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Güler S, Caylan A, Turan FN, Dağdeviren N. The prevalence of essential tremor in Edirne and its counties accompanied comorbid conditions. Neurol Res 2019; 41:847-856. [PMID: 31238803 DOI: 10.1080/01616412.2019.1628409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: We aimed to determine the prevalence and risk factors of Essential Tremor (ET) in Edirne and its districts, located in Western Thrace, which is the most western part of Turkey. Methods: In this study, 3008 individuals who could communicate and agreed to participate in the study were evaluated. To obtain the data from the applicants in 30 Family Health Centres in Edirne and its districts, a face-to-face questionnaire that consisted of 37 questions was prepared by the researchers. The questionnaire included general information, questions to evaluate potential concomitant comorbid conditions and questions regarding the symptomatology used in ET diagnosis, as well as questions to evaluate ET severity, was examined with the spiral test. Patients were classified by using the Washington Heights-Inwood Genetic Study of Essential Tremor (WHIGET) diagnostic and clinical evaluation scale. According to the diagnostic criteria for ET (used in participants who were examined and in those whose medical records were reviewed) were similar to those used in astudy conducted in Turkey. Results: Of 3008 individuals, 173 were diagnosed with ET according to the questionnaire results from Edirne and its districts, and the prevalence of ET was 5.8%. Approximately, 43.4% of the patients with ET were male, and 56.6% were female, which was not significantly different (p > 0.05). Participants with tremor related to alcohol withdrawal, hyperthyroidism, anxiety, depression other known causes of tremor were not considered to have ET. Thyroid disease was identified in 0.0% of the cases, and the control group was detected in 1.4%, which was not significantly different (p = 0.170). Psychiatric disease was identified in 0.0% of the cases, and the control group was detected in 1.3%, which was not significantly different (p = 0.271). Conclusions: ET prevalence studies will increase the awareness of the community and provide early diagnosis and treatment, as well as serve as a basis to reduce morbidity and improve the quality of life.
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Affiliation(s)
- Sibel Güler
- Department of Neurology, Trakya University Faculty of Medicine , Edirne , Turkey
| | - Ayşe Caylan
- Department of Family Medicine, Trakya University Faculty of Medicine , Edirne , Turkey
| | - F Nesrin Turan
- Department of Biostatistics, Trakya University Faculty of Medicine , Edirne , Turkey
| | - Nezih Dağdeviren
- Department of Family Medicine, Trakya University Faculty of Medicine , Edirne , Turkey
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Chen W, Hopfner F, Szymczak S, Granert O, Müller SH, Kuhlenbäumer G, Deuschl G. Topography of essential tremor. Parkinsonism Relat Disord 2017; 40:58-63. [PMID: 28442304 DOI: 10.1016/j.parkreldis.2017.04.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/05/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Topography of tremor manifestations is poorly investigated in essential tremor. The present study explores the prevalence and clinical correlates of head and/or voice tremor in essential tremor. METHODS Out of a prospectively designed registry of 972 patients, 884 patients with definite and probable essential tremor had complete information on tremor localization. Demographic and clinical characteristics were compared among four subgroups: group A (without head or voice tremor, n = 619), B (with head but without voice tremor, n = 155), C (with voice but without head tremor, n = 47), and D (with both head and voice tremor, n = 63). RESULTS In our patients, total prevalence of tremor was 24.7% for head, 12.4% for voice and 7.1% for the combination of head and voice. Logistic regression analyses showed that female gender is strongly associated with head tremor, which was confirmed by an additional meta-analysis. Severe hand tremor was the only factor associated with voice tremor. Both female gender and severe hand tremor increase the odds for having the combination of head and voice tremor. For males, hand tremor severity is significantly increased among those with head and voice tremor alone and in combination, but for females only for the combination. Patients with both head and voice tremor have more frequent involvement of legs and other localizations and are less responsive to β-blockers. CONCLUSIONS Female gender and severe hand tremor may increase the odds of head and/or voice tremor in essential tremor. The association of hand tremor severity with midline tremor is stronger for males than females.
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Affiliation(s)
- Wei Chen
- Department of Neurology, University Hospital Schleswig Holstein, 24105 Kiel, Germany; Department of Neurology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Franziska Hopfner
- Department of Neurology, University Hospital Schleswig Holstein, 24105 Kiel, Germany
| | - Silke Szymczak
- Institute of Medical Informatics and Statistics, Kiel University, 24105 Kiel, Germany
| | - Oliver Granert
- Department of Neurology, University Hospital Schleswig Holstein, 24105 Kiel, Germany
| | - Stefanie H Müller
- Department of Neurology, University Hospital Schleswig Holstein, 24105 Kiel, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Hospital Schleswig Holstein, 24105 Kiel, Germany
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig Holstein, 24105 Kiel, Germany; Department of Neurology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China.
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Renaud M, Marcel C, Rudolf G, Schaeffer M, Lagha-Boukbiza O, Chanson JB, Chelly J, Anheim M, Tranchant C. A step toward essential tremor gene discovery: identification of extreme phenotype and screening of HTRA2 and ANO3. BMC Neurol 2016; 16:238. [PMID: 27881096 PMCID: PMC5120508 DOI: 10.1186/s12883-016-0748-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 11/10/2016] [Indexed: 12/18/2022] Open
Abstract
Background Essential tremor (ET) is characterized by a frequent family history. No monogenic form of ET has been identified. We aimed at exploring ET patients to identify distinct subgroups and facilitate the identification of ET genes. We tested for the presence of HTRA2 p.G399S, and ANO3 p. W490C, p. R484 W and p. S685G mutations. Methods Between June 2011 and November 2013, all consecutive patients suspected with ET were prospectively included in a prospective, monocentric study. Family history, age at onset (AAO), features of tremor, benefit of alcohol and drugs, electrophysiological recording findings were collected. Sanger sequencing was performed for HTRA2 and ANO3 mutations screening. Results Sixty eight patients were investigated. Fourteen diagnosed with psychogenic (5) or dystonic tremor (9) were excluded. Regarding the 54 ET patients, mean AAO was 48 years (6–77), and mean disease duration 15 years (1–55). Bimodal distribution of AAO was consistent with phenotypic subgroups. In patients with AAO before 30 years, marked benefit of alcohol (p < 0.01) and ET family history (p < 0.01) were more frequent and the disease progression less severe (p < 0.0001). Neither HTRA2 nor ANO3 mutation were identified in our patients. Conclusions Our data support that distinct ET phenotypic subgroups may be encountered. We recommend to study separately extreme phenotypes of ET, particularly autosomal dominant families with early AAO (<30 years) and marked benefit of alcohol, to facilitate the identification of ET genes. Electromyographic recording remains a support to distinguish ET from differential diagnosis. HTRA2 and ANO3 mutations are not common causes of ET.
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Affiliation(s)
- Mathilde Renaud
- Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098, Strasbourg Cedex, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404, Illkirch, France
| | - Christophe Marcel
- Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098, Strasbourg Cedex, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Gabrielle Rudolf
- Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098, Strasbourg Cedex, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404, Illkirch, France
| | - Mickaël Schaeffer
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Département d'informations médicales, Hôpitaux universitaires de Strasbourg, Hôpital civil, 1 place de l'Hôpital, 67000, Strasbourg, France
| | - Ouhaïd Lagha-Boukbiza
- Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098, Strasbourg Cedex, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Jean-Baptiste Chanson
- Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098, Strasbourg Cedex, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Jamel Chelly
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404, Illkirch, France.,Service de Diagnostic génétique, Nouvel hôpital civil, 67000, Strasbourg Cedex, France
| | - Mathieu Anheim
- Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098, Strasbourg Cedex, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404, Illkirch, France
| | - Christine Tranchant
- Service of Neurology, University Hospital of Strasbourg, Hospital of Hautepierre, 1 avenue Molière, 67098, Strasbourg Cedex, France. .,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France. .,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67404, Illkirch, France.
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