Table 1
Demographic and Clinical Data
| Thumb F-E | Hand F-E | Forearm F-E | Forearm P-S | Arm Ab-Ad | Arm I-E rot | |||
|---|---|---|---|---|---|---|---|---|
| All patients treated with BoNT (n = 50) | 32 men 18 women | 43.26 ± 19.49 46 (10–84) | 5 | 37 | 16 | 37 | 20 | 10 |
| Patients interviewed by phone (n = 38) | 25 men 13 women | 42.30 ± 18.16 45 (10–82) | 5 | 28 | 7 | 31 | 12 | 6 |
| Essential tremor (n = 21) | 10 men 11 women | 45.20 ± 19.47 50 (10–82) | 1 | 17 | 3 | 19 | 6 | 1 |
| Holmes tremor** (n = 8) | 6 men 2 women | 46.50 ± 17.17 30.5 (18–62) | 1 | 5 | 4 | 5 | 4 | 4 |
| Others (PWT = 4; IDT = 4; PD = 1) | 9 men | 41.00 ± 16.42 41 (15–66) | 3 | 6 | 0 | 7 | 2 | 1 |
Abbreviations: Ab-Ad, abduction-adduction; BoNT, botulinum neurotoxin; F-E, flexion-extension I-E rot, internal-external rotation; IDT, idiopathic, dystonic tremor; IT, intention tremor; PD, Parkinson’s disease; P-S, pronosupination; PWT, primary writing tremor.
** Holmes tremor resulted from focal, cerebral lesions (thalamic, ischemic stroke: n = 5; thalamic hematoma: n = 2; thalamic teratoma: n = 1).
All data are quoted as the mean ± standard deviation and the median (range).
Table 2
Botulinum Neurotoxin Injections
| Age (years) | Dose (Ona units per limb) | BoNT type | Side effects | |||
|---|---|---|---|---|---|---|
| 56.66 ± 16.46 64 (18–87) | 63.74 ± 14.53 67.5 (20–88) | 12.45 ± 12.74 8.5 (1–57) | 63.74 ± 14.53 67.5 (20–88) | 136.24 ± 97.58 90 (45–390) | Ona: 33 Inco: 4 Abo: 1 | 7 patients (weakness in all cases) |
[i] Abbreviations: Abo, abobotulinumtoxin A; BoNT, botulinum neurotoxin; Inco, incobotulinumtoxin A; Ona, onabotulinumtoxin A.
[ii] All data are quoted as the mean ± standard deviation and the median (range).
Table 3
A Comparison of the Two Main Subgroups of Patients
| Group | Age at disease onset (years) | Age at the first BoNT injection (years) | Age at the time of post-treatment evaluation (years) | Number of tremor modes treated (per limb) | BoNT dose (Abo units per limb) |
|---|---|---|---|---|---|
| Essential tremor | 45.20 ± 19.47 50.5 (13–82) | 67.38 ± 68.14 67.0 (48–87) | 70.67 ± 8.38 70.0 (49–88) | 1.90 ± 0.71 2.0 (1–4) | 95.43 ± 54.07 85.0 (12–220) |
| Holmes tremor | 36.50 ± 17.17 30.5 (18–62) | 40.38 ± 19.26 37.0 (21–69) | 49.38 ± 17.59 49.0 (20–74) | 2.88 ± 1.55 3.0 (1–5) | 216.13 ± 127.93 212.5 (54–390) |
| t-value (p) in Student’s t-test | 1.17 (NS) | 5.39 (p < 10-3) | 8.24 (p = .01) | -1.73 (NS) | -2.60 (p = .03) |
[i] Abbreviations: Abo, abobotulinumtoxin A; BoNT, botulinum neurotoxin; NS, not significant.
[ii] All descriptive data are quoted as the mean ± standard deviation and the median (range).
Table 4
Results for the Patients Interviewed by Phone
| Etiology | ETEA score at baseline | ETEA score after BoNT injections | t-value (p) in student’s t-Test | QUEST score at baseline | QUEST score after BoNT injections | t-value (p) in student’s t-test | CGI-I patient score after BoNT injections |
|---|---|---|---|---|---|---|---|
| All patients interviewed by phone (n = 38) | 35.84 ± 14.26 36 (12–66) | 25.39 ± 14.40 27 (2–58) | 7.69 (<0.001) | 41.76 ± 18.71 46 (4–84) | 28.39 ± 18.55 29 (1–74) | 8.76 (<0.001) | 2.08 ± 0.97 2 (0–4) |
| Essential tremor (n = 21) | 40.76 ± 14.37 38 (17–66) | 30.33 ± 14.92 33 (3–58) | 5.03 (<0.001) | 47.00 ± 18.09 49 (18–84) | 32.24 ± 20.19 31 (4–74) | 6.22 (<0.001) | 2.24 ± 1.04 2 (0–4) |
| Holmes tremor (n = 8) | 28.63 ± 12.13 32 (13–42) | 21.00 ± 11.31 21 (9–39) | 4.49 (.003) | 42.63 ± 15.32 47 (15–61) | 30.00 ± 14.09 29 (10–55) | 3.7 (.008) | 2.13 ± 0.99 2 (0–3) |
| Other tremors (n = 9) | 30.78 ± 12.32 28 (12–52) | 17.78 ± 11.89 13 (2–33) | 4.92 (.001) | 28.78 ± 18.27 21 (4–54) | 18.00 ± 15.34 11 (1–42) | 7.53 (<0.001) | 1.67 ± 0.71 2 (1–3) |
[i] Abbreviations: BoNT, botulinum neurotoxin; CGI-I, Clinical Global Impression-Improvement; ETEA, Essential Tremor Embarrassment Assessment; QUEST, Quality of Life in Essential Tremor.
[ii] All descriptive data are quoted as the mean ± standard deviation and the median (range).