Journal
MOVEMENT DISORDERS
Volume 25, Issue 11, Pages 1633-1638Publisher
WILEY-LISS
DOI: 10.1002/mds.23144
Keywords
essential tremor; clinical correlate; gait; balance; ataxia; cerebellum; head tremor
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Funding
- National Institutes of Health (Bethesda, MD) [R01 NS39422, R01 NS42859]
- NIH [R01 NS42859]
- NINDS [R01 NS39422, R56 NS042859, T32 NS07153-24, R01 NS36630]
- NIA [2P01 A00027232-16]
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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. (C) 2010 Movement Disorder Society
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