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Rare tremors and tremors occurring in other neurological disorders. J Neurol Sci 2022; 435:120200. [DOI: 10.1016/j.jns.2022.120200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 12/21/2022]
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Association between Temporomandibular Joint Disorder and Parkinson's Disease. Brain Sci 2021; 11:brainsci11060747. [PMID: 34200085 PMCID: PMC8229075 DOI: 10.3390/brainsci11060747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 01/07/2023] Open
Abstract
This study performed two different analyses using a large set of population data from the Korean National Health Insurance Service Health Screening Cohort to evaluate the interactional association between temporomandibular disorder (TMD) and Parkinson’s disease (PD). Two nested case–control population-based studies were conducted on 514,866 participants. In Study I, 4455 participants with TMD were matched with 17,820 control participants, with a ratio of 1:4. In Study II, 6076 participants with PD were matched with 24,304 control participants, with a ratio of 1:4. Obesity, smoking, alcohol consumption, systolic, diastolic blood pressure, fasting blood glucose level, and total cholesterol were adjusted. The adjusted odds ratio (OR) for TMD was 1.43 (95% confidence interval (CI) = 1.02–2.00) in PD patients compared to non-PD patients in Study I (p < 0.001). The adjusted OR for PD was 1.56 (95% CI = 1.13–2.15) in TMD patients compared to non-TMD patients in Study II (p = 0.007). This study demonstrated that patients with TMD have a significantly higher risk of developing PD and, conversely, those with PD have a significantly higher risk of developing TMD.
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Wang XX, Feng Y, Li X, Zhu XY, Truong D, Ondo WG, Wu YC. Prodromal Markers of Parkinson's Disease in Patients With Essential Tremor. Front Neurol 2020; 11:874. [PMID: 32982913 PMCID: PMC7477377 DOI: 10.3389/fneur.2020.00874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Essential tremor (ET) is manifested as an isolated syndrome of bilateral upper limb action tremor. Parkinson's disease (PD) is the second most common neurodegenerative disease, with typical motor symptoms of bradykinesia, rigidity, and resting tremor. ET-PD describes the new-onset of PD in ET patients. Recently, numerous studies on epidemiology, genetics, pathology, clinical features, and neuroimaging studies are challenging the idea that ET is an isolated disease, suggesting that patients with ET have the tendency to develop PD. Methods: In this review article, we collected recent findings that reveal prodromal markers of PD in patients with ET. Results: Substantia nigra hyperechogenicity serves as a prodromal marker for predicting the development of PD in patients with ET and provides a reference for therapeutic strategies. Additional potential markers include other neuroimaging, clinical features, heart rate, and genetics, whereas others lack sufficient evidence. Conclusion: In consideration of the limited research of PD in patients with ET, we are still far from revealing the prodromal markers. However, from the existing follow-up studies on ET patients, Substantia nigra hyperechogenicity may enable further exploration of the relationship between ET and PD and the search for pathogenesis-based therapies.
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Affiliation(s)
- Xi-Xi Wang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai General Hospital of Nanjing Medical University, Nanjing, China
| | - Ya Feng
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuan Li
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Ying Zhu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daniel Truong
- Orange Coast Memorial Medical Center, The Truong Neurosciences Institute, Fountain Valley, CA, United States.,Department of Neurosciences and Psychiatry, University of California, Riverside, Riverside, CA, United States
| | - William G Ondo
- Weill Cornell Medical School, Methodist Neurological Institute, Houston, TX, United States
| | - Yun-Cheng Wu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abstract
INTRODUCTION OR BACKGROUND Tremor is one of the commonest movement disorders and can be disabling. There are many causes and treatment options include medications, adaptations, botulinum toxin injections and functional neurosurgery. SOURCES OF DATA Pubmed.gov peer-reviewed journal articles and reviews. AREAS OF AGREEMENT A new tremor classification has been published. Axis 1 of this classification highlights the clinical characteristics of tremor and axis 2 is dedicated to aetiology. The cerebello-thalamo-cortical network and connections to other brain areas is emerging as pivotal to many types of tremor. AREAS OF CONTROVERSY There has been ongoing debate around the clinical entity of essential tremor and its pathophysiological basis. GROWING POINTS Increasing understanding of the pathophysiology underpinning tremor is helping to improve classification and is pushing forward trials of new treatment options, particularly surgical options. AREAS TIMELY FOR DEVELOPING RESEARCH With deeper phenotyping from the new classification, genetics of common forms of tremor are ripe for discovery. New pharmacological therapeutic options are needed to complement the better understanding of the basis of tremor.
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Affiliation(s)
- Tabish A Saifee
- UCL Queen Square Institute of Neurology, Queen Square, London, UK
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Gövert F, Becktepe J, Deuschl G. [The new tremor classification of the International Parkinson and Movement Disorder Society : Update on frequent tremors]. DER NERVENARZT 2019; 89:376-385. [PMID: 29442146 DOI: 10.1007/s00115-018-0489-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tremor is one of the most frequent movement disorders. The recently published new classification of the Movement Disorder Society separates the clinical description of tremor syndromes as so-called axis 1 symptom constellations from the etiologies of tremor (axis 2). The same tremor syndromes can therefore be combined with different causes and vice versa. The terminology used in this classification is precisely defined and thereby also the necessary language for medical communication. Frequent tremor syndromes, such as enhanced physiologic tremor, dystonic and parkinsonian tremor as well as focal tremors and task and position-specific tremors are discussed with respect to the phenomenology, and current therapy.
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Affiliation(s)
- F Gövert
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität zu Kiel, Arnold-Heller Str. 3, 24105, Kiel, Deutschland.
| | - J Becktepe
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität zu Kiel, Arnold-Heller Str. 3, 24105, Kiel, Deutschland
| | - G Deuschl
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität zu Kiel, Arnold-Heller Str. 3, 24105, Kiel, Deutschland
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Sciacca G, Reggio E, Donzuso G, Nicoletti A, Drago F, Salomone S, Zappia M. Forehead Tremor: A Clinical Presentation of Myasthenia Gravis? Mov Disord Clin Pract 2018; 5:225-226. [DOI: 10.1002/mdc3.12593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/12/2018] [Accepted: 01/18/2018] [Indexed: 11/07/2022] Open
Affiliation(s)
- Giorgia Sciacca
- Department of Medical, Surgical Sciences and Advanced Technologies GF IngrassiaUniversity of CataniaCatania Italy
| | - Ester Reggio
- Department of Medical, Surgical Sciences and Advanced Technologies GF IngrassiaUniversity of CataniaCatania Italy
| | - Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies GF IngrassiaUniversity of CataniaCatania Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies GF IngrassiaUniversity of CataniaCatania Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Section of PharmacologyUniversity of CataniaCatania Italy
| | - Salvatore Salomone
- Department of Biomedical and Biotechnological Sciences, Section of PharmacologyUniversity of CataniaCatania Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies GF IngrassiaUniversity of CataniaCatania Italy
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Rossi M, Wilken M, Morisset P, Fariña S, Cerquetti D, Merello M. Facial tremors in patients with and without parkinsonism. Neurol Sci 2016; 37:1999-2002. [PMID: 27470304 DOI: 10.1007/s10072-016-2683-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/20/2016] [Indexed: 11/27/2022]
Abstract
Facial (lip and jaw) tremors can be an early sign of Parkinson's disease (PD), essential tremor and other parkinsonisms. Its response to acute dopaminergic therapy and further predictive clinical diagnosis has not been previously addressed. The aim of this study was to evaluate facial tremors response to acute dopaminergic therapy and further predictive value for clinical diagnosis. A retrospective review of medical records from patients with recent onset of facial tremor, with or without parkinsonism, submitted to acute levodopa challenge for clinical prediction of sustained long-term dopaminergic response was conducted. Twenty-eight out of 559 patients (5 %) had facial tremors, which responded to levodopa in 46 % of patients. Facial tremors response to acute levodopa challenge showed 92 % sensitivity and 93 % specificity to predict a final PD diagnosis. In PD patients, facial tremor magnitude of response to levodopa was not different from that of hand rest tremor (p = 0.8). Facial tremors, although infrequent, can be an early sign of PD. Positive response to acute levodopa challenge predicts long-term PD diagnosis.
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Affiliation(s)
- Malco Rossi
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, 1428, Ciudad Autónoma de Buenos Aires, Argentina
| | - Miguel Wilken
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, 1428, Ciudad Autónoma de Buenos Aires, Argentina
| | - Pierre Morisset
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, 1428, Ciudad Autónoma de Buenos Aires, Argentina
| | - Sofia Fariña
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, 1428, Ciudad Autónoma de Buenos Aires, Argentina
| | - Daniel Cerquetti
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, 1428, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marcelo Merello
- Movement Disorders Section, Neuroscience Department, Raul Carrea Institute for Neurological Research (FLENI), Montañeses 2325, 1428, Ciudad Autónoma de Buenos Aires, Argentina.
- Argentine National Scientific and Technological Research Council (CONICET), Buenos Aires, Argentina.
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Abstract
PURPOSE OF REVIEW This review focuses on important new findings in the field of tremor and illustrates the consequences for the current definition and classification of tremor. RECENT FINDINGS Since 1998 when the consensus criteria for tremor were proposed, new variants of tremors and new diagnostic methods were discovered that have changed particularly the concepts of essential tremor and dystonic tremor. Accumulating evidence exists that essential tremor is not a single entity rather different conditions that share the common symptom action tremor without other major abnormalities. Tremor is a common feature in patients with adult-onset focal dystonia and may involve several different body parts and forms of tremor. Recent advances, in particular, in the field of genetics, suggest that dystonic tremor may even be present without overt dystonia. Monosymptomatic asymmetric rest and postural tremor has been further delineated, and apart from tremor-dominant Parkinson's disease, there are several rare conditions including rest and action tremor with normal dopamine transporter imaging (scans without evidence of dopaminergic deficit) and essential tremor with tremor at rest. SUMMARY Increasing knowledge in the last decades changed the view on tremors and highlights several caveats in the current tremor classification. Given the ambiguous assignment between tremor phenomenology and tremor etiology, a more cautious definition of tremors on the basis of clinical assessment data is needed.
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