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Title: Essential tremor-Parkinson's disease: A double whammy.

Authors: Louis, Elan D; Wise, Adina; Alcalay, Roy N; Rao, Ashwini K; Factor-Litvak, Pam

Published In J Neurol Sci, (2016 Jul 15)

Abstract: 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.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.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.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.

PubMed ID: 27288775 Exiting the NIEHS site

MeSH Terms: Affect; Aged; Cost of Illness; Essential Tremor/complications*; Essential Tremor/drug therapy; Essential Tremor/epidemiology; Essential Tremor/physiopathology*; Female; Humans; Male; Mental Status Schedule; Parkinson Disease/complications*; Parkinson Disease/drug therapy; Parkinson Disease/epidemiology; Parkinson Disease/physiopathology*; Postural Balance; Prospective Studies; Severity of Illness Index

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