Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul 15:366:47-51.
doi: 10.1016/j.jns.2016.04.040. Epub 2016 Apr 23.

Essential tremor-Parkinson's disease: A double whammy

Elan D Louis  1 , Adina Wise  2 , Roy N Alcalay  3 , Ashwini K Rao  4 , Pam Factor-Litvak  5
Affiliations

Essential tremor-Parkinson's disease: A double whammy

Elan D Louis et al. J Neurol Sci. .

Abstract

Background: Surprisingly little has been written about the combined clinical entity, essential tremor-Parkinson's disease (ET-PD), which is the result of a double disease hit. We carefully quantified tremor burden using a wide range of measures (tremor severity, tremor-related disability, tremor-related quality of life) and furthermore, studied additional motor and non-motor features in ET-PD.

Methods: In this prospective, clinical-epidemiological study, we performed a standardized, structured clinical evaluation of 27 ET-PD patients, comparing them to age-matched samples of 35 PD and 109 ET patients.

Results: The number of hours/day shaking was lowest in PD (median=3.0), intermediate in ET (median=10.0) and highest in ET-PD (median=14.0) (p<0.001). All measures of mobility and balance (Berg Balance test, Activities-specific Balance Confidence Scale, Timed Up and Go test) worsened across groups in a stepwise manner from ET to PD to ET-PD (p<0.05). Mini-mental state test scores worsened (p=0.002) and daytime sleepiness increased (p=0.002) across groups from ET to PD to ET-PD.

Conclusions: The ET-PD patient seems to be more than just a PD patient with a little more kinetic tremor. Aside from a significantly greater tremor burden, ET-PD patients exhibited more cognitive and sleep problems and more mobility and balance problems than patients with isolated PD.

Keywords: Clinical; Essential tremor; Parkinson’s disease.

PubMed Disclaimer

Conflict of interest statement

None

References

    1. Chaudhuri KR, Buxton-Thomas M, Dhawan V, Peng R, Meilak C, Brooks DJ. Long duration asymmetrical postural tremor is likely to predict development of Parkinson’s disease and not essential tremor: clinical follow up study of 13 cases. J Neurol Neurosurg Psychiatry. 2005;76:115–7. - PMC - PubMed
    1. Shahed J, Jankovic J. Exploring the relationship between essential tremor and Parkinson’s disease. Parkinsonism Relat Disord. 2007;13:67–76. - PubMed
    1. Benito-Leon J, Louis ED, Bermejo-Pareja F. Risk of incident Parkinson’s disease and parkinsonism in essential tremor: a population based study. J Neurol Neurosurg Psychiatry. 2009;80:423–5. - PubMed
    1. Minen MT, Louis ED. Emergence of Parkinson’s disease in essential tremor: a study of the clinical correlates in 53 patients. Mov Disord. 2008;23:1602–5. - PMC - PubMed
    1. Ghika A, Kyrozis A, Potagas C, Louis ED. Motor and non-motor features: Differences between patients with isolated essential tremor and patients with both essential tremor and Parkinson’s disease. Tremor Other Hyperkinet Mov (N Y) 2015 Aug 14;5:335. doi: 10.7916/D83777WK. - DOI - PMC - PubMed