TY - JOUR
T1 - Is there a Premotor Phase of Essential Tremor?
AU - Lenka, Abhishek
AU - Benito-Leon, Julian
AU - Louis, Elan D.
N1 - Publisher Copyright:
© 2017 Lenka et al.
PY - 2017
Y1 - 2017
N2 - Background: Essential tremor (ET) is the most common tremor disorder. In addition to its hallmark feature, kinetic tremor of the upper limbs, patients may have a number of non-motor symptoms and signs (NMS). Several lines of evidence suggest that ET is a neurodegenerative disorder and certain NMS may antedate the onset of tremor. This article comprehensively reviews the evidence for the existence of a ‘‘premotor phase’’ of ET, and discusses plausible biological explanations and implications. Methods: A PubMed search in May 2017 identified articles for this review. Results: The existence of a premotor phase of ET gains support primarily from longitudinal data. In individuals who develop incident ET, baseline (i.e., premotor) evaluations reveal greater cognitive dysfunction, a faster rate of cognitive decline, and the presence of a protective effect of education against dementia. In addition, baseline evaluations also reveal more self-reported depression, antidepressant medication use, and shorter sleep duration in individuals who eventually develop incident ET. In cross-sectional studies, certain personality traits and NMS (e.g., olfactory dysfunction) also suggest the existence of a premotor phase. Discussion: There is preliminary evidence supporting the existence of a premotor phase of ET. The mechanisms are unclear; however, the presence of Lewy bodies in some ET brains in autopsy studies and involvement of multiple neural networks in ET as evident from the neuroimaging studies, are possible contributors. Most evidence is from a longitudinal cohort (Neurological Disorders of Central Spain: NEDICES); additional longitudinal studies are warranted to gain better insights into the premotor phase of ET.
AB - Background: Essential tremor (ET) is the most common tremor disorder. In addition to its hallmark feature, kinetic tremor of the upper limbs, patients may have a number of non-motor symptoms and signs (NMS). Several lines of evidence suggest that ET is a neurodegenerative disorder and certain NMS may antedate the onset of tremor. This article comprehensively reviews the evidence for the existence of a ‘‘premotor phase’’ of ET, and discusses plausible biological explanations and implications. Methods: A PubMed search in May 2017 identified articles for this review. Results: The existence of a premotor phase of ET gains support primarily from longitudinal data. In individuals who develop incident ET, baseline (i.e., premotor) evaluations reveal greater cognitive dysfunction, a faster rate of cognitive decline, and the presence of a protective effect of education against dementia. In addition, baseline evaluations also reveal more self-reported depression, antidepressant medication use, and shorter sleep duration in individuals who eventually develop incident ET. In cross-sectional studies, certain personality traits and NMS (e.g., olfactory dysfunction) also suggest the existence of a premotor phase. Discussion: There is preliminary evidence supporting the existence of a premotor phase of ET. The mechanisms are unclear; however, the presence of Lewy bodies in some ET brains in autopsy studies and involvement of multiple neural networks in ET as evident from the neuroimaging studies, are possible contributors. Most evidence is from a longitudinal cohort (Neurological Disorders of Central Spain: NEDICES); additional longitudinal studies are warranted to gain better insights into the premotor phase of ET.
KW - Essential tremor
KW - Non-motor
KW - Pre-clinical
KW - Premotor
KW - Prodromal
UR - http://www.scopus.com/inward/record.url?scp=85125600112&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85125600112&partnerID=8YFLogxK
U2 - 10.5334/TOHM.382
DO - 10.5334/TOHM.382
M3 - Article
AN - SCOPUS:85125600112
SN - 2160-8288
VL - 7
JO - Tremor and Other Hyperkinetic Movements
JF - Tremor and Other Hyperkinetic Movements
M1 - 498
ER -