TY - JOUR
T1 - Mental status test scores are inversely correlated with tremor severity
T2 - A study of 161 elderly essential tremor cases
AU - Louis, Elan D.
AU - Viner, Amanda S.
AU - Gillman, Arthur
N1 - Funding Information:
* To whom correspondence should be addressed. E-mail: EDL2@columbia.edu Editor: Dr. Julian Benito-Leon, ‘‘12 de Octubre’’ Hospital, Spain Received: October 13, 2011 Accepted: January 12, 2012 Published: June 27, 2012 Copyright: ’ 2012 Louis et al. This is an open-access article distributed under the terms of the Creative Commons Attribution–Noncommercial–No Derivatives License, which permits the user to copy, distribute, and transmit the work provided that the original author(s) and source are credited; that no commercial use is made of the work; and that the work is not altered or transformed. Funding: National Institutes of Health Grant R01 NS042859 (Dr. Louis). Financial Disclosures: None. Conflict of Interest: The authors report no conflict of interest.
Publisher Copyright:
© 2012 Louis et al.
PY - 2012
Y1 - 2012
N2 - Background: There is an increasing awareness that patients with essential tremor (ET) may exhibit non-motor features, including cognitive dysfunction. Yet there are surprisingly few data in ET on the association, if any, between cognitive dysfunction and motor dysfunction (i.e., tremor severity). Establishing links between the cognitive and motor features of ET would imply that the two share a common underlying pathogenic process. Recent neuroimaging data support this notion. Methods: ET cases were enrolled in a clinical-pathological study at Columbia University Medical Center, New York. The Folstein Mini-Mental State Examination (FMMSE) and Modified Mini Mental Status Examination (mMMSE) were administered. Action tremor was rated with a total tremor score (TTS). Results: There were 161 ET cases (mean age 83.9±5.7 years, median FMMSE 28, median mMMSE 50). The FMMSE and mMMSE were inversely correlated with the TTS (r520.22, p50.005; and r520.17, p50.029). The association, while statistically significant, was modest in magnitude. In linear regression models that adjusted for age, gender, and education, the association between cognitive test scores and TTS remained robust (p<0.001). After excluding 68 (42.2%) cases taking ET medications with potential cognitive side effects, results remained unchanged. Conclusions: Each of the two cognitive test scores was associated with tremor severity such that greater cognitive dysfunction occurred in cases with more marked tremor. These data support recent imaging data, which suggest that the cerebellar neurodegeneration underlying ET may be involved in the expression of cognitive symptoms in ET.
AB - Background: There is an increasing awareness that patients with essential tremor (ET) may exhibit non-motor features, including cognitive dysfunction. Yet there are surprisingly few data in ET on the association, if any, between cognitive dysfunction and motor dysfunction (i.e., tremor severity). Establishing links between the cognitive and motor features of ET would imply that the two share a common underlying pathogenic process. Recent neuroimaging data support this notion. Methods: ET cases were enrolled in a clinical-pathological study at Columbia University Medical Center, New York. The Folstein Mini-Mental State Examination (FMMSE) and Modified Mini Mental Status Examination (mMMSE) were administered. Action tremor was rated with a total tremor score (TTS). Results: There were 161 ET cases (mean age 83.9±5.7 years, median FMMSE 28, median mMMSE 50). The FMMSE and mMMSE were inversely correlated with the TTS (r520.22, p50.005; and r520.17, p50.029). The association, while statistically significant, was modest in magnitude. In linear regression models that adjusted for age, gender, and education, the association between cognitive test scores and TTS remained robust (p<0.001). After excluding 68 (42.2%) cases taking ET medications with potential cognitive side effects, results remained unchanged. Conclusions: Each of the two cognitive test scores was associated with tremor severity such that greater cognitive dysfunction occurred in cases with more marked tremor. These data support recent imaging data, which suggest that the cerebellar neurodegeneration underlying ET may be involved in the expression of cognitive symptoms in ET.
KW - Clinical
KW - Essential tremor
KW - Mental status
KW - Non-motor
KW - Tremor severity
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U2 - 10.5334/TOHM.86
DO - 10.5334/TOHM.86
M3 - Article
AN - SCOPUS:84978321098
SN - 2160-8288
VL - 2
JO - Tremor and Other Hyperkinetic Movements
JF - Tremor and Other Hyperkinetic Movements
ER -