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Multicenter Study
. 2022 Sep;43(9):5369-5376.
doi: 10.1007/s10072-022-06104-w. Epub 2022 May 24.

The Italian tremor Network (TITAN): rationale, design and preliminary findings

Roberto Erro  1 , Andrea Pilotto  2 , Marcello Esposito  3 , Enrica Olivola  4 , Alessandra Nicoletti  5 , Giulia Lazzeri  6 , Luca Magistrelli  7 , Carlo Dallocchio  8 , Roberta Marchese  9 , Matteo Bologna  4   10 , Alessandro Tessitore  11 , Salvatore Misceo  12 , Angelo Fabio Gigante  12 , Carmen Terranova  13 , Vincenzo Moschella  14 , Lazzaro di Biase  15   16   17 , Raffaella Di Giacopo  18 , Francesca Morgante  13   19 , Francesca Valentino  20 , Anna De Rosa  21 , Assunta Trinchillo  21 , Maria Chiara Malaguti  22 , Livia Brusa  23 , Angela Matinella  8 , Francesca Di Biasio  9 , Giulia Paparella  4 , Rosa De Micco  11 , Elena Contaldi  7 , Nicola Modugno  4 , Alessio Di Fonzo  6 , Alessandro Padovani  2 , Paolo Barone  24 ; TITAN Study Group
Affiliations
Multicenter Study

The Italian tremor Network (TITAN): rationale, design and preliminary findings

Roberto Erro et al. Neurol Sci. 2022 Sep.

Erratum in

  • Correction to: The Italian tremor Network (TITAN): rationale, design and preliminary findings.
    Erro R, Pilotto A, Esposito M, Olivola E, Nicoletti A, Lazzeri G, Magistrelli L, Dallocchio C, Marchese R, Bologna M, Tessitore A, Misceo S, Gigante AF, Terranova C, Moschella V, di Biase L, Di Giacopo R, Morgante F, Valentino F, De Rosa A, Trinchillo A, Malaguti MC, Brusa L, Matinella A, Di Biasio F, Paparella G, De Micco R, Contaldi E, Modugno N, Di Fonzo A, Padovani A, Barone P; TITAN Study Group. Erro R, et al. Neurol Sci. 2022 Dec;43(12):7013-7014. doi: 10.1007/s10072-022-06216-3. Neurol Sci. 2022. PMID: 35718847 Free PMC article. No abstract available.

Abstract

Introduction: The recently released classification has revised the nosology of tremor, defining essential tremor (ET) as a syndrome and fueling an enlightened debate about some newly conceptualized entities such as ET-plus. As a result, precise information of demographics, clinical features, and about the natural history of these conditions are lacking.

Methods: The ITAlian tremor Network (TITAN) is a multicenter data collection platform, the aim of which is to prospectively assess, according to a standardized protocol, the phenomenology and natural history of tremor syndromes.

Results: In the first year of activity, 679 patients have been recruited. The frequency of tremor syndromes varied from 32% of ET and 41% of ET-plus to less than 3% of rare forms, including focal tremors (2.30%), task-specific tremors (1.38%), isolated rest tremor (0.61%), and orthostatic tremor (0.61%). Patients with ET-plus were older and had a higher age at onset than ET, but a shorter disease duration, which might suggest that ET-plus is not a disease stage of ET. Familial aggregation of tremor and movement disorders was present in up to 60% of ET cases and in about 40% of patients with tremor combined with dystonia. The body site of tremor onset was different between tremor syndromes, with head tremor being most commonly, but not uniquely, associated with dystonia.

Conclusions: The TITAN study is anticipated to provide clinically relevant prospective information about the clinical correlates of different tremor syndromes and their specific outcomes and might serve as a basis for future etiological, pathophysiological, and therapeutic research.

Keywords: Classification; Dystonic tremor; Essential tremor; Prevalence; Rest tremor.

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Conflict of interest statement

Roberto Erro receives royalties from publication of Case Studies in Movement Disorders—Common and Uncommon Presentations (Cambridge University Press, 2017) and of Paroxysmal Movement Disorders (Springer, 2020). He has received consultancies from Sanofi and honoraria for speaking from the International Parkinson's Disease and Movement Disorders Society. Paolo Barone received consultancies as a member of the advisory board for Zambon, Lundbeck, UCB, Chiesi, Abbvie, and Acorda. Anna De Rosa received consultancies from Lundbeck, and from Bial as a member of advisory board. Andrea Pilotto received grant support from Ministry of Education, Research and University (MIUR) and IMI H2020 Initiative (IDEA-FAST project- MI2-2018-15-06), received research support from Zambon SrL Italy and Bial italy; he received speaker honoraria from Abbvie, Biomarin, Bial and Zambon Pharmaceuticals. Alessandro Padovani received grant support from Ministry of Health (MINSAL) and Ministry of Education, Research and University (MIUR), from CARIPLO Foundation; personal compensation as a consultant/scientific advisory board member for Biogen 2019-2020-2021 Roche 2019-2020 Nutricia 2020-2021 General Healthcare (GE) 2019; he received honoraria for lectures at meeting ADPD2020 from Roche, Lecture at meeting of the Italian society of Neurology 2020 from Biogen and from Roche, Lecture at meeting AIP 2020 and 2021 from Biogen and from Nutricia, Educational Consulting 2019-2020-2021 from Biogen. Lazzaro di Biase has received a speaker honoraria from Bial, consultant honoraria from Abbvie and research funding from Zambon, is the scientific director and one of the shareholders of Brain Innovations Srl, a University spinoff of Campus Bio-Medico University of Rome. All other authors have nothing to disclose.

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