (without head or voice tremor, n = 619), B (with head but without voice tremor, n = 155), C (with voice but without head tremor, n = 47), and D (with both head and voice tremor, n = 63). Results In our patients, total prevalence of tremor was 24.7% for head, 12.4% for voice and 7.1% for the combination of head and voice. Logistic regression analyses showed that female gender is strongly associated with head tremor, which was confirmed by an additional meta-analysis. Severe hand tremor was the only factor associated with voice tremor. Both female gender and severe hand tremor increase the odds for having the combination of head and voice tremor. For males, hand tremor severity is significantly increased among those with head and voice tremor alone and in combination, but for females only for the combination. Patients with both head and voice tremor have more frequent involvement of legs and other localizations and are less responsive to β-blockers. Conclusions Female gender and severe hand tremor may increase the odds of head and/or voice tremor in essential tremor. The association of hand tremor severity with midline tremor is stronger for males than females.
| Original language | English |
|---|---|
| Journal | Parkinsonism and Related Disorders |
| Volume | 40 |
| Pages (from-to) | 58-63 |
| Number of pages | 6 |
| ISSN | 1353-8020 |
| DOIs | |
| Publication status | Published - 07.2017 |
Funding
The authors would like to thank all the ET patients participating in the study. F. Hopfner received grants from the German Research Council (DFG DE 438/11-1), the International Essential Tremor Foundation (IETF) and the medical faculty of the Christian-Albrechts-University Kiel. Wei Chen received grants from Youth Fund of Shanghai Ninth People's Hospital (2013), K.C.Wong Medical Fund of Shanghai Jiao Tong University (2015), and National Natural Science Fund of China (81401039). Silke Szymczak receives research support from the German Federal Ministry of Education and Research (BMBF). Oliver Granert has received a lecture fee from UCB. Stefanie H. M?ller reports no disclosures. G. Kuhlenb?umer receives research support from the German Research Council (DFG), the International Essential Tremor Foundation (IETF) and the Christian-Albrechts-University Kiel. G. Deuschl has received lecture fees from UCB, Medtronic and Desitin and has been serving as a consultant for Medtronic, Sapiens, Boston Scientific and Britannica. He received royalties from Thieme publishers. He receives through his institution funding for his research from the German Research Council, the German Ministry of Education and Health and Medtronic. All authors are government employees.
