Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences

Ali S. Shalash; Hadeer Mohamed; Alia H. Mansour; Ahmed Elkady; Hanan Elrassas; Eman Hamid; Mahmoud H. Elbalkimy

doi:10.5334/tohm.471

Figures & Tables

Table 1

Comparison of NMSs and QoL between ET Patients and Controls

	ET patients	Controls	p*
	N = 30	N = 30	p*
Age	45.20 ± 18.10 (18–76)	43.43 ± 17.27 (19–77)	0.700
FTMRS_TOTAL	42.10 ± 13.80 (19–79)
(1) Tremor severity	17.10 ± 6.20 (7–33)
(2) Handwriting	15.73 ±5 .30 (8–28)
(3) Functional disability	9.40 ± 3.59 (4–18)
MoCA	25.73 ± 3.04 (21–30)	27.40 ± 2.34 (24–30)	0.021
BDI	13.33±6.00 (70%)	8.77 ± 4.16 (26.7%)	0.001
HARS	15.67 ± 6.25	9.70 ± 4.47	<0.001
PSQI	6.13 ± 2.87	4.40 ± 2.53	0.016
Non-motor symptoms scale*
NMSS Total	58.03 ± 21.50 (100%)	17.20 ± 11.80 (96.7%)	<0.001
(1) Cardiovascular	4.17 ± 3.60 (80%)	1.00 ± 1.51 (43.3%)	<0.001
(2) Sleep/fatigue	10.53 ± 6.07 (100%)	4.10 ± 3.52 (80%)	<0.001
(3) Mood/cognition	17.57 ± 7.67 (100%)	5.43 ± 3.77 (83.3%)	<0.001
(4) Perceptual problems	1.37 ± 1.87 (46.6%)	0.23 ± 0.63 (13.3%)	0.003
(5) Attention/memory	8.13 ± 5.19 (100%)	2.83 ± 3.09 (73.3%)	<0.001
(6) Gastrointestinal symptoms	1.50 ± 2.70 (43.3%)	0.17 ± 0.46 (13.3%)	0.010
(7) Urinary symptoms	1.10 ± 1.90 (30%)	0.33 ± 0.71 (20%)	0.043
(8) Sexual function	4.13 ± 3.51 (70%)	0.53 ± 1.25 (16.7 %)	<0.001
(9) Miscellaneous	9.53 ± 4.88 (96.6%)	2.57 ± 3.01(56.7%)	<0.001
HRQoL Subscales**
(1) Physical Functioning (PF)	57.17 ±11.24	79.15±11.43	<0.001
(2) Role physical (RP)	58.12±10.23	77.43±9.72	<0.001
(3) Bodily pain (BP)	58.42±11.43	76.25±7.200	<0.001
(4) General health (GH)	61.72±10.881	77.92±11.077	<0.001
(5) Vitality (VT)	54.23±11.80	74.93±9.44	<0.001
(6) Role-emotional (RE)	52.25±11.62	77.63±8.32	<0.001
(7) Mental health (MH)	51.47±11.13	76.58±11.864	<0.001
(8) Social functioning (SF)	52.71±9.31	75.40±9.062	<0.001

Abbreviations: BDI, Beck Depression Inventory; HARS, Hamilton Anxiety Rating Scale; MoCA, Montreal Cognitive Assessment; NMSS, Non-Motor Symptoms Scale; PSQI, Pittsburgh Sleep Quality Index; SD, Standard Deviation. p < 0.05: significant; p < 0.001: highly significant; * Compared by student’s t-tests.

* Higher scores indicate worse functions.

** The physical components of SF-36 include PF, RP, BP, and GH scales, whereas mental components include VT, SF, RE, and MH scales. Higher scores reflect better health status.

Table 2

Correlations of HRQoL with NMSs in ET Patients

		PF	RP	RE	VT	MH	SF	BP	GH
Cardiovascular	r	−0.674	−0.623	−0.642	−0.697	−0.610	−0.536	−0.560	−0.627
	p	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*	0.002*	0.001*	<0.001*
Sleep/fatigue	r	−0.601	−0.597	−0.680	−0.553	−0.701	−0.619	−0.515	−0.513
	p	<0.001*	<0.001*	<0.001*	0.002*	<0.001*	<0.001*	0.004*	0.004*
Mood/cognition	r	−0.640	−0.693	−0.692	−0.547	−0.631	−0.588	−0.561	−0.587
	p	<0.001*	<0.001*	<0.001*	0.002*	<0.001*	0.001*	0.001*	0.001*
Perceptual abnormalities	r	−0.064	0.076	0.017	−0.021	0.157	0.205	0.027	−0.113
	p	0.738	0.689	0.929	0.911	0.408	0.276	0.889	0.553
Attention/memory	r	−0.467	−0.408	−0.683	−0.688	−0.677	−0.622	−0.474	−0.585
	p	0.009*	0.025*	<0.001*	<0.001*	<0.001*	<0.001*	0.008*	0.001*
Gastrointestinal	r	−0.182	−0.177	−0.354	−0.293	−0.178	−0.311	−0.259	−0.344
	p	0.335	0.349	0.055	0.117	0.346	0.094	0.167	0.063
Urinary	r	−0.185	−0.176	−0.082	−0.163	0.009	−0.015	−0.162	−0.074
	p	0.328	0.351	0.668	0.391	0.962	0.935	0.394	0.699
Sexual function	r	−0.420	−0.334	−0.335	−0.539	−0.249	−0.392	−0.393	−0.275
	p	0.021*	0.071	0.070	0.002*	0.185	0.032*	0.032*	0.141
Miscellaneous	r	−0.533	−0.578	−0.437	−0.569	−0.359	−0.439	−0.607	−0.478
	p	0.002*	0.001*	0.016*	0.001*	0.052*	0.015*	<0.001*	0.008*
NMS total	r	−0.858	−0.836	−0.916	−0.904	−0.819	−0.811	−0.800	−0.813
	p	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*	<0.001*

[i] Abbreviations: BP, Bodily Pain; GH, General Health; MH, Mental Health; NMS, Non-Motor Symptoms; PF, Physical Functioning; RE, Role Emotional; RP, Role-Physical; SF, Social Functioning; VT, Vitality. p < 0.05: significant. p < 0.001: highly significant. Correlations by Pearson Correlation Coefficient; Italics values indicates significant of p values.

Table 3

Comparison of Neuropsychiatric Symptoms and NMS between ET Patients and Controls

	Younger ET patients ≤ 45 years	Older ET patients 45 years	p*	Younger controls ≤ 45 years	p*	Older controls > 45 years	p*
Number	14	16		17		13
Age	28.14 ± 8.22	60.13 ± 8.09	<0.001	29.71 ± 4.77	0.513	61.39 ± 8.62	0.689
MoCA	27.43 ± 2.59	24.25 ± 2.65	0.003	29.12 ± 1.11	0.021	25.15 ±1.41	0.277
BDI	12.43 ± 6.63	14.13 ± 5.49	0.450	8.23 ± 4.92	0.056	9.39 ± 2.96	0.009
PSQI	5.50 ± 2.10	6.69 ± 3.38	0.266	4.24 ± 2.93	0.187	4.62 ± 1.98	0.062
NMSS total	50.43 ± 14.18	64.69 ± 24.86	0.069	10.53 ± 7.38	<0.001	25.92 ± 10.87	<0.001
(1) Cardiovascular	3.79 ± 3.87	4.50 ± 3.43	0.596	0.06 ± 0.24	<0.001	2.23 ± 1.59	0.037
(2) Sleep/fatigue	8.07 ± 5.50	12.69 ± 5.87	0.035	3.53 ± 3.48	0.009	4.85 ± 3.56	<0.001
(3) Mood/cognition	16.43 ± 6.51	18.56 ± 8.64	0.457	4.65 ± 3.2	<0.001	6.46 ± 4.20	<0.001
(4)Perceptual problems	1.71 ± 2.46	1.06 ± 1.123	0.349	0	0.007	0.54 ± 0.88	0.181
(5)Attention/memory	6.29 ± 4.08	9.75 ± 5.63	0.067	1.18 ± 1.29	<0.001	5.00 ± 3.44	0.013
(6) Gastrointestinal symptoms	1.64 ± 2.47	1.38 ± 2.96	0.792	0	0.01	0.39 ± 0.65	0.249
(7) Urinary symptoms	0.64 ± 1.74	1.50 ± 2.00	0.224	0	0.136	0.77 ± 0.93	0.236
(8) Sexual function	2.86 ± 3.39	5.25 ± 3.32	0.006	0	0.002	1.23 ± 1.69	<0.001
(9) Miscellaneous	9.00 ± 5.41	10.00 ± 4.50	0.585	1.12 ± 2.23	<0.001	4.46 ± 2.90	0.001

Abbreviations: BDI, Beck Depression Inventory; MoCA, Montreal Cognitive Assessment; NMSS, Non-Motor Symptoms Scale; PSQI, Pittsburgh Sleep Quality Index; SD, Standard Deviation. p < 0.05: significant. p < 0.001: highly significant.

* Compared by student’s t-tests; Bold values indicates significant of p values.

Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences

Figures & Tables

Table 1

Table 2

Table 3

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