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Calomino C, Quattrone A, Bianco MG, Nisticò R, Buonocore J, Crasà M, Vaccaro MG, Sarica A, Quattrone A. Combined cortical thickness and blink reflex recovery cycle to differentiate essential tremor with and without resting tremor. Front Neurol 2024; 15:1372262. [PMID: 38585347 PMCID: PMC10995929 DOI: 10.3389/fneur.2024.1372262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/14/2024] [Indexed: 04/09/2024] Open
Abstract
Objective To investigate the performance of structural MRI cortical and subcortical morphometric data combined with blink-reflex recovery cycle (BRrc) values using machine learning (ML) models in distinguishing between essential tremor (ET) with resting tremor (rET) and classic ET. Methods We enrolled 47 ET, 43 rET patients and 45 healthy controls (HC). All participants underwent brain 3 T-MRI and BRrc examination at different interstimulus intervals (ISIs, 100-300 msec). MRI data (cortical thickness, volumes, surface area, roughness, mean curvature and subcortical volumes) were extracted using Freesurfer on T1-weighted images. We employed two decision tree-based ML classification algorithms (eXtreme Gradient Boosting [XGBoost] and Random Forest) combining MRI data and BRrc values to differentiate between rET and ET patients. Results ML models based exclusively on MRI features reached acceptable performance (AUC: 0.85-0.86) in differentiating rET from ET patients and from HC. Similar performances were obtained by ML models based on BRrc data (AUC: 0.81-0.82 in rET vs. ET and AUC: 0.88-0.89 in rET vs. HC). ML models combining imaging data (cortical thickness, surface, roughness, and mean curvature) together with BRrc values showed the highest classification performance in distinguishing between rET and ET patients, reaching AUC of 0.94 ± 0.05. The improvement in classification performances when BRrc data were added to imaging features was confirmed by both ML algorithms. Conclusion This study highlights the usefulness of adding a simple electrophysiological assessment such as BRrc to MRI cortical morphometric features for accurately distinguishing rET from ET patients, paving the way for a better classification of these ET syndromes.
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Affiliation(s)
- Camilla Calomino
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Andrea Quattrone
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University, Catanzaro, Italy
| | - Maria Giovanna Bianco
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Rita Nisticò
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Jolanda Buonocore
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University, Catanzaro, Italy
| | - Marianna Crasà
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Maria Grazia Vaccaro
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Alessia Sarica
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
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Rajan R, Anandapadmanabhan R, Vishnoi A, Latorre A, Thirugnanasambandam N, Dipani A, Biswas D, Radhakrishnan DM, Srivastava A, Bhatia KP. Essential Tremor and Essential Tremor Plus Are Essentially Similar Electrophysiologically. Mov Disord Clin Pract 2024; 11:136-142. [PMID: 38386479 PMCID: PMC10883406 DOI: 10.1002/mdc3.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/25/2023] [Accepted: 11/10/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The merits of classifying the heterogeneous group of essential tremors into essential tremor (ET) and essential tremor plus (ETP) are debated. OBJECTIVES We studied the electrophysiological and spiral characteristics of tremor in ET and ETP. METHODS We reviewed standardized videos from a tremor database and clinically classified patients into ET, ETP, or dystonic tremor (DT). The following variables were derived from combined tri-axial accelerometry-surface electromyography (EMG)-peak frequency, total power, peak power, full width half maximum, tremor stability index and EMG-coherence. We analyzed hand-drawn spirals to derive mean deviation, tremor variability, inter-, and intra-loop widths. We compared these variables among the groups. RESULTS We recruited 72 participants (81.9% male) with mean age 47.7 ± 16.1 years and Fahn-Tolosa-Marin Tremor Rating Scale total score 31.1 ± 14.1. Patients with ET were younger (P = 0.014) and had less severe tremor (P = 0.020) compared to ETP and DT. In ETP group, 48.6% had subtle dystonia. Peak frequency was greater in ETP (7.3 ± 0.3 Hz) compared to DT (6.1 ± 0.4 Hz; P = 0.024). Peak power was greater in ETP and DT for postural tremor. Rest tremor was recordable on accelerometry in 26.7% of ET. Other variables were similar among the groups. CONCLUSION Electrophysiological evaluation revealed postural tremor of frequency 6 to 7 Hz in ET, ETP, and DT with subtle differences more severe tremor in ETP and DT, and higher frequency in ETP compared to DT. Our findings suggest a similar tremor oscillator in these conditions, supporting the view that these entities are part of a spectrum of tremor disorders, rather than distinct etiological entities.
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Affiliation(s)
- Roopa Rajan
- All India Institute of Medical Sciences (AIIMS)New DelhiIndia
| | | | - Aayushi Vishnoi
- All India Institute of Medical Sciences (AIIMS)New DelhiIndia
| | - Anna Latorre
- University College London Hospitals (UCL)LondonUnited Kingdom
| | | | - Alish Dipani
- National Brain Research Centre (NBRC)ManesarIndia
| | - Deblina Biswas
- All India Institute of Medical Sciences (AIIMS)New DelhiIndia
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Erro R, Lazzeri G, Gigante AF, Pilotto A, Magistrelli L, Bologna M, Terranova C, Olivola E, Dallocchio C, Moschella V, Valentino F, Di Biasio F, Nicoletti A, De Micco R, Brusa L, Sorrentino C, Matinella A, Bertino S, Paparella G, Modugno N, Contaldi E, Padovani A, Di Fonzo A, Restaino M, Barone P. Clinical correlates of "pure" essential tremor: the TITAN study. Front Neurol 2023; 14:1233524. [PMID: 37681007 PMCID: PMC10481166 DOI: 10.3389/fneur.2023.1233524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/24/2023] [Indexed: 09/09/2023] Open
Abstract
Background To date, there are no large studies delineating the clinical correlates of "pure" essential tremor (ET) according to its new definition. Methods From the ITAlian tremor Network (TITAN) database, we extracted data from patients with a diagnosis of "pure" ET and excluded those with other tremor classifications, including ET-plus, focal, and task-specific tremor, which were formerly considered parts of the ET spectrum. Results Out of 653 subjects recruited in the TITAN study by January 2022, the data of 208 (31.8%) "pure" ET patients (86M/122F) were analyzed. The distribution of age at onset was found to be bimodal. The proportion of familial cases by the age-at-onset class of 20 years showed significant differences, with sporadic cases representing the large majority of the class with an age at onset above 60 years. Patients with a positive family history of tremor had a younger onset and were more likely to have leg involvement than sporadic patients despite a similar disease duration. Early-onset and late-onset cases were different in terms of tremor distribution at onset and tremor severity, likely as a function of longer disease duration, yet without differences in terms of quality of life, which suggests a relatively benign progression. Treatment patterns and outcomes revealed that up to 40% of the sample was unsatisfied with the current pharmacological options. Discussion The findings reported in the study provide new insights, especially with regard to a possible inversed sex distribution, and to the genetic backgrounds of "pure" ET, given that familial cases were evenly distributed across age-at-onset classes of 20 years. Deep clinical profiling of "pure" ET, for instance, according to age at onset, might increase the clinical value of this syndrome in identifying pathogenetic hypotheses and therapeutic strategies.
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Affiliation(s)
- Roberto Erro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, Baronissi, SA, Italy
| | - Giulia Lazzeri
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Angelo Fabio Gigante
- Department of Medical Sciences and Public Health, Section of Neurology, San Paolo Hospital, Bari, Italy
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luca Magistrelli
- Department of Translational Medicine, Movement Disorders Centre, Neurology Unit, University of Piemonte Orientale, Novara, Italy
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- Neuromed Institute IRCCS, Pozzilli, IS, Italy
| | - Carmen Terranova
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Carlo Dallocchio
- Neurology Unit, Department of Medical Area, ASST Pavia, Voghera, PV, Italy
| | | | - Francesca Valentino
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | | | - Alessandra Nicoletti
- Department “G.F. Ingrassia”, Section of Neurosciences, University of Catania, Catania, Italy
| | - Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Livia Brusa
- Neurology Department, S.Eugenio Hospital, Rome, Italy
| | - Cristiano Sorrentino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, Baronissi, SA, Italy
| | - Angela Matinella
- Neurology Unit, Department of Medical Area, ASST Pavia, Voghera, PV, Italy
| | - Salvatore Bertino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | | | - Elena Contaldi
- Department of Translational Medicine, Movement Disorders Centre, Neurology Unit, University of Piemonte Orientale, Novara, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessio Di Fonzo
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Marialuisa Restaino
- Department of Economics and Statistics, University of Salerno, Fisciano, SA, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, Baronissi, SA, Italy
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4
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Lenka A, Pandey S. Dystonia and tremor: Do they have a shared biology? INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 169:413-439. [PMID: 37482399 DOI: 10.1016/bs.irn.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Dystonia and tremor are the two most commonly encountered hyperkinetic movement disorders encountered in clinical practice. While there has been substantial progress in the research on these two disorders, there also exists a lot of gray areas. Entities such as dystonic tremor and tremor associated with dystonia occupy a major portion of the "gray zone". In addition, there is a marked clinical heterogeneity and overlap of several clinical and epidemiological features among dystonia and tremor. These facts raise the possibility that dystonia and tremor could be having shared biology. In this chapter, we revisit critical aspects of this possibility that may have important clinical and research implications in the future. We comprehensively review the points in favor and against the theory that dystonia and tremor have shared biology from clinical, epidemiological, genetic and neuroimaging studies.
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Affiliation(s)
- Abhishek Lenka
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, TX, United States
| | - Sanjay Pandey
- Department of Neurology, Amrita Hospital, Faridabad, Delhi National Capital Region, India.
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5
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Angelini L, Paparella G, De Biase A, Maraone A, Panfili M, Berardelli I, Cannavacciuolo A, Di Vita A, Margiotta R, Fabbrini G, Berardelli A, Bologna M. Longitudinal study of clinical and neurophysiological features in essential tremor. Eur J Neurol 2023; 30:631-640. [PMID: 36437695 PMCID: PMC10107502 DOI: 10.1111/ene.15650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Essential tremor (ET) is a common and heterogeneous disorder characterized by postural/kinetic tremor of the upper limbs and other body segments and by non-motor symptoms, including cognitive and psychiatric abnormalities. Only a limited number of longitudinal studies have comprehensively and simultaneously investigated motor and non-motor symptom progression in ET. Possible soft signs that configure the ET-plus diagnosis are also under-investigated in follow-up studies. We aimed to longitudinally investigate the progression of ET manifestations by means of clinical and neurophysiological evaluation. METHODS Thirty-seven ET patients underwent evaluation at baseline (T0) and at follow-up (T1; mean interval ± SD = 39.89 ± 9.83 months). The assessment included the clinical and kinematic evaluation of tremor and voluntary movement execution, as well as the investigation of cognitive and psychiatric disorders. RESULTS A higher percentage of patients showed tremor in multiple body segments and rest tremor at T1 as compared to T0 (all p-values < 0.01). At T1, the kinematic analysis revealed reduced finger-tapping movement amplitude and velocity as compared to T0 (both p-values < 0.001). The prevalence of cognitive and psychiatric disorders did not change between T0 and T1. Female sex, absence of family history, and rest tremor at baseline were identified as predictive factors of worse disease progression. CONCLUSIONS ET progression is characterized by the spread of tremor in multiple body segments and by the emergence of soft signs. We also identified possible predictors of disease worsening. The results contribute to a better understanding of ET classification and pathophysiology.
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Affiliation(s)
- Luca Angelini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Annalisa Maraone
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Panfili
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health, and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Antonella Di Vita
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Roberta Margiotta
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
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6
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Sun Q, He R, Huang H, Cao H, Wang X, Liu H, Wang C, Lei L, Wang P, Cui G, Ma J, Gu P, An D, Jia M, Sun Z, Wu H, Lin J, Tang J, Zhou X, Li M, Zeng S, Chen Y, Yan X, Guo J, Xu Q, Liu Z, Shen L, Jiang H, Wu X, Xiao Q, Chen H, Xu Y, Tang B. Age and Sex Affect Essential Tremor (ET) Plus: Clinical Heterogeneity in ET Based on the National Survey in China. Aging Dis 2022:AD.2022.1205. [PMID: 37163423 PMCID: PMC10389817 DOI: 10.14336/ad.2022.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/05/2022] [Indexed: 05/12/2023] Open
Abstract
The new term essential tremor (ET) plus was proposed in the 2018 tremor consensus criteria. The National Survey of Essential Tremor Plus in China, a large multicenter registry study, aimed to evaluate the clinical features of pure ET and ET plus and explore possible factors related to ET plus. All patients with ET underwent neurological examination and neuropsychological assessment at 17 clinical sites. The diagnosis was made according to the 2018 consensus criteria. Clinicodemographic characteristics were analyzed. A total of 1160 patients were included, including 546 patients with pure ET and 614 patients with ET plus. The proportion of females was significantly higher in the ET plus than that in the pure ET (P = 0.001). The age at onset (AAO) of pure ET showed a bimodal distribution, with peaks in the 2nd and 5th decades. However, the AAO of the ET plus group demonstrated a skewed distribution, with a single peak in the 6th decade. Female sex (OR=1.645, P<0.001), older age (OR=1.023, P<0.001), lower educational level (OR=0.934, P<0.001), head tremor (OR=1.457, P<0.001), and higher the Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS)-II scores (OR=1.134, P<0.001) were significantly associated with ET plus. Old age and female sex may contribute to ET plus development. Pure ET showed a bimodal distribution for AAO, whereas ET plus showed a unimodal distribution. It remains unclear whether pure ET and ET plus are merely different stages of a single disease or represent distinct disease entities.
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Affiliation(s)
- Qiying Sun
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Runcheng He
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hongyan Huang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Hongmei Cao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xuejing Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hong Liu
- Department of Neurology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shangxi, China
| | - Chunyu Wang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lifang Lei
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Puqing Wang
- Department of Neurology, Xiang Yang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei, China
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jianjun Ma
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ping Gu
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Di An
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, Hebei, China
| | - Min Jia
- Department of Neurology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China
| | - Zhanfang Sun
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Heng Wu
- Department of Neurology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Jinsheng Lin
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Jiayu Tang
- Department of Neurology, Hunan Provincial Brain Hospital, Changsha, Hunan, China
| | - Xun Zhou
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingqiang Li
- Department of Neurology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Sheng Zeng
- Department of Geriatric Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yase Chen
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinxiang Yan
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jifeng Guo
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qian Xu
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhenhua Liu
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lu Shen
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
| | - Hong Jiang
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
| | - Xinyin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Qin Xiao
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haibo Chen
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Yanming Xu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Beisha Tang
- Department of Neurology, Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
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7
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Zhou X, Huang H, He R, Zeng S, Liu Z, Xu Q, Guo J, Yan X, Duan R, Li J, Tang B, Xu Y, Sun Q. Clinical Features and Reclassification of Essential Tremor with
NOTCH2NLC
GGC
Repeat Expansions based on a long‐term follow‐up. Eur J Neurol 2022; 29:3600-3610. [DOI: 10.1111/ene.15552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Xun Zhou
- Department of Geriatric Neurology, Xiangya Hospital Central South University Changsha Hunan China
| | - Hongyan Huang
- Department of Neurology, West China Hospital Sichuan University Chengdu China
| | - Runcheng He
- Department of Neurology, Xiangya Hospital Central South University Changsha Hunan China
| | - Sheng Zeng
- Department of Geriatric Neurology, The Second Xiangya Hospital Central South University Changsha Hunan China
| | - Zhenhua Liu
- Department of Neurology, Xiangya Hospital Central South University Changsha Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders Central South University Changsha Hunan China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital Central South University Changsha Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders Central South University Changsha Hunan China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital Central South University Changsha Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders Central South University Changsha Hunan China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital Central South University Changsha Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders Central South University Changsha Hunan China
| | - Ranhui Duan
- Center for Medical Genetics, School of Life Sciences Central South University Changsha Hunan China
| | - Jinchen Li
- Department of Geriatric Neurology, Xiangya Hospital Central South University Changsha Hunan China
- Department of Neurology, Xiangya Hospital Central South University Changsha Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China
- Center for Medical Genetics, School of Life Sciences Central South University Changsha Hunan China
| | - Beisha Tang
- Department of Geriatric Neurology, Xiangya Hospital Central South University Changsha Hunan China
- Department of Neurology, Xiangya Hospital Central South University Changsha Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China
- Center for Medical Genetics, School of Life Sciences Central South University Changsha Hunan China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders Central South University Changsha Hunan China
| | - Yanming Xu
- Department of Neurology, West China Hospital Sichuan University Chengdu China
| | - Qiying Sun
- Department of Geriatric Neurology, Xiangya Hospital Central South University Changsha Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders Central South University Changsha Hunan China
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8
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Cerebellar voxel-based morphometry in essential tremor. J Neurol 2022; 269:6029-6035. [DOI: 10.1007/s00415-022-11291-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/29/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022]
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9
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Erro R, Sorrentino C, Russo M, Barone P. Essential tremor plus rest tremor: current concepts and controversies. J Neural Transm (Vienna) 2022; 129:835-846. [PMID: 35672518 PMCID: PMC9217824 DOI: 10.1007/s00702-022-02516-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/11/2022] [Indexed: 12/24/2022]
Abstract
Since the initial description of Essential Tremor (ET), the entity of ET with rest tremor has proven to be a controversial concept. Some authors argued it could be a late manifestation of ET, others suggested it could be a variant of ET, yet others suggested it could represent a transitional state between ET and Parkinson's disease. The novel tremor classification has proposed the construct of ET-plus to differentiate patients with rest tremor from pure ET. However, there is no clarity of what ET-plus rest tremor represents. With the aim of shedding light on this controversial entity, we have, therefore, systematically reviewed all clinical, electrophysiological, imaging and anatomopathological studies indexed in the Medline database published both before and after the new tremor classification and involving patients with ET-plus rest tremor. Forty-four studies involving 4028 patients were included in this review and analyzed in detail by means of descriptive statistics. The results of the current review suggest that ET-plus rest tremor is a heterogenous group of conditions: thus, rest tremor might represent a late feature of ET, might reflect a different disorder with higher age at onset and lower dependance on genetic susceptibility than ET, might suggest the development of Parkinson's disease or might indicate a misdiagnosis of ET. The reviewed lines of evidence refuse recent claims arguing against the construct of ET-plus, which should be viewed as a syndrome with different possible underpinnings, and highlights methodological issues to be solved in future research.
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Affiliation(s)
- Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Via Allende, Baronissi, SA, Italy.
| | | | - Maria Russo
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Via Allende, Baronissi, SA, Italy
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Erro R, Pilotto A, Esposito M, Olivola E, Nicoletti A, Lazzeri G, Magistrelli L, Dallocchio C, Marchese R, Bologna M, Tessitore A, Misceo S, Gigante AF, Terranova C, Moschella V, di Biase L, Di Giacopo R, Morgante F, Valentino F, De Rosa A, Trinchillo A, Malaguti MC, Brusa L, Matinella A, Di Biasio F, Paparella G, De Micco R, Contaldi E, Modugno N, Di Fonzo A, Padovani A, Barone P. The Italian tremor Network (TITAN): rationale, design and preliminary findings. Neurol Sci 2022; 43:5369-5376. [PMID: 35608737 PMCID: PMC9385818 DOI: 10.1007/s10072-022-06104-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/29/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION The recently released classification has revised the nosology of tremor, defining essential tremor (ET) as a syndrome and fueling an enlightened debate about some newly conceptualized entities such as ET-plus. As a result, precise information of demographics, clinical features, and about the natural history of these conditions are lacking. METHODS The ITAlian tremor Network (TITAN) is a multicenter data collection platform, the aim of which is to prospectively assess, according to a standardized protocol, the phenomenology and natural history of tremor syndromes. RESULTS In the first year of activity, 679 patients have been recruited. The frequency of tremor syndromes varied from 32% of ET and 41% of ET-plus to less than 3% of rare forms, including focal tremors (2.30%), task-specific tremors (1.38%), isolated rest tremor (0.61%), and orthostatic tremor (0.61%). Patients with ET-plus were older and had a higher age at onset than ET, but a shorter disease duration, which might suggest that ET-plus is not a disease stage of ET. Familial aggregation of tremor and movement disorders was present in up to 60% of ET cases and in about 40% of patients with tremor combined with dystonia. The body site of tremor onset was different between tremor syndromes, with head tremor being most commonly, but not uniquely, associated with dystonia. CONCLUSIONS The TITAN study is anticipated to provide clinically relevant prospective information about the clinical correlates of different tremor syndromes and their specific outcomes and might serve as a basis for future etiological, pathophysiological, and therapeutic research.
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Affiliation(s)
- Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Via Allende 43, 84081, Baronissi, SA, Italy.
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | | | - Alessandra Nicoletti
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | - Giulia Lazzeri
- Neurology Unit, Department of Neuroscience, Dino Ferrari Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Magistrelli
- Department of Translational Medicine, Movement Disorders Centre, Neurology Unit, University of Piemonte Orientale, Novara, Italy
| | - Carlo Dallocchio
- Neurology Unit, Department of Medical Area, ASST Pavia, Voghera, PV, Italy
| | | | - Matteo Bologna
- Neuromed Institute IRCCS, Pozzilli, IS, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences, Università Della Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Misceo
- Neurosensory Department, Neurology Unit, San Paolo Hospital, ASL Bari, Bari, Italy
| | - Angelo Fabio Gigante
- Neurosensory Department, Neurology Unit, San Paolo Hospital, ASL Bari, Bari, Italy
| | - Carmen Terranova
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Lazzaro di Biase
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Rome, Italy.,Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico Di Roma, Rome, Italy.,Brain Innovations Lab, Università Campus Bio-Medico Di Roma, Rome, Italy
| | | | - Francesca Morgante
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St. George's, University of London, London, UK
| | - Francesca Valentino
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Anna De Rosa
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - Assunta Trinchillo
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | | | - Livia Brusa
- Neurology Department, S.Eugenio Hospital, Rome, Italy
| | - Angela Matinella
- Neurology Unit, Department of Medical Area, ASST Pavia, Voghera, PV, Italy
| | | | | | - Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, Università Della Campania "Luigi Vanvitelli", Naples, Italy
| | - Elena Contaldi
- Department of Translational Medicine, Movement Disorders Centre, Neurology Unit, University of Piemonte Orientale, Novara, Italy
| | | | - Alessio Di Fonzo
- Neurology Unit, Department of Neuroscience, Dino Ferrari Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Via Allende 43, 84081, Baronissi, SA, Italy
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