The evolution of tremor in Parkinson's Disease: insights from a 4-year longitudinal assessment.
The evolution of tremor in Parkinson's Disease: insights from a 4-year longitudinal assessment.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Rome, IT · Author affiliation
Department of Human Neuroscience, Sapienza University of Rome, Viale Dell'Università 30, Rome, 00185, Italy.Location evidence
IT · Author affiliation · country only
IRCCS Neuromed, Via Atinense 18, Pozzilli, IS, 86077, Italy.Location evidence
Salerno, IT · Author affiliation
Department of Neurology, Ruggi D'Aragona and S.Giovanni Di Dio Hospital, Via San Leonardo, Salerno, 84131, Italy.Location evidence
A plain-language reading has not been prepared for this paper yet.
Original abstract
IntroductionWhile tremor is considered a cardinal motor sign in patients with Parkinson's disease (PD), little is known about the evolution of the different types of PD tremor over time.AimsOur objectives were to assess the rate of progression of the various types of PD tremor over the disease course and to verify if the presence of different tremors is consistently associated with specific motor and non-motor burdens over time. Finally, we investigated whether the presence of different tremors can predict specific trajectories of disease progression.MethodsOne hundred PD patients were enrolled and 73 completed a 4-year follow up. Clinical evaluations included the administration of standardized PD scales to assess the severity of motor and non-motor manifestations. The occurrence and severity of rest, re-emergent, and action tremors were accurately evaluated at baseline and 4 years later. Adjusted linear regression models were used to assess tremor type's influence on disease progression.ResultsTremor occurrence and severity decreased during PD progression, with a more significant reduction in action tremor compared to rest and re-emergent tremor. Patients with rest and re-emergent tremor had milder motor symptoms at baseline and milder motor and non-motor manifestations at follow-up. The presence of rest and re-emergent tremor predicted a lower progression of non-motor symptoms.ConclusionsThis longitudinal study revealed that the various types of PD tremor have different evolutions over disease course, can predict distinct trajectories of disease progression and are underpinned by distinct pathophysiological mechanisms.