Tandem gait performance in essential tremor: Clinical correlates and association with midline tremors

Elan D. Louis, Eileen Rios, Ashwini K. Rao

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Gait difficulty has been reported in essential tremor (ET) although it has been the subject of a limited number of studies. We broadly assessed these clinical correlates, including the association of gait difficulty with a variety of midline tremors (jaw, voice, neck). Tandem gait (10 steps) was assessed in 122 ET cases. Cranial tremor score (0-3) was the number of locations (neck, jaw, voice) in which tremor was present. Number of tandem mis-steps positively correlated with age (P < 0.001), age of tremor onset (P = 0.001), and presence of neck (P < 0.001), jaw (P = 0.001), and voice tremors (P = 0.047). Number of tandem mis-steps increased markedly with cranial tremor score: 0 (0.8 ± 1.2), 1 (1.1 ± 1.6), 2 (2.3 ± 3.0), 3 (3.7 ± 1.6) (P < 0.001). It was not correlated with severity of arm or leg tremors. ET patients with cranial tremors (neck, jaw, voice), those with older age of onset, and those of current older age are more likely to manifest tandem gait difficulty. Tandem gait difficulty was not correlated with severity of limb tremors. Tandem gait difficulty and cranial tremors in ET may both be symptomatic of the same underlying pathophysiology, a disturbance of cerebellar regulation of the midline, which is distinct from its regulation of the limbs.

Original languageEnglish (US)
Pages (from-to)1633-1638
Number of pages6
JournalMovement Disorders
Issue number11
StatePublished - Aug 15 2010
Externally publishedYes


  • Ataxia
  • Balance
  • Cerebellum
  • Clinical correlate
  • Essential tremor
  • Gait
  • Head tremor

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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