Parkinsonism and tremor syndromes

Bellows, Steven T.; Jankovic, Joseph

doi:10.1016/j.jns.2021.120018

Cited by 13 publications

(6 citation statements)

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“…This demonstrates, from the other end of the spectrum, frequent diagnostic uncertainty in some tremulous patients at the borders of the classification of PD (Erro et al 2016 ). The evidence that a number of ET + RT cases had an abnormal DAT-SPECT, despite no or minimal evidence of parkinsonism beyond RT, is supported by some imaging studies demonstrating basal ganglia involvement in these patients (Caligiuri et al 2017 ; Nicoletti et al 2015 ) and corroborate the admittedly controversial hypothesis that ET might evolve in PD (Bellows and Jankovic 2022 , 2021 ). This hypothesis would be supported by the evidence that the proportion of ET + RT cases with abnormal DAT-SPECT increased in studies recruiting patients with longer disease duration.…”

Section: Rest Tremor In Essential Tremor Might Indicate Superimposed ...mentioning

confidence: 70%

“…Charles D. Marsden later adapted Critchley's proposal into his clinical classification of the variants of ET and also acknowledged that RT could be observed in severe ET cases (ie, ET type 3) (Marsden et al 1984 ). However, the entity of ET with RT has since proven to be a controversial concept (Quinn et al 2011 ; Espay et al 2017 ) with different hypotheses put forward: some argued it could reflect a more advanced stage of ET (Louis 2021 ; Cohen et al 2003 ), while others suggested it being a transitional state between ET and Parkinson's Disease (PD) (Bellows and Jankovic 2022 ); yet, another possibility is that it represents a different entity altogether (Rapoport et al 1990 ), as presumed by the recently released tremor classification (Bhatia et al 2018 ). Facing this uncertainty, the new tremor classification by the International Parkinson's and Movement Disorder Society (IPMDS) has revised the nosology of tremor syndromes and created the diagnostic category of ET-plus for those patients fulfilling the criteria for ET, but also exhibiting RT (or additional “soft signs” that do not suffice to make an alternative diagnosis) (Bhatia et al 2018 ).…”

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confidence: 99%

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Essential tremor plus rest tremor: current concepts and controversies

et al. 2022

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Since the initial description of Essential Tremor (ET), the entity of ET with rest tremor has proven to be a controversial concept. Some authors argued it could be a late manifestation of ET, others suggested it could be a variant of ET, yet others suggested it could represent a transitional state between ET and Parkinson's disease. The novel tremor classification has proposed the construct of ET-plus to differentiate patients with rest tremor from pure ET. However, there is no clarity of what ET-plus rest tremor represents. With the aim of shedding light on this controversial entity, we have, therefore, systematically reviewed all clinical, electrophysiological, imaging and anatomopathological studies indexed in the Medline database published both before and after the new tremor classification and involving patients with ET-plus rest tremor. Forty-four studies involving 4028 patients were included in this review and analyzed in detail by means of descriptive statistics. The results of the current review suggest that ET-plus rest tremor is a heterogenous group of conditions: thus, rest tremor might represent a late feature of ET, might reflect a different disorder with higher age at onset and lower dependance on genetic susceptibility than ET, might suggest the development of Parkinson's disease or might indicate a misdiagnosis of ET. The reviewed lines of evidence refuse recent claims arguing against the construct of ET-plus, which should be viewed as a syndrome with different possible underpinnings, and highlights methodological issues to be solved in future research.

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Section: Rest Tremor In Essential Tremor Might Indicate Superimposed ...mentioning

confidence: 70%

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confidence: 99%

Essential tremor plus rest tremor: current concepts and controversies

et al. 2022

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“…As the time series of each source activity already represented the difference between two tremor phenotypes, our findings first demonstrated there is a difference of power in the frequency domain. Although a few studies reported no difference in mean frequency between RT and RET, 5,42 several studies showed a visible higher frequency and peak power of RET compared to RT. 6,7,9 Second, the mimicked tremor from healthy controls exhibited frequency coupling between tremor frequency from PMC with β power from the CER, at a relatively lower level, in contrast to γ frequency.…”

Section: Discussionmentioning

confidence: 96%

Re‐emergent Tremor in Parkinson's Disease: Evidence of Pathologic β and Prokinetic γ Activity

Ding,

Nasseroleslami,

Mirzac

et al. 2024

Movement Disorders

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BackgroundRe‐emergent tremor is characterized as a continuation of resting tremor and is often highly therapy refractory. This study examines variations in brain activity and oscillatory responses between resting and re‐emergent tremors in Parkinson's disease.MethodsForty patients with Parkinson's disease (25 males, mean age, 66.78 ± 5.03 years) and 40 age‐ and sex‐matched healthy controls were included in the study. Electroencephalogram and electromyography signals were simultaneously recorded during resting and re‐emergent tremors in levodopa on and off states for patients and mimicked by healthy controls. Brain activity was localized using the beamforming technique, and information flow between sources was estimated using effective connectivity. Cross‐frequency coupling was used to assess neuronal oscillations between tremor frequency and canonical frequency oscillations.ResultsDuring levodopa on, differences in brain activity were observed in the premotor cortex and cerebellum in both the patient and control groups. However, Parkinson's disease patients also exhibited additional activity in the primary sensorimotor cortex. On withdrawal of levodopa, different source patterns were observed in the supplementary motor area and basal ganglia area. Additionally, levodopa was found to suppress the strength of connectivity (P < 0.001) between the identified sources and influence the tremor frequency‐related coupling, leading to a decrease in β (P < 0.001) and an increase in γ frequency coupling (P < 0.001).ConclusionsDistinct variations in cortical–subcortical brain activity are evident in tremor phenotypes. The primary sensorimotor cortex plays a crucial role in the generation of re‐emergent tremor. Moreover, oscillatory neuronal responses in pathological β and prokinetic γ activity are specific to tremor phenotypes. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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“…Atypisk parkinsonisme omfatter ulike nevrodegenerative sykdommer med parkinsonisme som en del av symptompresentasjonen (6). De ulike syndromene overlapper hverandre og kan vaere vanskelig å skille fra Parkinsons sykdom tidlig i forløpet.…”

Section: Introduksjonunclassified

“…Enkelte oversiktsstudier har antydet at de utgjør i underkant av 15 % av de nevrodegenerative parkinsonistiske sykdommene (7), hvilket innebaerer faerre enn 1400 med sykdommene i Norge. Prognosen er også dårligere, med betydelig mer symptombyrde tidlig i forløpet og forkortet levetid (6).…”

Section: Introduksjonunclassified

Norsk Parkinsonregister og biobank

Pedersen,

Lange,

Fiske

2023

Nor J Epidemiol

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SAMMENDRAGNorsk Parkinsonregister og biobank fikk status som nasjonalt medisinsk kvalitetsregister av Helsedirektorateti 2016 og startet datainnsamling fra pasienter med Parkinsons sykdom og atypisk nevrodegenerativparkinsonisme i desember 2018. Registerets hovedmål er å sikre kvalitet og enhetlig diagnostikk, behandlingog oppfølging av pasientgruppen. Dette gjøres ved å samle inn kliniske data, gjennomføre kvalitetsforbedringav behandlingstilbudet og drive forskning på årsaksforhold og sykdomsmekanismer ved å kombinereregisterdata og biobankmateriale. Registeret har i løpet av de første fire årene med datainnsamling møtt påen rekke utfordringer knyttet til koronapandemi og ressursknapphet i helsetjenesten. Flere tiltak har blittgjennomført for å løse dette og vi ser nå tydelig effekt av disse. Ved utgangen av 2022 hadde registeret endekningsgrad på nesten 22 %.ENGLISH SUMMARYThe Norwegian Parkinson’s Registry and Biobank was granted status as a National Quality Registry by theNorwegian Directorate of Health in 2016 and startet registration of patients with Parkinson’s disease andatypical neurodegenerative parkinsonism in December 2018. The main aim of the registry is to ensure qualityand uniform diagnostics, treatment and follow-up of the patient group by collecting clinical data, implementingquality offers of treatment and conducting research into causal relationships and disease mechanisms bycombining registry data and biobank material. During the first four years of data collection, the Parkinson’sRegistry has encountered a number of challenges related to coronavirus pandemic and resource scarcity inthe health service. Several measures have been implemented to solve these challenges, and we are nowstarting to see the effect of these measures. At the end of 2022, a coverage rate of nearly 22 % was achieved.

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Parkinsonism and tremor syndromes

Cited by 13 publications

References 242 publications

Essential tremor plus rest tremor: current concepts and controversies

Essential tremor plus rest tremor: current concepts and controversies

Re‐emergent Tremor in Parkinson's Disease: Evidence of Pathologic β and Prokinetic γ Activity

Norsk Parkinsonregister og biobank

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