Non-Motor Symptoms of Essential Tremor Are Independent of Tremor Severity and Have an Impact on Quality of Life

Thomas Musacchio; Veronika Purrer; Aikaterini Papagianni; Anna Fleischer; Daniel Mackenrodt; Carolin Malsch; Götz Gelbrich; Frank Steigerwald; Jens Volkmann; Stephan Klebe

doi:10.5334/tohm.284

Figures & Tables

Flowchart Depicting the Diagnosis of All Recruited Participants

Table 1

Clinical-demographic Data of 110 ET Cases¹

Characteristics	Cases
Age, y	65.2 ± 14.1
Sex, M	65 (59.1%)
Age of onset, y	41.4 ± 21.0
Disease duration, y	23.8 ± 16.4
FTRS score	36.8 ± 14.6
Familial ET	82 (74.5%)
Alcohol sensitivity
Responder	49 (44.5%
Non-responder	40 (36.4%)
Unknown	21 (19.1%)
Topographical distribution of tremor
Upper extremities	110 (100%)
Voice	51 (46.4%)
Head	46 (41.8%)
Lower extremities	18 (16.4%)

1 Values are presented as mean ± SD or number (%).

Abbreviations: ET, Essential Tremor; FTRS, Fahn-Tolosa-Marin Tremor Rating Scale; M, Male; y, Years.

Table 2

Non-motor Parameters among Patients with ET and Controls

	ET Cases			Control Subjects¹			Mean Difference	95% Confidence Interval		P⁷

n	Mean	SD	n	Mean	SD		Mean Difference	95% Confidence Interval		P⁷
SF-36 domain
Physical³^,⁵
Physical function	110	75.4	23.1	2886	85.7	22.1	2.4	−1.8	6.6	0.25
Role physical	110	63.9	40.4	2856	83.7	31.7	−9.2	−16.9	−1.4	0.021
Bodily pain	110	69.7	27.6	2905	79.1	27.4	−1.6	−6.7	3.5	0.53
General health	110	61.0	18.1	2859	68.1	20.2	1.0	−2.5	4.6	0.57
PCS⁴^,⁶	110	46.2	10.3	2773	50.2	10.2	2.3	0.4	4.2	0.017
Mental³^,⁵
Vitality	110	54.7	17.6	2876	63.3	18.5	−4.8	−8.2	−1.4	0.006
Social function	110	75.9	24.4	2911	88.8	18.4	−10.2	−14.9	−5.6	<0.001²
Role emotional	110	70.6	40.6	2855	90.4	25.6	−16.6	−24.3	−8.9	<0.001²
Mental health	110	63.9	18.7	2871	73.9	16.4	−10.2	−13.7	−6.7	<0.001²
MCS⁴^,⁶	110	45.9	11.1	2773	51.5	8.1	−6.4	−8.5	−4.3	<0.001²
AES	110	33.0	8.3	37	23.5	5.8	9.5	6.6	12.5	<0.001²
STAI-T⁵	110	39.8	11.3	2385	35.8	9,5	3.7	1.6	5.9	0.001²
BDI	110	8.0	6.5	86	6.5	5.2	1.5	−0.2	3.2	0.081
ESS	110	6.6	3.4	159	5.7	3.0	0.9	0.1	1.7	0.021
FAB	110	16.2	1.8	42	17.3	0.8	−1.1	−1.5	−0.7	<0.001²
PANDA-cognition	110	19.3	5.6	108	23.6	5.4	−4.3	−5.8	−2.9	<0.001²
Sniffin Sticks⁶	110	8.8	2.3	1012	10.2	2.1	−0.3	−0.7	0.1	0.139

Abbreviations: AES, Apathy Evaluation Score; BDI, Beck Depression Inventory; ESS, Epworth Sleepiness Scale; ET, Essential Tremor; FAB, Frontal Assessment Battery; MCS, Mental Component Score; PANDA, Parkinson Neuropsychometric Dementia Assessment; PCS, Physical Component Score; SD, Standard Deviation; SF-36, Short-Form 36-Item Health Survey; STAI-T, State-Trait Anxiety Scale.

1 For details of the control subjects refer to the methods and literature.

2 Remains significant after Bonferroni-Holm adjustment (multiple testing).

3 Transformed scores.

4 Normalized scores.

5 Stratified by age and sex.

6 Stratified by age.

7 Compared using Student’s t-tests.

Means and SDs of Patients with ET and Controls on SF-36 Subdomains.
Significant after Bonferroni-Holm correction. * p < 0.001. ET, Essential Tremor; SD, Standard Deviation; SF-36, Short-Form 36-Item Health Survey.

Means and SDs of Patients with ET and Controls on the AES, STAI-T, FAB, and PANDA.
Significance after Bonferroni-Holm correction. * p ≤ 0.001. AES, Apathy Evaluation Scale; ET, Essential Tremor; FAB, Frontal Assessment Battery; PANDA, Parkinson Neuropsychometric Dementia Assessment; SD, Standard Deviation; STAI-T, State-Trait Anxiety Trait.

Table 3

Correlations between Age, Tremor Characteristics and Non-motor Scores (n = 110)

	SF-36 PCS		SF-36 MCS		AES		STAI-T		BDI		ESS		FAB		PANDA		Sniffin Sticks
	r	P	r	P	r	P	r	P	r	P	r	P	r	P	r	P	r	P
Age	−0.350	<0.001	0.182	0.057	0.064	0.504	−0.086	0.374	0.111	0.247	−0.004	0.965	−0.407	<0.001	−0.294	0.002	−0.462	<0.001
AOO	−0.301	0.001	0.157	0.102	0.022	0.820	−0.97	0.314	0.045	0.642	0.056	0.564	−0.248	0.009	−0.209	0.029	−0.338	<0.001
DD	0.109	0.257	−0.079	0.410	0.050	0.606	0.050	0.601	0.018	0.850	−0.081	0.398	0.003	0.979	0.054	0.574	0.022	0.816
FTRS score¹	−0.267	0.005	−0.161	0.096	0.164	0.089	0.170	0.079	0.183	0.057	0.048	0.625	−0.157	0.106	−0.386	<0.001	−0.255	0.008
SF-36 MCS	0.092	0.337
AES	−0.340	<0.001	−0.427	<0.001
STAI-T	−0.351	<0.001	−0.780	<0.001	0.620	<0.001
BDI	−0.480	<0.001	−0.522	<0.001	0.591	<0.001	0.699	<0.001
ESS	−0.203	0.033	−0.269	0.004	0.326	0.001	0.333	<0.001	0.361	<0.001
FAB	0.382	<0.001	0.084	0.381	−0.361	<0.001	−0.253	0.008	−0,288	0.002	−0.206	0.030
PANDA	0.198	0.038	0.016	0.867	−0.336	<0.001	−0.74	0.444	−0.154	0.108	−0.040	0.675	0.418	<0.001

Abbreviations: AES, Apathy Evaluation Score; AOO, Age of Onset; BDI, Beck Depression Inventory; DD, Disease Duration; ESS, Epworth Sleepiness Scale; FAB, Frontal Asssessment Battery; FTRS, Fahn-Tolosa-Marin Tremor Rating Scale; MCS, Mental Component Score; PANDA, Parkinson Neuropsychometric Dementia Assessment; PCS, Physical Component Score; SF-36, Short-Form 36-Item Health Survey; STAI-T, State-Trait Anxiety Scale; r, Spearman’s Rho Correlation Coefficient.

1 108 patients completed the FTRS.

Non-Motor Symptoms of Essential Tremor Are Independent of Tremor Severity and Have an Impact on Quality of Life

Figures & Tables

Figure 1

Flowchart Depicting the Diagnosis of All Recruited Participants

Table 1

Clinical-demographic Data of 110 ET Cases¹

Table 2

Non-motor Parameters among Patients with ET and Controls

Figure 2

Means and SDs of Patients with ET and Controls on SF-36 Subdomains.

Figure 3

Means and SDs of Patients with ET and Controls on the AES, STAI-T, FAB, and PANDA.

Table 3

Correlations between Age, Tremor Characteristics and Non-motor Scores (n = 110)

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My account

Non-Motor Symptoms of Essential Tremor Are Independent of Tremor Severity and Have an Impact on Quality of Life

Figures & Tables

Figure 1

Flowchart Depicting the Diagnosis of All Recruited Participants

Table 1

Clinical-demographic Data of 110 ET Cases1

Table 2

Non-motor Parameters among Patients with ET and Controls

Figure 2

Means and SDs of Patients with ET and Controls on SF-36 Subdomains.

Figure 3

Means and SDs of Patients with ET and Controls on the AES, STAI-T, FAB, and PANDA.

Table 3

Correlations between Age, Tremor Characteristics and Non-motor Scores (n = 110)

Clinical-demographic Data of 110 ET Cases¹