Differences Between Essential Tremor Developing Parkinson's Disease and Essential Tremor

Abstract

ÖZET Amaç: Esansiel tremor (ET) en yayg›n ekstrapiramidal hastal›kt›r ve baz› ET hastalar› sonradan Parkinson Hastal›¤› (PH) gelifltirebilirler. Ancak bugüne kadar kesin bir birliktelik tan›mlanmam›flt›r. Biz ET ve PH aras›ndaki iliflkiyi anlamak için, ET ile ET sonras› PH gelifltiren hastalar aras›ndaki farkl›l›klar› demografik ve klinik aç›dan araflt›rd›k. Yöntemler: Yüz k›rk dört ET ve 336 PH hastas› retrospektif olarak klinik kay›tla-r›ndan de¤erlendirildi ve yafl, cinsiyet, ET bafllama yafl›, ailede ET öyküsü, asimetrik veya simetrik tremor REM-uyku davran›fl bozuklu¤u (REM-SBD) öyküsü kaydedildi. Bulgular: Otuz üç PH öncesi ET'si olan hasta önceki klinik kay›tlar›na dayanarak ETPD hastas› olarak de¤erlendirildi. ET'den PH'e dönme süresi ortalama 12±11.4 y›l idi (1-47). Gruplar aras›nda cinsiyet farkl›l›¤› yoktu. ET hastalar›nda ETPD hastalar› ile karfl›laflt›r›ld›¤›nda ortalama yafl, ET bafllama yafl›, asimetrik tremor ve REM-SBD öyküsü anlaml› olarak daha azd›. ET hastalar›nda ailede ET öyküsü ve bafl tremoru ETPD'den daha fazla idi. Sonuç: Bizim sonuçlar›m›z asimetrik tremor, geç bafllang›çl› ET ve REM-SBD öyküsü olan ET hastalar›n›n sonradan PH gelifltirebilece¤ine dikkati çekmifltir. ABSTRACT Objective: Essential tremor (ET) is the most prevalent extrapyramidal disorder and some ET patients may later develop Parkinson's disease (PD). However, up to date, precise association was not determined. To understand the relationship between ET and PD, we investigated differences between patients with ET and ET developing PD (ETPD) in terms of demographic and clinical characteristics. Methods: One hundred forty-four patients with ET and 336 PD patients were retrospectively assessed from their clinical charts, and their current age, gender, onset age of ET, family history of ET, asymmetrical or symmetrical tremor and history of REM-Sleep Behavior Disorders (REM-SBD) were recorded. Results: Thirty-three patients who had ET prior to PD were evaluated as ETPD patients based on previous clinical records. The mean duration from ET to PD was 12±11.4 years (range: 1-47). There was no difference in gender between the groups. The mean age, the mean age at ET onset, asymmetrical tremor and REM-SBD history were significantly lower in ET patients compared to ETPD patients. The family history of ET and head tremor was more frequent in ET patients than in ETPD. Conclusions: Our results point out that some patients with ET, having asymmetrical tremor, late onset and REM-SBD history may develop PD