Drżenie esencjalne
Rokowania, prognozy i postęp choroby

Drżenie esencjalne (ET) to przewlekłe, postępujące zaburzenie neurologiczne, charakteryzujące się powolnym nasilaniem drżenia, szczególnie kończyn górnych, z rocznym wzrostem nasilenia o 1 punkt w skali TRS przed wizytą i około 2 punkty w trakcie obserwacji klinicznej. Roczna szybkość pogorszenia wynosi od 1,5% do 5%. ET może rozprzestrzeniać się na ramiona i głowę, a jego przebieg jest bardziej agresywny przy asymetrycznym początku, późnym wieku zachorowania (>65 lat) oraz w postaci ET-plus, która wiąże się z wyższym tempem pogorszenia funkcji poznawczych (NMSS, MMSE, MoCA). Pacjenci z ET mają zwiększone ryzyko rozwoju choroby Parkinsona, szczególnie w przypadku obecności drżenia spoczynkowego, zaburzeń zachowania podczas snu REM oraz nasilonych objawów pozaruchowych. Roczny wskaźnik konwersji ET do choroby Parkinsona wynosi 9,1/1000 osobolat, a w ET-plus jest 2,9-krotnie wyższy niż w czystym ET.

  1. Prognostyka drżenia esencjalnego
    1. Tempo progresji choroby
    2. Czynniki predykcyjne progresji choroby
    3. Czynniki predykcyjne śmiertelności
    4. Ryzyko konwersji do innych chorób neurologicznych
    5. Wpływ na długość życia
    6. Progresja wpływu choroby na codzienne funkcjonowanie
    7. Sieci metaboliczne a progresja choroby
    8. Nowe metody oceny progresji
    9. Perspektywy terapeutyczne a rokowanie
  2. Podsumowanie rokowania w drżeniu esencjalnym
    1. Kolejne rozdziały

Prognostyka drżenia esencjalnego

Drżenie esencjalne (ET) jest jednym z najczęstszych zaburzeń neurologicznych, charakteryzującym się powolnym, progresywnym przebiegiem. Choć dawniej uważano je za łagodne schorzenie (stąd określenie „łagodne drżenie samoistne”), współczesne badania wskazują, że może ono znacząco wpływać na jakość życia pacjentów i wiązać się z ryzykiem zwiększonej śmiertelności w niektórych grupach chorych12. Zrozumienie naturalnej historii choroby oraz czynników predykcyjnych jej progresji ma kluczowe znaczenie dla optymalizacji opieki nad pacjentami.

Tempo progresji choroby

Drżenie esencjalne ma charakter postępujący, przy czym tempo progresji jest zwykle powolne. Badania kliniczne wykazały, że nasilenie drżenia, mierzone za pomocą skali TRS (Tremor Rating Scale), wzrasta średnio o 1 punkt rocznie przed pierwszą wizytą w klinice oraz o około 2 punkty rocznie w okresie obserwacji klinicznej3. Przeciętna roczna szybkość pogorszenia drżenia kończyn górnych lub rąk szacuje się na poziomie 1,5% do 5% rocznie4.

Warto zauważyć, że choć częstotliwość drżenia może zmniejszać się z wiekiem, jego amplituda i nasilenie zwykle rosną, co prowadzi do postępującego ograniczenia funkcjonalnego5. Drżenie początkowo może dotyczyć tylko rąk, ale z upływem czasu (zazwyczaj wielu lat) może rozprzestrzeniać się na ramiona i głowę6.

Czynniki predykcyjne progresji choroby

Badania identyfikują kilka istotnych czynników związanych z szybszą progresją drżenia esencjalnego:

  • Asymetryczny początek drżenia – zarówno asymetryczny początek drżenia zgłaszany przez pacjenta, jak i asymetryczne oceny drżenia podczas pierwszej wizyty w klinice są związane ze zwiększonym tempem narastania nasilenia drżenia w czasie7
  • Czas trwania choroby – dłuższy czas trwania choroby wpływa na jej progresję zarówno w fazie przedklinicznej, jak i klinicznej8
  • Wiek zachorowania – pacjenci z początkiem choroby po 65. roku życia mają zwiększone ryzyko rozwoju choroby Parkinsona oraz utraty słuchu9
  • Typ drżenia – pacjenci z drżeniem esencjalnym plus (ET-plus) wykazują znacznie wyższe średnie roczne tempo pogorszenia w skalach NMSS, MMSE i MoCA w porównaniu z pacjentami z czystym ET10

Czynniki predykcyjne śmiertelności

Długoterminowe badania prospektywne zidentyfikowały czynniki związane ze zwiększonym ryzykiem śmiertelności u pacjentów z drżeniem esencjalnym, szczególnie wśród osób starszych11. W analizach jednoczynnikowych wykazano, że następujące czynniki zwiększają ryzyko zgonu:

  • Starszy wiek (HR = 1,16, p < 0,001)
  • Niższy wynik w Montrealskiej Ocenie Funkcji Poznawczych (HR = 0,88, p = 0,004)
  • Wyższy wynik w Clinical Dementia Rating (HR = 4,53, p < 0,001)
  • Wyższy wynik w Geriatrycznej Skali Depresji (HR = 1,07, p = 0,048)
  • Mniejsza pewność równowagi (HR = 0,98, p = 0,006)
  • Większa liczba upadków (HR = 1,11, p = 0,003)
  • Większa liczba błędów w chodzie tandemowym (HR = 1,53, p = 0,004)

12

W końcowym modelu wieloczynnikowym niezależnymi czynnikami związanymi ze zwiększonym ryzykiem śmiertelności były: starszy wiek (HR = 1,14, p = 0,005), wyższy wynik CDR (HR = 3,80, p = 0,002) oraz wyższy wynik GDS (HR = 1,11, p = 0,01)13.

Ryzyko konwersji do innych chorób neurologicznych

Pacjenci z drżeniem esencjalnym mają zwiększone ryzyko rozwoju innych chorób neurologicznych, w szczególności choroby Parkinsona1415. W badaniu z długoterminową obserwacją (średnio 22,6 miesiąca) wykazano, że:

  • Roczny wskaźnik konwersji ET do choroby Parkinsona wynosi 9,1/1000 osobolat16
  • Wśród pacjentów z czystym ET, 0,9% rozwinęło chorobę Parkinsona (wskaźnik konwersji 4,6/1000 osobolat)17
  • Wśród pacjentów z ET-plus, 2,4% rozwinęło chorobę Parkinsona (wskaźnik konwersji 13,4/1000 osobolat), co stanowi 2,9-krotnie wyższe ryzyko niż w czystym ET18
  • Roczny wskaźnik konwersji z czystego ET do ET-plus wynosił 30,2/1000 osobolat19

Istotnymi klinicznymi czynnikami predykcyjnymi konwersji ET do choroby Parkinsona są: drżenie spoczynkowe, zaburzenia zachowania podczas snu REM (pRBD) oraz bardziej nasilone objawy pozaruchowe20.

Wpływ na długość życia

Interesujące dane pochodzą z badania analizującego wpływ drżenia esencjalnego na długowieczność i wskaźniki śmiertelności w rodzinach. Wbrew wcześniejszym obawom, badanie to wykazało, że mediana wieku w chwili śmierci dla zmarłych osób z ET wynosiła 80 lat, w porównaniu do 70 lat dla osób bez ET. Analiza przeżycia ujawniła znacząco dłuższą długość życia w grupie ET+, ze współczynnikiem ryzyka 0,44, wskazującym na niższe ryzyko śmiertelności u pacjentów z ET, szczególnie wśród mężczyzn21. Sugeruje to, że ET może być związane z dłuższą oczekiwaną długością życia, co otwiera interesujące możliwości dalszych badań nad mechanizmami mogącymi dawać tę potencjalną przewagę w długowieczności22.

Progresja wpływu choroby na codzienne funkcjonowanie

Wraz z postępem drżenia esencjalnego, pacjenci doświadczają narastających trudności w wykonywaniu codziennych czynności2324. Główne trudności, których mogą doświadczać pacjenci z postępującym drżeniem esencjalnym, obejmują:

  • Zakłopotanie społeczne, które może ograniczać aktywności poza domem2526
  • Niezdolność zawodowa w sytuacjach wymagających występów publicznych, jak w przypadku muzyka czy mówcy27
  • Trudności w wykonywaniu zadań wymagających stabilnej ręki, takich jak rysowanie, pisanie na klawiaturze, pisanie odręczne, jedzenie, golenie się czy picie2829
  • Zwiększone zmęczenie z powodu wysiłku wkładanego w wykonywanie codziennych czynności30
  • Stres i gniew związany z obniżoną jakością życia31
  • Zmiany nastroju32

W przypadkach bardziej zaawansowanego drżenia, niektórzy pacjenci mogą ostatecznie nie być w stanie żyć samodzielnie i potrzebować opieki rodziny lub zamieszkania w ośrodku opieki wspomaganej lub placówce opieki pielęgniarskiej33.

Sieci metaboliczne a progresja choroby

Badania nad neuronalnymi korelatami drżenia i funkcji poznawczych w drżeniu esencjalnym dostarczają istotnych informacji na temat progresji choroby. Wzorzec przestrzennej kowariancji metabolicznej związany z ET (ETRP) charakteryzuje się względnie zwiększonym metabolizmem w móżdżku, pniu mózgu i korze skroniowo-potylicznej, wraz z relatywnym zmniejszeniem metabolizmu głównie w korze czołowo-skroniowej i ruchowej34.

Ekspresja sieci wykazywała odwrotne korelacje z nasileniem drżenia i czasem trwania choroby oraz pozytywne korelacje z dysfunkcją poznawczą35. Ujemna korelacja ekspresji sieci z czasem trwania choroby i nasileniem drżenia sugeruje przede wszystkim kompensacyjną rolę sieci, która zawodzi w zaawansowanych stadiach choroby36. Odwrotna korelacja ekspresji sieci z funkcjami poznawczymi wskazuje, że rola sieci różni się dla domen poznawczych i ruchowych37.

Nowe metody oceny progresji

W ocenie progresji drżenia esencjalnego i jego wpływu na codzienne funkcjonowanie pomocne są nowe narzędzia oceny wyników zgłaszanych przez pacjentów. Skala TETRAS PRO (Patient-Reported Outcome measure) została zwalidowana jako rzetelne narzędzie do oceny wpływu funkcjonalnego drżenia esencjalnego38.

TETRAS PRO silnie koreluje (r > 0,7) z administrowaną przez klinicystów podskalą TETRAS-P, opartą na wywiadzie kliniczno-pacjenckim podskalą TETRAS ADL oraz skalą jakości życia QUEST zgłaszaną przez pacjentów39. Głównym czynnikiem wpływającym na wynik TETRAS PRO jest nasilenie drżenia (mierzone TETRAS-P), w drugiej kolejności depresja (HADS-D), a w minimalnym stopniu umiejętności radzenia sobie (ECQ-ISE)40.

Perspektywy terapeutyczne a rokowanie

Postępy w leczeniu drżenia esencjalnego mogą wpływać na długoterminowe rokowanie. Ultrasonografia skupiona pod kontrolą rezonansu magnetycznego (MRgFUS) stosowana do talamotomii wykazuje obiecujące wyniki, szczególnie u zdrowych pacjentów z asymetrycznym drżeniem esencjalnym41. Mimo obaw historycznych związanych z obustronną talamotomią, współczesne techniki z zastosowaniem FUS, które są niezwykle precyzyjne, stale monitorowane i kierowane obrazowaniem MRI, mogą umożliwić bezpieczne i wykonalne dwustronne zabiegi u pacjentów z ET42.

Nowe podejścia neuromodulacyjne, takie jak nieinwazyjne tłumienie drżenia esencjalnego poprzez przerwanie jego spójności czasowej, mogą stanowić fundament dla nowej strategii interwencyjnej w ET43. Trwałe zmniejszenie amplitudy drżenia po zakończeniu okresu stymulacji może mieć potencjał terapeutyczny poprzez neuroplastyczność44. Przyszłe badania z większymi kohortami pacjentów i dłuższymi okresami stymulacji są potrzebne do lepszego określenia wielkości i czasu trwania redukcji drżenia oraz oceny profilu bezpieczeństwa45.

Należy jednak podkreślić, że wszelkie procedury chirurgiczne wiążą się z ryzykiem i powinny być dokładnie omówione z doświadczonym specjalistą przed zabiegiem46.

Podsumowanie rokowania w drżeniu esencjalnym

Drżenie esencjalne jest schorzeniem postępującym, ale zwykle powoli, często w ciągu wielu lat lub nawet dekad. Choć nie zagraża bezpośrednio życiu, może powodować znaczne ograniczenia funkcjonalne i wpływać na jakość życia4748. Czynniki takie jak asymetryczny początek drżenia, wiek zachorowania czy obecność dodatkowych objawów neurologicznych (ET-plus) mogą wskazywać na bardziej agresywny przebieg choroby lub większe ryzyko konwersji do choroby Parkinsona4950.

Badania sugerują, że regularny skrining w kierunku objawów depresyjnych, ocena funkcji poznawczych i śledzenie wyników CDR oraz ocena równowagi powinny być uwzględniane podczas oceny pacjentów z ET, ponieważ mogą być one niezależnymi predyktorami śmiertelności u osób starszych z tym schorzeniem51.

Postępy w leczeniu, w tym rozwój nowych technik neuromodulacyjnych i chirurgicznych, mogą potencjalnie zmienić naturalny przebieg choroby i poprawić długoterminowe rokowanie5253.

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6292933/
    Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET. […] In univariate Cox regression models, older age (HR = 1.16, p 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality. […] This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.
  • #2 Essential Tremor: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11886-essential-tremor
    Essential tremor is usually progressive, meaning it gets worse over time. This is usually a slow process. The average rate that arm or hand tremors get worse is between 1.5% and 5% a year. […] Essential tremor starts small and usually only affects your hands at first. Over time, usually many years, the tremors may spread to affect your arm and head. As the condition progresses, you may begin to struggle with certain activities and may need help to do them. […] Essential tremor is a permanent, life-long condition once it starts. Its not curable, and it doesnt go away on its own. […] In years past, the term benign, meaning harmless, was a standard part of its name, as in benign essential tremor. However, experts now recognize that while essential tremor isnt harmful directly, it can cause severe disruptions in your life.
  • #3 Essential tremor: predictors of disease progression in a clinical cohort
    https://pmc.ncbi.nlm.nih.gov/articles/PMC2077383/
    To examine the utility of baseline factors to predict disease progression among a clinical cohort of patients diagnosed with essential tremor. […] On average, the TRS total score increased by 1 point per year before the first visit to the clinic and by about 2 points per year during the observed study period. […] Essential tremor is a slow, progressive disease. The rate of disease progression and the factors associated with disease progression may vary throughout the disease course. […] Predictive factors associated with disease progression during the preclinical (ie, up to the first clinic visit) and clinical phase were different, although duration with disease was common to both. […] The most important factors associated with disease progression during the observed followup period were two variables that capture the degree of asymmetrical disease—that is, both asymmetrical selfreported tremor onset and asymmetrical tremor ratings at the first clinic visit were associated with an increased rate of tremor severity over time.
  • #4 Essential Tremor: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11886-essential-tremor
    Essential tremor is usually progressive, meaning it gets worse over time. This is usually a slow process. The average rate that arm or hand tremors get worse is between 1.5% and 5% a year. […] Essential tremor starts small and usually only affects your hands at first. Over time, usually many years, the tremors may spread to affect your arm and head. As the condition progresses, you may begin to struggle with certain activities and may need help to do them. […] Essential tremor is a permanent, life-long condition once it starts. Its not curable, and it doesnt go away on its own. […] In years past, the term benign, meaning harmless, was a standard part of its name, as in benign essential tremor. However, experts now recognize that while essential tremor isnt harmful directly, it can cause severe disruptions in your life.
  • #5 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #6 Essential Tremor: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11886-essential-tremor
    Essential tremor is usually progressive, meaning it gets worse over time. This is usually a slow process. The average rate that arm or hand tremors get worse is between 1.5% and 5% a year. […] Essential tremor starts small and usually only affects your hands at first. Over time, usually many years, the tremors may spread to affect your arm and head. As the condition progresses, you may begin to struggle with certain activities and may need help to do them. […] Essential tremor is a permanent, life-long condition once it starts. Its not curable, and it doesnt go away on its own. […] In years past, the term benign, meaning harmless, was a standard part of its name, as in benign essential tremor. However, experts now recognize that while essential tremor isnt harmful directly, it can cause severe disruptions in your life.
  • #7 Essential tremor: predictors of disease progression in a clinical cohort
    https://pmc.ncbi.nlm.nih.gov/articles/PMC2077383/
    To examine the utility of baseline factors to predict disease progression among a clinical cohort of patients diagnosed with essential tremor. […] On average, the TRS total score increased by 1 point per year before the first visit to the clinic and by about 2 points per year during the observed study period. […] Essential tremor is a slow, progressive disease. The rate of disease progression and the factors associated with disease progression may vary throughout the disease course. […] Predictive factors associated with disease progression during the preclinical (ie, up to the first clinic visit) and clinical phase were different, although duration with disease was common to both. […] The most important factors associated with disease progression during the observed followup period were two variables that capture the degree of asymmetrical disease—that is, both asymmetrical selfreported tremor onset and asymmetrical tremor ratings at the first clinic visit were associated with an increased rate of tremor severity over time.
  • #8 Essential tremor: predictors of disease progression in a clinical cohort
    https://pmc.ncbi.nlm.nih.gov/articles/PMC2077383/
    To examine the utility of baseline factors to predict disease progression among a clinical cohort of patients diagnosed with essential tremor. […] On average, the TRS total score increased by 1 point per year before the first visit to the clinic and by about 2 points per year during the observed study period. […] Essential tremor is a slow, progressive disease. The rate of disease progression and the factors associated with disease progression may vary throughout the disease course. […] Predictive factors associated with disease progression during the preclinical (ie, up to the first clinic visit) and clinical phase were different, although duration with disease was common to both. […] The most important factors associated with disease progression during the observed followup period were two variables that capture the degree of asymmetrical disease—that is, both asymmetrical selfreported tremor onset and asymmetrical tremor ratings at the first clinic visit were associated with an increased rate of tremor severity over time.
  • #9 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #10
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    ET-plus patients exhibited significantly higher average annual rates of deterioration in NMSS (0.55 [0, 2.40] points/year vs. 0 [0, 0.81] points/year, Z = 3.541, P 0.001), MMSE (0 [0, 0.52] points/year vs. 0 [0, 0.43] points/year, Z = 2.782, P = 0.005), and MoCA (0.52 [0, 0.63] points/year vs. 0 [0, 0.52] points/year, Z = 3.331, P = 0.001) scores compared to pure ET patients. […] A total of 468 patients with ET (including 461 patients followed up face-to-face and 7 deceased patients) were included in the disease outcome investigation. With an average follow-up duration of 22.6 months (1.88 years), 8/468 (1.7%) ET patients progressed to PD, yielding an annual conversion rate of 9.1/1000 person-years. Among 222 patients with pure ET, 2 (0.9%) progressed to PD, yielding an annual conversion rate of 4.6/1000 person-years. Among 246 patients with ET-plus, 6 (2.4%) progressed to PD, with a conversion rate of 13.4/1000 person-years, 2.9-fold higher than that of pure ET.
  • #11 What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6292933/
    Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET. […] In univariate Cox regression models, older age (HR = 1.16, p 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality. […] This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.
  • #12 What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6292933/
    Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET. […] In univariate Cox regression models, older age (HR = 1.16, p 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality. […] This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.
  • #13 What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6292933/
    Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET. […] In univariate Cox regression models, older age (HR = 1.16, p 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality. […] This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.
  • #14 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #15
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    ET-plus patients exhibited significantly higher average annual rates of deterioration in NMSS (0.55 [0, 2.40] points/year vs. 0 [0, 0.81] points/year, Z = 3.541, P 0.001), MMSE (0 [0, 0.52] points/year vs. 0 [0, 0.43] points/year, Z = 2.782, P = 0.005), and MoCA (0.52 [0, 0.63] points/year vs. 0 [0, 0.52] points/year, Z = 3.331, P = 0.001) scores compared to pure ET patients. […] A total of 468 patients with ET (including 461 patients followed up face-to-face and 7 deceased patients) were included in the disease outcome investigation. With an average follow-up duration of 22.6 months (1.88 years), 8/468 (1.7%) ET patients progressed to PD, yielding an annual conversion rate of 9.1/1000 person-years. Among 222 patients with pure ET, 2 (0.9%) progressed to PD, yielding an annual conversion rate of 4.6/1000 person-years. Among 246 patients with ET-plus, 6 (2.4%) progressed to PD, with a conversion rate of 13.4/1000 person-years, 2.9-fold higher than that of pure ET.
  • #16
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    ET-plus patients exhibited significantly higher average annual rates of deterioration in NMSS (0.55 [0, 2.40] points/year vs. 0 [0, 0.81] points/year, Z = 3.541, P 0.001), MMSE (0 [0, 0.52] points/year vs. 0 [0, 0.43] points/year, Z = 2.782, P = 0.005), and MoCA (0.52 [0, 0.63] points/year vs. 0 [0, 0.52] points/year, Z = 3.331, P = 0.001) scores compared to pure ET patients. […] A total of 468 patients with ET (including 461 patients followed up face-to-face and 7 deceased patients) were included in the disease outcome investigation. With an average follow-up duration of 22.6 months (1.88 years), 8/468 (1.7%) ET patients progressed to PD, yielding an annual conversion rate of 9.1/1000 person-years. Among 222 patients with pure ET, 2 (0.9%) progressed to PD, yielding an annual conversion rate of 4.6/1000 person-years. Among 246 patients with ET-plus, 6 (2.4%) progressed to PD, with a conversion rate of 13.4/1000 person-years, 2.9-fold higher than that of pure ET.
  • #17
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    ET-plus patients exhibited significantly higher average annual rates of deterioration in NMSS (0.55 [0, 2.40] points/year vs. 0 [0, 0.81] points/year, Z = 3.541, P 0.001), MMSE (0 [0, 0.52] points/year vs. 0 [0, 0.43] points/year, Z = 2.782, P = 0.005), and MoCA (0.52 [0, 0.63] points/year vs. 0 [0, 0.52] points/year, Z = 3.331, P = 0.001) scores compared to pure ET patients. […] A total of 468 patients with ET (including 461 patients followed up face-to-face and 7 deceased patients) were included in the disease outcome investigation. With an average follow-up duration of 22.6 months (1.88 years), 8/468 (1.7%) ET patients progressed to PD, yielding an annual conversion rate of 9.1/1000 person-years. Among 222 patients with pure ET, 2 (0.9%) progressed to PD, yielding an annual conversion rate of 4.6/1000 person-years. Among 246 patients with ET-plus, 6 (2.4%) progressed to PD, with a conversion rate of 13.4/1000 person-years, 2.9-fold higher than that of pure ET.
  • #18
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    ET-plus patients exhibited significantly higher average annual rates of deterioration in NMSS (0.55 [0, 2.40] points/year vs. 0 [0, 0.81] points/year, Z = 3.541, P 0.001), MMSE (0 [0, 0.52] points/year vs. 0 [0, 0.43] points/year, Z = 2.782, P = 0.005), and MoCA (0.52 [0, 0.63] points/year vs. 0 [0, 0.52] points/year, Z = 3.331, P = 0.001) scores compared to pure ET patients. […] A total of 468 patients with ET (including 461 patients followed up face-to-face and 7 deceased patients) were included in the disease outcome investigation. With an average follow-up duration of 22.6 months (1.88 years), 8/468 (1.7%) ET patients progressed to PD, yielding an annual conversion rate of 9.1/1000 person-years. Among 222 patients with pure ET, 2 (0.9%) progressed to PD, yielding an annual conversion rate of 4.6/1000 person-years. Among 246 patients with ET-plus, 6 (2.4%) progressed to PD, with a conversion rate of 13.4/1000 person-years, 2.9-fold higher than that of pure ET.
  • #19
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    In conclusion, disease progression was faster in ET-plus patients than in pure ET patients, while neurological soft signs can predict disease progression. The annual conversion rate from pure ET to ET-plus was 30.2/1000 persons/year. Age at onset is an important clinical predictor of this conversion. The annual conversion rate from ET to PD is 9.1/1000 persons per year. Rest tremor, pRBD, and more severe non-motor symptoms are significant clinical predictors of conversion from ET to PD.
  • #20
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    In conclusion, disease progression was faster in ET-plus patients than in pure ET patients, while neurological soft signs can predict disease progression. The annual conversion rate from pure ET to ET-plus was 30.2/1000 persons/year. Age at onset is an important clinical predictor of this conversion. The annual conversion rate from ET to PD is 9.1/1000 persons per year. Rest tremor, pRBD, and more severe non-motor symptoms are significant clinical predictors of conversion from ET to PD.
  • #21 Effects of essential tremor on longevity and mortality rates in families | PLOS One
    https://journals.plos.org/plosone/article/peerReview?id=10.1371/journal.pone.0320422
    The aim of this study is to analyze the effects of essential tremor on longevity and mortality rates in families. […] Results showed that the median age at death for deceased ET+ individuals was 80 years, compared to 70 years for ET- individuals. Living ET+ individuals had a median age of 63 years, while ET- individuals had a median age of 60 years. Survival analysis revealed a significantly longer lifespan for the ET+ group, with a hazard ratio of 0.44, indicating a lower mortality risk in ET+ patients, particularly among males. […] Our findings suggest that ET could indeed be associated with longer life expectancy, offering an intriguing avenue for further research into the underlying mechanisms that might confer this potential longevity advantage.
  • #22 Effects of essential tremor on longevity and mortality rates in families | PLOS One
    https://journals.plos.org/plosone/article/peerReview?id=10.1371/journal.pone.0320422
    The aim of this study is to analyze the effects of essential tremor on longevity and mortality rates in families. […] Results showed that the median age at death for deceased ET+ individuals was 80 years, compared to 70 years for ET- individuals. Living ET+ individuals had a median age of 63 years, while ET- individuals had a median age of 60 years. Survival analysis revealed a significantly longer lifespan for the ET+ group, with a hazard ratio of 0.44, indicating a lower mortality risk in ET+ patients, particularly among males. […] Our findings suggest that ET could indeed be associated with longer life expectancy, offering an intriguing avenue for further research into the underlying mechanisms that might confer this potential longevity advantage.
  • #23 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #24 Essential Tremor: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11886-essential-tremor
    Essential tremor is usually progressive, meaning it gets worse over time. This is usually a slow process. The average rate that arm or hand tremors get worse is between 1.5% and 5% a year. […] Essential tremor starts small and usually only affects your hands at first. Over time, usually many years, the tremors may spread to affect your arm and head. As the condition progresses, you may begin to struggle with certain activities and may need help to do them. […] Essential tremor is a permanent, life-long condition once it starts. Its not curable, and it doesnt go away on its own. […] In years past, the term benign, meaning harmless, was a standard part of its name, as in benign essential tremor. However, experts now recognize that while essential tremor isnt harmful directly, it can cause severe disruptions in your life.
  • #25 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #26 What is Essential Tremor? | Brown University Health
    https://www.brownhealth.org/be-well/what-essential-tremor
    Typically, ET worsens over time, but very slowlyusually years and sometimes decades. ET is not life-threatening. However, it can be socially embarrassing and even disabling, affecting ones ability to perform daily activities. […] Any surgical procedures carry risk and should be thoroughly discussed with an experienced specialist prior to surgery.
  • #27 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #28 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #29 Essential Tremor: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11886-essential-tremor
    People with more severe tremors struggle with activities such as cooking, using kitchen utensils, drinking from a cup, hygiene activities, grooming and dressing. Some people who have essential tremor eventually cant live independently and need to live with family or in an assisted living or skilled nursing facility setting.
  • #30 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #31 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #32 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Essential-Tremor-Prognosis.aspx
    Essential tremor is mild in many cases, and remains this way. However, in other individuals, it is progressive, starting on one side of the body but becoming bilateral over the next few years. […] While the frequency of essential tremor often decreases with age, its severity increases. This means that the individual may eventually find it difficult to carry out their routine activities, including eating, shaving, or writing, among others. […] Finally, individuals with essential tremor have an increased risk of developing Parkinson disease, and hearing loss. This is especially true if the tremor first started over the age of 65 years. […] In short, the main difficulties to be envisaged for a patient with progressive essential tremor include: Social embarrassment which may limit activities outside the home, Professional incompetence in situations where public performances are required, as in the case of a musician or a speaker, Difficulty in completing tasks which require a steady hand, such as drawing, typing, writing, eating, shaving, or drinking, Increased fatigue due to the effort expended to complete daily activities, Stress and anger at the decreased quality of life, Mood changes, Development of other neurological conditions such as Parkinson disease.
  • #33 Essential Tremor: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11886-essential-tremor
    People with more severe tremors struggle with activities such as cooking, using kitchen utensils, drinking from a cup, hygiene activities, grooming and dressing. Some people who have essential tremor eventually cant live independently and need to live with family or in an assisted living or skilled nursing facility setting.
  • #34 Identification of a metabolic brain network characterizing essential tremor | Scientific Reports
    https://www.nature.com/articles/s41598-024-82069-4
    The neuronal correlate of tremor genesis and cognitive function in essential tremor (ET) and its modulation by deep brain stimulation (DBS) are poorly understood. […] The ET related metabolic spatial covariance pattern (ETRP) was characterized by relatively increased metabolism in the cerebellum, brainstem, and temporo-occipital cortices, accompanied by relative metabolic decreases mainly in fronto-temporal and motor cortices. Network expression showed inverse correlations with tremor severity and disease duration and positive correlations with cognitive dysfunction. […] Our findings suggest ET is characterized by an abnormal brain network associated with disease phenotype. […] ETRP expression exhibited negative correlations with disease duration and tremor severity, suggesting a primarily compensatory role of the network that fails in advanced disease stages. The inverse correlation of network expression with cognitive function, i.e. higher network expression in more severely impaired subjects, indicates that the networks role differs for cognitive and motor domains.
  • #35 Identification of a metabolic brain network characterizing essential tremor | Scientific Reports
    https://www.nature.com/articles/s41598-024-82069-4
    The neuronal correlate of tremor genesis and cognitive function in essential tremor (ET) and its modulation by deep brain stimulation (DBS) are poorly understood. […] The ET related metabolic spatial covariance pattern (ETRP) was characterized by relatively increased metabolism in the cerebellum, brainstem, and temporo-occipital cortices, accompanied by relative metabolic decreases mainly in fronto-temporal and motor cortices. Network expression showed inverse correlations with tremor severity and disease duration and positive correlations with cognitive dysfunction. […] Our findings suggest ET is characterized by an abnormal brain network associated with disease phenotype. […] ETRP expression exhibited negative correlations with disease duration and tremor severity, suggesting a primarily compensatory role of the network that fails in advanced disease stages. The inverse correlation of network expression with cognitive function, i.e. higher network expression in more severely impaired subjects, indicates that the networks role differs for cognitive and motor domains.
  • #36 Identification of a metabolic brain network characterizing essential tremor | Scientific Reports
    https://www.nature.com/articles/s41598-024-82069-4
    The neuronal correlate of tremor genesis and cognitive function in essential tremor (ET) and its modulation by deep brain stimulation (DBS) are poorly understood. […] The ET related metabolic spatial covariance pattern (ETRP) was characterized by relatively increased metabolism in the cerebellum, brainstem, and temporo-occipital cortices, accompanied by relative metabolic decreases mainly in fronto-temporal and motor cortices. Network expression showed inverse correlations with tremor severity and disease duration and positive correlations with cognitive dysfunction. […] Our findings suggest ET is characterized by an abnormal brain network associated with disease phenotype. […] ETRP expression exhibited negative correlations with disease duration and tremor severity, suggesting a primarily compensatory role of the network that fails in advanced disease stages. The inverse correlation of network expression with cognitive function, i.e. higher network expression in more severely impaired subjects, indicates that the networks role differs for cognitive and motor domains.
  • #37 Identification of a metabolic brain network characterizing essential tremor | Scientific Reports
    https://www.nature.com/articles/s41598-024-82069-4
    The neuronal correlate of tremor genesis and cognitive function in essential tremor (ET) and its modulation by deep brain stimulation (DBS) are poorly understood. […] The ET related metabolic spatial covariance pattern (ETRP) was characterized by relatively increased metabolism in the cerebellum, brainstem, and temporo-occipital cortices, accompanied by relative metabolic decreases mainly in fronto-temporal and motor cortices. Network expression showed inverse correlations with tremor severity and disease duration and positive correlations with cognitive dysfunction. […] Our findings suggest ET is characterized by an abnormal brain network associated with disease phenotype. […] ETRP expression exhibited negative correlations with disease duration and tremor severity, suggesting a primarily compensatory role of the network that fails in advanced disease stages. The inverse correlation of network expression with cognitive function, i.e. higher network expression in more severely impaired subjects, indicates that the networks role differs for cognitive and motor domains.
  • #38 Validation of a New Patient-Reported Outcome Measure of the Functional Impact of Essential Tremor on Activities of Daily Living | Tremor and Other Hyperkinetic Movements
    https://tremorjournal.org/articles/10.5334/tohm.886
    TETRAS PRO is a valid and reliable scale that is influenced strongly by tremor severity, moderately by mood (depression), and minimally by coping skills. The MDC for TETRAS PRO is probably sufficient to detect clinically important change. […] TETRAS PRO correlated strongly (r 0.7) with the clinician-administered TETRAS-P subscale, the clinician-patient interview-based TETRAS ADL subscale, and the QUEST patient-reported quality of life scale. […] TETRAS-P, HADS-D and ECQ-ISE combined to explain approximately 67% of the total variance of TETRAS PRO, with TETRAS-P being the principal driver, followed by HADS-D, and ECQ-ISE. […] TETRAS PRO exhibited very good internal consistency (Cronbach alpha = 0.894 and McDonald omega = 0.903). […] TETRAS PRO had excellent test-retest reliability over 30 days when no treatment change was in effect. The MDC 95%CI (MDC95) was 5.49.0 for a 1-day interval between assessments and 5.28.0 for a 30-day interval.
  • #39 Validation of a New Patient-Reported Outcome Measure of the Functional Impact of Essential Tremor on Activities of Daily Living | Tremor and Other Hyperkinetic Movements
    https://tremorjournal.org/articles/10.5334/tohm.886
    TETRAS PRO is a valid and reliable scale that is influenced strongly by tremor severity, moderately by mood (depression), and minimally by coping skills. The MDC for TETRAS PRO is probably sufficient to detect clinically important change. […] TETRAS PRO correlated strongly (r 0.7) with the clinician-administered TETRAS-P subscale, the clinician-patient interview-based TETRAS ADL subscale, and the QUEST patient-reported quality of life scale. […] TETRAS-P, HADS-D and ECQ-ISE combined to explain approximately 67% of the total variance of TETRAS PRO, with TETRAS-P being the principal driver, followed by HADS-D, and ECQ-ISE. […] TETRAS PRO exhibited very good internal consistency (Cronbach alpha = 0.894 and McDonald omega = 0.903). […] TETRAS PRO had excellent test-retest reliability over 30 days when no treatment change was in effect. The MDC 95%CI (MDC95) was 5.49.0 for a 1-day interval between assessments and 5.28.0 for a 30-day interval.
  • #40 Validation of a New Patient-Reported Outcome Measure of the Functional Impact of Essential Tremor on Activities of Daily Living | Tremor and Other Hyperkinetic Movements
    https://tremorjournal.org/articles/10.5334/tohm.886
    TETRAS PRO is a valid and reliable scale that is influenced strongly by tremor severity, moderately by mood (depression), and minimally by coping skills. The MDC for TETRAS PRO is probably sufficient to detect clinically important change. […] TETRAS PRO correlated strongly (r 0.7) with the clinician-administered TETRAS-P subscale, the clinician-patient interview-based TETRAS ADL subscale, and the QUEST patient-reported quality of life scale. […] TETRAS-P, HADS-D and ECQ-ISE combined to explain approximately 67% of the total variance of TETRAS PRO, with TETRAS-P being the principal driver, followed by HADS-D, and ECQ-ISE. […] TETRAS PRO exhibited very good internal consistency (Cronbach alpha = 0.894 and McDonald omega = 0.903). […] TETRAS PRO had excellent test-retest reliability over 30 days when no treatment change was in effect. The MDC 95%CI (MDC95) was 5.49.0 for a 1-day interval between assessments and 5.28.0 for a 30-day interval.
  • #41 Advances in Treatments of Essential Tremor
    https://www.movementdisorders.org/MDS/Scientific-Issues/posts/Advances-Treatments-Essential-Tremor
    Essential tremor (ET) is one of the most common movement disorders worldwide. ET tends to progress with age and can eventually become functionally disabling for some patients. […] The success of MRgFUS thalamotomy for essential tremor continues to improve with increasing experience in the ultrasound community and with advances in the technology. While the great majority of cases are effective and satisfactory to patients with ET, there remain several key variables which must be considered to ensure success: […] Healthy patients with asymmetrical ET respond the best to focused ultrasound thalamotomy. […] Historically, there has been a fear for bilateral thalamotomies as the rates of dysarthria and dysphasia approached 25%, but these cases were primarily performed in an era prior to MRI. Today, bilateral staged thalamotomy may be safe and feasible for ET using FUS lesioning which is extremely precise, continuously monitored, and image guided with MRI. […] A substantial amount of research is underway to develop new treatments for ET, a common disorder that causes social stigma and functional disability.
  • #42 Advances in Treatments of Essential Tremor
    https://www.movementdisorders.org/MDS/Scientific-Issues/posts/Advances-Treatments-Essential-Tremor
    Essential tremor (ET) is one of the most common movement disorders worldwide. ET tends to progress with age and can eventually become functionally disabling for some patients. […] The success of MRgFUS thalamotomy for essential tremor continues to improve with increasing experience in the ultrasound community and with advances in the technology. While the great majority of cases are effective and satisfactory to patients with ET, there remain several key variables which must be considered to ensure success: […] Healthy patients with asymmetrical ET respond the best to focused ultrasound thalamotomy. […] Historically, there has been a fear for bilateral thalamotomies as the rates of dysarthria and dysphasia approached 25%, but these cases were primarily performed in an era prior to MRI. Today, bilateral staged thalamotomy may be safe and feasible for ET using FUS lesioning which is extremely precise, continuously monitored, and image guided with MRI. […] A substantial amount of research is underway to develop new treatments for ET, a common disorder that causes social stigma and functional disability.
  • #43 Non-invasive suppression of essential tremor via phase-locked disruption of its temporal coherence | Nature Communications
    https://www.nature.com/articles/s41467-020-20581-7
    Aberrant neural oscillations hallmark numerous brain disorders. […] The tremor suppression is sustained shortly after the end of the stimulation and can be phenomenologically predicted. […] The suppression of ET amplitude is attributed to a disruption of the cascade of coherent activities in the olivocerebellar loop. […] The sustained drop in tremor amplitude after the end of the stimulation period may hold potential for a therapeutic effect via neural plasticity. […] The causal relationship between the amplitude of ET and its temporal coherence provides an important insight into the dynamics of the central oscillator underlying the disease. […] Our results may provide the foundation for a new interventional strategy for ET. […] Future studies with larger patient cohorts and longer stimulation periods, are needed to better pinpoint the magnitude and duration of the tremor reduction and to assess the safety profile. […] In the future, neuromodulatory strategies that target the temporal coherence of the pathology may offer new opportunities to treat a wide range of brain disorders underpinned by aberrant synchronous oscillations.
  • #44 Non-invasive suppression of essential tremor via phase-locked disruption of its temporal coherence | Nature Communications
    https://www.nature.com/articles/s41467-020-20581-7
    Aberrant neural oscillations hallmark numerous brain disorders. […] The tremor suppression is sustained shortly after the end of the stimulation and can be phenomenologically predicted. […] The suppression of ET amplitude is attributed to a disruption of the cascade of coherent activities in the olivocerebellar loop. […] The sustained drop in tremor amplitude after the end of the stimulation period may hold potential for a therapeutic effect via neural plasticity. […] The causal relationship between the amplitude of ET and its temporal coherence provides an important insight into the dynamics of the central oscillator underlying the disease. […] Our results may provide the foundation for a new interventional strategy for ET. […] Future studies with larger patient cohorts and longer stimulation periods, are needed to better pinpoint the magnitude and duration of the tremor reduction and to assess the safety profile. […] In the future, neuromodulatory strategies that target the temporal coherence of the pathology may offer new opportunities to treat a wide range of brain disorders underpinned by aberrant synchronous oscillations.
  • #45 Non-invasive suppression of essential tremor via phase-locked disruption of its temporal coherence | Nature Communications
    https://www.nature.com/articles/s41467-020-20581-7
    Aberrant neural oscillations hallmark numerous brain disorders. […] The tremor suppression is sustained shortly after the end of the stimulation and can be phenomenologically predicted. […] The suppression of ET amplitude is attributed to a disruption of the cascade of coherent activities in the olivocerebellar loop. […] The sustained drop in tremor amplitude after the end of the stimulation period may hold potential for a therapeutic effect via neural plasticity. […] The causal relationship between the amplitude of ET and its temporal coherence provides an important insight into the dynamics of the central oscillator underlying the disease. […] Our results may provide the foundation for a new interventional strategy for ET. […] Future studies with larger patient cohorts and longer stimulation periods, are needed to better pinpoint the magnitude and duration of the tremor reduction and to assess the safety profile. […] In the future, neuromodulatory strategies that target the temporal coherence of the pathology may offer new opportunities to treat a wide range of brain disorders underpinned by aberrant synchronous oscillations.
  • #46 What is Essential Tremor? | Brown University Health
    https://www.brownhealth.org/be-well/what-essential-tremor
    Typically, ET worsens over time, but very slowlyusually years and sometimes decades. ET is not life-threatening. However, it can be socially embarrassing and even disabling, affecting ones ability to perform daily activities. […] Any surgical procedures carry risk and should be thoroughly discussed with an experienced specialist prior to surgery.
  • #47 What is Essential Tremor? | Brown University Health
    https://www.brownhealth.org/be-well/what-essential-tremor
    Typically, ET worsens over time, but very slowlyusually years and sometimes decades. ET is not life-threatening. However, it can be socially embarrassing and even disabling, affecting ones ability to perform daily activities. […] Any surgical procedures carry risk and should be thoroughly discussed with an experienced specialist prior to surgery.
  • #48 Essential Tremor: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11886-essential-tremor
    Essential tremor is usually progressive, meaning it gets worse over time. This is usually a slow process. The average rate that arm or hand tremors get worse is between 1.5% and 5% a year. […] Essential tremor starts small and usually only affects your hands at first. Over time, usually many years, the tremors may spread to affect your arm and head. As the condition progresses, you may begin to struggle with certain activities and may need help to do them. […] Essential tremor is a permanent, life-long condition once it starts. Its not curable, and it doesnt go away on its own. […] In years past, the term benign, meaning harmless, was a standard part of its name, as in benign essential tremor. However, experts now recognize that while essential tremor isnt harmful directly, it can cause severe disruptions in your life.
  • #49 Essential tremor: predictors of disease progression in a clinical cohort
    https://pmc.ncbi.nlm.nih.gov/articles/PMC2077383/
    To examine the utility of baseline factors to predict disease progression among a clinical cohort of patients diagnosed with essential tremor. […] On average, the TRS total score increased by 1 point per year before the first visit to the clinic and by about 2 points per year during the observed study period. […] Essential tremor is a slow, progressive disease. The rate of disease progression and the factors associated with disease progression may vary throughout the disease course. […] Predictive factors associated with disease progression during the preclinical (ie, up to the first clinic visit) and clinical phase were different, although duration with disease was common to both. […] The most important factors associated with disease progression during the observed followup period were two variables that capture the degree of asymmetrical disease—that is, both asymmetrical selfreported tremor onset and asymmetrical tremor ratings at the first clinic visit were associated with an increased rate of tremor severity over time.
  • #50
    https://journals.lww.com/cmj/fulltext/2025/01050/essential_tremor_plus_affects_disease_prognosis__a.18.aspx
    ET-plus patients exhibited significantly higher average annual rates of deterioration in NMSS (0.55 [0, 2.40] points/year vs. 0 [0, 0.81] points/year, Z = 3.541, P 0.001), MMSE (0 [0, 0.52] points/year vs. 0 [0, 0.43] points/year, Z = 2.782, P = 0.005), and MoCA (0.52 [0, 0.63] points/year vs. 0 [0, 0.52] points/year, Z = 3.331, P = 0.001) scores compared to pure ET patients. […] A total of 468 patients with ET (including 461 patients followed up face-to-face and 7 deceased patients) were included in the disease outcome investigation. With an average follow-up duration of 22.6 months (1.88 years), 8/468 (1.7%) ET patients progressed to PD, yielding an annual conversion rate of 9.1/1000 person-years. Among 222 patients with pure ET, 2 (0.9%) progressed to PD, yielding an annual conversion rate of 4.6/1000 person-years. Among 246 patients with ET-plus, 6 (2.4%) progressed to PD, with a conversion rate of 13.4/1000 person-years, 2.9-fold higher than that of pure ET.
  • #51 What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6292933/
    Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET. […] In univariate Cox regression models, older age (HR = 1.16, p 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality. […] This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.
  • #52 Non-invasive suppression of essential tremor via phase-locked disruption of its temporal coherence | Nature Communications
    https://www.nature.com/articles/s41467-020-20581-7
    Aberrant neural oscillations hallmark numerous brain disorders. […] The tremor suppression is sustained shortly after the end of the stimulation and can be phenomenologically predicted. […] The suppression of ET amplitude is attributed to a disruption of the cascade of coherent activities in the olivocerebellar loop. […] The sustained drop in tremor amplitude after the end of the stimulation period may hold potential for a therapeutic effect via neural plasticity. […] The causal relationship between the amplitude of ET and its temporal coherence provides an important insight into the dynamics of the central oscillator underlying the disease. […] Our results may provide the foundation for a new interventional strategy for ET. […] Future studies with larger patient cohorts and longer stimulation periods, are needed to better pinpoint the magnitude and duration of the tremor reduction and to assess the safety profile. […] In the future, neuromodulatory strategies that target the temporal coherence of the pathology may offer new opportunities to treat a wide range of brain disorders underpinned by aberrant synchronous oscillations.
  • #53 Advances in Treatments of Essential Tremor
    https://www.movementdisorders.org/MDS/Scientific-Issues/posts/Advances-Treatments-Essential-Tremor
    Essential tremor (ET) is one of the most common movement disorders worldwide. ET tends to progress with age and can eventually become functionally disabling for some patients. […] The success of MRgFUS thalamotomy for essential tremor continues to improve with increasing experience in the ultrasound community and with advances in the technology. While the great majority of cases are effective and satisfactory to patients with ET, there remain several key variables which must be considered to ensure success: […] Healthy patients with asymmetrical ET respond the best to focused ultrasound thalamotomy. […] Historically, there has been a fear for bilateral thalamotomies as the rates of dysarthria and dysphasia approached 25%, but these cases were primarily performed in an era prior to MRI. Today, bilateral staged thalamotomy may be safe and feasible for ET using FUS lesioning which is extremely precise, continuously monitored, and image guided with MRI. […] A substantial amount of research is underway to develop new treatments for ET, a common disorder that causes social stigma and functional disability.

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drżenie esencjalne plus talamotomia drżenie esencjalne chód tandemowy zaburzenie neurologiczne drżenie samoistne MRgFUS drżenie spoczynkowe neuroplastyczność Geriatryczna Skala Depresji zaburzenie zachowania podczas snu REM choroba Parkinsona utrata słuchu dysfunkcja poznawcza drżenie kończyn górnych