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. 2022 Mar 17:13:842732.
doi: 10.3389/fneur.2022.842732. eCollection 2022.

Association of Essential Tremor With Dementia and Affective Disorders: A Meta-Analysis

Yajun Shang  1   2 , Xinjie Chen  2   3 , Mingda Ai  2   4 , Xiaoran Gao  5 , Shujuan Dai  2   4 , Mingjie Zhao  2   4 , Cen Yang  5 , Liangfeng Wang  6 , Junyan Zhang  7 , Lianmei Zhong  2   4 , Tianhao Bao  8   9 , Xiaolei Liu  2   4
Affiliations

Association of Essential Tremor With Dementia and Affective Disorders: A Meta-Analysis

Yajun Shang et al. Front Neurol. .

Abstract

Background: The dementia and affective disorders are common non-motor features in patients with essential tremor (ET). However, the relationship of ET with cognitive impairments and affective disorders remains controversial. This meta-analysis aimed to analyze the association of ET with dementia and affective disorders.

Methods: Original studies published from January 1999 to October 2019 were systematically searched from the database of Medline (OvidSP), EMBASE (OvidSP), and the Cochrane Central Register of Controlled Trials. Pooled standard mean difference (SMD, random effect model), odds ratios (ORs), relative risk (RR), and 95% CI were calculated.

Results: Compared with the Non-ET group, patients with ET had significantly lower Mini-Mental State Examination (MMSE) score (SMD, -1.16; 95% CI, -1.75 to -0.58; p = 0.0001) and had significantly higher depressive and anxiety symptoms scale score (SMD, 0.55; 95% CI, 0.22-0.87; p = 0.0009). The OR for dementia and affective disorders in individuals with ET compared with individuals without ET was 2.49 (95% CI, 2.17-2.85, p < 0.00001). While there was no significant difference in Montreal Cognitive Assessment (MoCA) score between ET and Non-ET groups (SMD, -0.52; 95% CI, -0.16 to 0.13; p = 0.23), there was a significant difference in the risk of mortality between ET and Non-ET groups (RR = 4.69, 95% CI, 2.18-10.07).

Conclusion: The non-motor symptoms should not be neglected among patients with ET. However, the causal relationship between ET and dementia, depression, and anxiety is unclear.

Keywords: anxiety; dementia; depression; essential tremor; movement disorders.

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Conflict of interest statement

JZ was employed by Bothwin Clinical Study Consultant. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Mini-Mental State Examination (MMSE) score in patients between ET and Non-ET groups. (A). Subgroup analyses of MMSE score between essential tremor (ET) and Non-ET. (B). MMSE score between ET and Non-ET (2 studies were excluded).
Figure 3
Figure 3
Montreal Cognitive Assessment (MoCA) score between essential tremor (ET) and Non-ET groups.
Figure 4
Figure 4
Depressive and anxiety symptoms scale score between essential tremor (ET) and Non-ET groups. (A). The relationship between ET and depressive and anxiety symptom scale score. (B). Subgroup analyses of the relationship between ET and depressive and anxiety symptom scale score.
Figure 5
Figure 5
Association of dementia, affective disorders between essential tremor (ET) and Non-ET groups. (A). The events of dementia and affective disorders in ET and Non-ET groups. (B). Subgroup analyses of the events of dementia and affective disorders in ET and Non-ET groups.
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