Objective: Spectrum of non-motor symptoms in essential tremor in a Tunisian population

Background: Several studies have recently lighted out the importance of NMS in ET. These symptoms still, however, under-recognized despite their reported negative impact on patient’s quality of life.

Methods: We conducted a cross-sectional study in the Department of Neurology at Razi University Hospital in Tunisia (October-December 2016) including consecutive patients with ET according to the consensus criteria of the tremor Investigation Group (TRIG), of duration of more than 6 months, with no other neurological or psychiatric disease history. Demographic and clinical data were collected. The Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and the previously validated Arabic version of Non-Motor Symptoms Scale (NMSS) were used to assess respectively motor and non motor symptoms.

Results: Thirty-one patients were included with a mean age of 71,35 years, mean age of tremor onset of 62 years and mean duration of tremor of 9,30 years. Family history of tremor was reported in 77,4% of the population (n=24).  Postural tremor was asymmetric in 64,5% of cases, and rest tremor was the most frequent associated motor sign (35,5%; n=11). The mean TRS total score was 36,68 [3–82]. All the patients reported NMS with NMSS mean score of 69,35 [11–188].These NMS were mild in 19,4% of patients, moderate in 9,7%, severe in 19,4% and very severe in 51,6%. Urinary problems, attention/memory problems, sleep/fatigue problems and mood/cognition problems were the most severe non-motor symptoms in our population, with mean scores of 36,10; 35,39, 29,16 and 22,75, respectively. Perceptual problems were the less severe symptoms, with a mean score of 0,98. The motor total score was correlated to the age of participants (p=0,002); but not to the age at onset of tremor (p=0,09). NMSS total score was not correlated neither to age (p=0,28), age at onset tremor (p=0,21) nor to the motor total score (p=0,24).

Conclusions: NMS were constant in our cohort, very severe in more than half of the patients, and not correlated to motor signs. These findings may denote a peculiar phenotype of ET in our population, needing further genetic investigations to be confirmed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/spectrum-of-non-motor-symptoms-in-essential-tremor-in-a-tunisian-population/