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Features in essential tremor and the development of Parkinson's disease vs. parkinsonism.
Neurological Sciences ( IF 2.7 ) Pub Date : 2020-05-11 , DOI: 10.1007/s10072-020-04439-w
Hsien Lee Lau 1 , Sarah E Marmol 1 , Jason Margolesky 1
Affiliation  

BACKGROUND Patients with essential tremor (ET) are at higher risk to develop Parkinson's disease (PD). Recent studies suggest that propranolol (common treatment for ET) can augment pathologic expression of alpha-synuclein. We studied features associated with the development of Parkinson's disease with antecedant essential tremor (ET-PD) compared with ET-plus with parkinsonism (PK). DESIGN Retrospective case series from a tertiary movement disorders center including patients with ET and PD, found to have ET-PD or ET-plus (PK). RESULTS We analyzed two groups: (1) ET-plus (PK) (n = 33) and (2) ET-PD (n = 35). Constipation and anosmia were more common in the ET-PD group (73% and 48%) than in the ET-plus (PK) group (33% and 19%). The ET-plus (PK) group was more likely to undergo dopamine transporter (DAT) scans compared with the ET-PD group (73% vs. 34%) and less likely to receive levodopa trials (21% vs. 91%). There were no significant differences in self-reported REM sleep behavior disorders or beta-blocker use. Similar rates of depression, anxiety, cognitive complaints, and family history of tremor or PD were reported in both groups. CONCLUSION ET-PD and ET-plus (PK) can be clinically difficult to differentiate as they have overlapping motor and non-motor features. Beta-blocker use did not predict development of ET-PD or ET-plus (PK); however, anosmia and constipation may be helpful non-motor distinguishing features. DAT scans and levodopa trials may be valuable in clarifying the diagnoses.

中文翻译:

原发性震颤的特征以及帕金森氏病与帕金森氏症的发展。

背景技术患有原发性震颤(ET)的患者罹患帕金森氏病(PD)的风险更高。最近的研究表明,普萘洛尔(ET的常见治疗方法)可以增强α-突触核蛋白的病理表达。我们研究了先天性原发性震颤(ET-PD)与帕金森综合症(PK)的ET-plus相比与帕金森氏病发展相关的特征。设计来自三级运动障碍中心的回顾性病例系列,包括患有ET-PD或ET-plus(PK)的ET和PD患者。结果我们分析了两组:(1)ET-plus(PK)(n = 33)和(2)ET-PD(n = 35)。ET-PD组(73%和48%)比ET-plus(PK)组(33%和19%)更常见便秘和失眠。与ET-PD组相比,ET-plus(PK)组更有可能接受多巴胺转运蛋白(DAT)扫描(73%对34%),接受左旋多巴试验的可能性较小(21%对91%)。自我报告的REM睡眠行为障碍或使用β受体阻滞剂无显着差异。两组的抑郁症,焦虑症,认知障碍和家族性震颤或PD史相似。结论ET-PD和ET-plus(PK)在临床上很难区分,因为它们具有重叠的运动和非运动特征。使用β受体阻滞剂不能预测ET-PD或ET-plus(PK)的发展。然而,失眠和便秘可能是有助于非运动区分的特征。DAT扫描和左旋多巴试验可能对澄清诊断有价值。自我报告的REM睡眠行为障碍或使用β受体阻滞剂无显着差异。两组的抑郁症,焦虑症,认知障碍和家族性震颤或PD史相似。结论ET-PD和ET-plus(PK)在临床上很难区分,因为它们具有重叠的运动和非运动特征。使用β受体阻滞剂不能预测ET-PD或ET-plus(PK)的发展。然而,失眠和便秘可能是有助于非运动区分的特征。DAT扫描和左旋多巴试验可能对澄清诊断有价值。自我报告的REM睡眠行为障碍或使用β受体阻滞剂无显着差异。两组的抑郁症,焦虑症,认知障碍和家族性震颤或PD史相似。结论ET-PD和ET-plus(PK)在临床上难以区分,因为它们具有重叠的运动和非运动特征。使用β受体阻滞剂不能预测ET-PD或ET-plus(PK)的发展。然而,失眠和便秘可能是有助于非运动区分的特征。DAT扫描和左旋多巴试验可能对澄清诊断有价值。结论ET-PD和ET-plus(PK)在临床上很难区分,因为它们具有重叠的运动和非运动特征。使用β受体阻滞剂不能预测ET-PD或ET-plus(PK)的发展。然而,失眠和便秘可能是有助于非运动区分的特征。DAT扫描和左旋多巴试验可能对澄清诊断有价值。结论ET-PD和ET-plus(PK)在临床上难以区分,因为它们具有重叠的运动和非运动特征。使用β受体阻滞剂不能预测ET-PD或ET-plus(PK)的发展。然而,失眠和便秘可能是有助于非运动区分的特征。DAT扫描和左旋多巴试验可能对澄清诊断有价值。
更新日期:2020-05-11
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