Comparing Essential Tremor with and without Soft Dystonic Signs and Tremor Combined with Dystonia: The TITAN Study. in Movement disorders clinical practice / Mov Disord Clin Pract. 2024 Jun;11(6):645-654. doi: 10.1002/mdc3.14026. Epub 2024 Apr 9.
2024
AOU Novara
Tipo pubblicazione
Journal Article
Autori/Collaboratori (32)Vedi tutti...
Erro R
Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy.
Lazzeri G
Neurology Unit, Department of Neuroscience, Dino Ferrari Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Terranova C
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
et alii...
Abstract
BACKGROUND: Tremor disorders remain as clinical diagnoses and the rate of misdiagnosis between the commonest non-parkinsonian tremors is relatively high. OBJECTIVES: To compare the clinical features of Essential Tremor without other features (pure ET), ET plus soft dystonic signs (ET?+?DS), and tremor combined with dystonia (TwD). METHODS: We compared the clinical features of patients with pure ET, ET?+?DS, and TwD enrolled in The ITAlian tremor Network (TITAN). Linear regression models were performed to determine factors associated with health status and quality of life. RESULTS: Three-hundred-eighty-three patients were included. Sex distribution was significantly different between the groups with males being more represented in pure ET and females in TwD. The initial site of tremor was different between the groups with about 40% of TwD having head tremor and ET?+?DS unilateral upper limb tremor at onset. This pattern mirrored the distribution of overt dystonia and soft dystonic signs at examination. Sensory trick, task-specificity, and position-dependence were more common, but not exclusive, to TwD. Pure ET patients showed the lowest degree of alcohol responsiveness and ET?+?DS the highest. Midline tremor was more commonly encountered and more severe in TwD than in the other groups. Regression analyses demonstrated that tremor severity, sex, age, and to a lesser degree the variable "group", independently predicted health status and quality of life, suggesting the existence of other determinants beyond tremor. CONCLUSIONS: Pure ET and TwD manifest with a phenotypic overlap, which calls for the identification of diagnostic biomarkers. ET?+?DS shared features with both syndromes, suggesting intra-group heterogeneity.
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PMID : 38594807
DOI : 10.1002/mdc3.14026
Keywords
Humans; Male; Female; Essential Tremor/physiopathology/diagnosis/complications; Dystonia/diagnosis; Middle Aged; Aged; Quality of Life; Tremor/diagnosis/physiopathology; Adult; Aged, 80 and over; Severity of Illness Index; dystonia; essential tremor plus; gender; quality of life; soft signs;