Drżenie rąk – Epidemiologia

Drżenie rąk
Epidemiologia

Drżenie samoistne (ET) jest najczęstszym zaburzeniem ruchowym, charakteryzującym się mimowolnymi, rytmicznymi drganiami, głównie rąk, ale także innych części ciała. Globalna częstość występowania ET w populacji ogólnej wynosi od 0,32% (95% CI=0,12-0,91) do 1,33%, z około 24,91 milionami chorych na świecie. Występuje bimodalny rozkład wieku zachorowania, z pierwszym szczytem w okresie późnej adolescencji i drugim w późnej dorosłości. Częstość wzrasta znacząco z wiekiem – u osób powyżej 60 lat wynosi około 5%, a u osób powyżej 80 lat 2,87% (95% CI=1,07-7,49), osiągając nawet do 20% u pacjentów powyżej 90 lat. Ryzyko wzrasta o 74% z każdą dekadą życia (p < 0,0001). ET ma silny komponent genetyczny, z autosomalnym dominującym dziedziczeniem w około 50% przypadków, a wiek wystąpienia objawów jest istotnie niższy u osób z rodzinną historią choroby (40 ± 22 lat vs 57 ± 18 lat). Występują także różnice płciowe – globalnie częściej dotyka mężczyzn (0,36% vs 0,28% u kobiet), choć dane są niejednoznaczne.

Epidemiologia drżenia rąk

Rozpowszechnienie drżenia samoistnego
Wpływ wieku na występowanie drżenia
Różnice płciowe w występowaniu drżenia
Czynniki genetyczne i rodzinne
Drżenie w populacji pediatrycznej
Regionalne i etniczne różnice w występowaniu drżenia

Nadzór i monitorowanie drżenia rąk

Nowoczesne metody monitorowania drżenia
Wyzwania w nadzorze epidemiologicznym
Badania kliniczne i inicjatywy badawcze
Implikacje dla zdrowia publicznego
Progresja i rokowanie
Kolejne rozdziały

Epidemiologia drżenia rąk

Drżenie rąk (tremor) jest najczęstszym zaburzeniem ruchowym napotkanym w praktyce klinicznej. Charakteryzuje się ono mimowolnymi, rytmicznymi, oscylacyjnymi ruchami części ciała, najczęściej rąk, ale może również dotyczyć ramion, głowy, nóg, a rzadziej tułowia. ¹²³

Rozpowszechnienie drżenia samoistnego

Drżenie samoistne (ET – Essential Tremor) jest najczęstszym neurologicznym powodem drżenia posturalnego lub kinetycznego oraz jednym z najczęstszych zaburzeń neurologicznych w ogóle. ¹²³ Szacunkowa częstość występowania drżenia samoistnego na świecie waha się znacznie w zależności od badanej populacji i regionu geograficznego. Według kompleksowej metaanalizy, ogólnoświatowa częstość występowania drżenia samoistnego w populacji ogólnej wynosi około 1,33%, z istotną statystycznie heterogenicznością między badaniami (I² = 99,3%, p < 0,0001). ¹

Nowsze badania z 2020 roku wskazują, że globalna częstość występowania drżenia samoistnego wynosi 0,32% (95% przedział ufności [CI]=0,12-0,91), co przekłada się na około 24,91 miliona osób dotkniętych tym schorzeniem na całym świecie. ¹² W Stanach Zjednoczonych szacuje się, że drżenie samoistne dotyka nawet 10 milionów osób. ¹² W Wielkiej Brytanii liczbę osób z drżeniem samoistnym szacuje się na około 1 milion. ¹

Wpływ wieku na występowanie drżenia

Częstość występowania drżenia samoistnego znacznie wzrasta wraz z wiekiem. ¹²³ Dane epidemiologiczne wykazują bimodalny rozkład wieku zachorowania – pierwszy szczyt występuje w okresie późnej adolescencji lub wczesnej dorosłości, a drugi w późniejszej dorosłości. ¹²³

W ogólnej populacji, częstość występowania drżenia samoistnego u osób poniżej 20 roku życia wynosi zaledwie 0,04% (95% CI=0,00-0,29), podczas gdy u osób w wieku 80 lat i starszych wzrasta do 2,87% (95% CI=1,07-7,49). ¹² U osób w wieku powyżej 60 lat częstość występowania wzrasta do około 5%, a w niektórych badaniach u osób w wieku 60-65 lat mediana surowej częstości występowania wynosi 5,9%, a średnia 8,0%. ¹²

Według metaanalizy, częstość występowania drżenia samoistnego zwiększa się o 74% z każdą dekadą życia (p < 0,0001). ¹ Warto zauważyć, że chociaż drżenie samoistne zazwyczaj ujawnia się do 65. roku życia i praktycznie zawsze do 70. roku życia, to w przypadku występowania rodzinnego może pojawić się znacznie wcześniej. ¹²³

Różnice płciowe w występowaniu drżenia

Wyniki badań dotyczących różnic płciowych w występowaniu drżenia samoistnego są niejednoznaczne. Niektóre badania sugerują, że drżenie samoistne występuje z podobną częstością u mężczyzn i kobiet. ¹²³ Inne badania wskazują na niewielką przewagę występowania u mężczyzn. ¹²

Według globalnych danych z 2020 roku, częstość występowania drżenia samoistnego jest wyższa u mężczyzn (0,36%, 95% CI=0,14-1,03) niż u kobiet (0,28%, 95% CI=0,11-0,79). Wśród 24,91 miliona osób dotkniętych drżeniem samoistnym na świecie, 56% stanowią mężczyźni. ¹ Natomiast metaanaliza opublikowana w „Tremor and Other Hyperkinetic Movements” nie wykazała istotnego wpływu płci na częstość występowania drżenia samoistnego (p = 0,90). ¹

Interesujące jest to, że pomimo ogólnych trendów, mogą występować różnice w manifestacji drżenia samoistnego między płciami. Drżenie głowy może być częstsze u kobiet, podczas gdy posturalne drżenie rąk może być bardziej nasilone u mężczyzn. ¹

Czynniki genetyczne i rodzinne

Historia rodzinna odgrywa znaczącą rolę w rozwoju drżenia samoistnego. Około 50% przypadków ma charakter dziedziczny, z autosomalnym dominującym wzorcem dziedziczenia. ¹²³ W niektórych badaniach rodzinna historia drżenia samoistnego była obserwowana w 30-70% przypadków. ¹

U bliźniąt jednojajowych zgodność występowania drżenia samoistnego sięga 90%, co silnie sugeruje istotny komponent genetyczny. ¹² Wiek wystąpienia objawów jest często znacznie młodszy (40 ± 22 lat) u osób z historią rodzinną w porównaniu do osób bez takiej historii (57 ± 18 lat). ¹ Ryzyko względne jest około 5 razy wyższe, jeśli krewny pierwszego stopnia ma drżenie samoistne, i 10 razy wyższe, jeśli krewny pierwszego stopnia ma wczesny początek choroby. ¹

Drżenie w populacji pediatrycznej

Istnieje znacząca luka w danych epidemiologicznych dotyczących drżenia samoistnego u dzieci w Stanach Zjednoczonych i na świecie. Systematyczny przegląd literatury opublikowany w 2009 roku nie zidentyfikował badań epidemiologicznych skupiających się wyłącznie na drżeniu samoistnym u dzieci. ¹

Mimo to, drżenie samoistne może występować w populacji pediatrycznej, szczególnie w przypadkach rodzinnych. ¹² Objawy drżenia u dzieci mogą być łagodne, ale mogą nasilać się z wiekiem i wpływać na codzienne funkcjonowanie, zwłaszcza na precyzyjne czynności ruchowe, takie jak jedzenie, pisanie, mówienie czy utrzymywanie równowagi. ¹

Regionalne i etniczne różnice w występowaniu drżenia

Częstość występowania drżenia samoistnego wykazuje znaczące różnice geograficzne. W Stanach Zjednoczonych zaobserwowano różnice w częstości występowania tego zaburzenia między różnymi regionami (Nowy Jork, Mississippi i Arizona), z szacunkami dla osób w wieku powyżej 60 lat wahającymi się od 1,3% do 20,5%. ¹

W kontekście różnic etnicznych, nie przeprowadzono wielu kompleksowych badań. Jedno z badań oceniające grupę wieloetniczną (biali, Afroamerykanie, Latynosi) wykazało różnice w obecności lub braku drżenia głowy oraz zmiennej ocenie drżenia między podgrupami. ¹

Nadzór i monitorowanie drżenia rąk

Monitorowanie i nadzór nad drżeniem rąk w populacji stanowi istotne wyzwanie dla zdrowia publicznego. W ostatnich latach opracowano innowacyjne metody nadzoru epidemiologicznego, które uzupełniają tradycyjne badania kliniczne.

Nowoczesne metody monitorowania drżenia

Jednym z innowacyjnych podejść do monitorowania drżenia rąk na skalę populacyjną jest wykorzystanie anonimizowanych sygnałów ruchu kursora myszy komputerowej. Dostępność danych o ruchach kursora myszy na dużą skalę i w ujęciu długoterminowym stwarza możliwość badania drżenia rąk w sposób, który był niemożliwy w warunkach laboratoryjnych o ograniczonym czasie trwania lub podczas krótkich ocen przyłóżkowych. ¹

Badania wykazały, że zdarzenia drżenia kursora obserwowano u 73,1% uczestników, którzy zgłosili drżenie rąk, w porównaniu do 3,4% w grupie kontrolnej. Ta zbieżność między zdarzeniami drżenia kursora u osób wyszukujących diagnostyczne zapytania doświadczalne a rozkładami drżenia z badań klinicznych potwierdza skuteczność wykorzystania ruchów kursora myszy do szacowania drżenia. ¹²

Wyzwania w nadzorze epidemiologicznym

Jednym z głównych wyzwań w badaniach epidemiologicznych drżenia samoistnego jest brak uzgodnionych i wspólnych narzędzi oraz definicji. Podkreśla się potrzebę przyjęcia międzynarodowo uznanego podejścia diagnostycznego w przyszłych badaniach epidemiologicznych drżenia samoistnego. ¹

Innym wyzwaniem jest fakt, że drżenie samoistne jest generalnie diagnozą wykluczającą, stawianą na podstawie kryteriów klinicznych. W czasie obserwacji u 30-50% pacjentów z początkowym rozpoznaniem drżenia samoistnego identyfikuje się drugą lub alternatywną diagnozę drżenia. ¹ Dlatego ważne jest stosowanie standardowych kryteriów diagnostycznych i narzędzi oceny w badaniach epidemiologicznych.

Badania kliniczne i inicjatywy badawcze

Obecnie prowadzone są różne badania kliniczne mające na celu lepsze zrozumienie epidemiologii drżenia samoistnego. Na przykład, w Wielkiej Brytanii prowadzone jest badanie mające na celu scharakteryzowanie profili pacjentów z drżeniem samoistnym poprzez opisanie epidemiologii, charakterystyki pacjentów i schematów leczenia, wykorzystania zasobów opieki zdrowotnej i kosztów, oraz specjalności lekarzy diagnozujących/leczących. ¹

Ośrodki medyczne, takie jak UT Southwestern Medical Center, prowadzą badania nad epidemiologią środowiskową drżenia samoistnego, co może przyczynić się do lepszego zrozumienia czynników ryzyka i przyczyn tego schorzenia. ¹

Implikacje dla zdrowia publicznego

Drżenie samoistne u osób w wieku powyżej 65 lat występuje z częstością podobną do choroby Alzheimera u osób starszych, co sugeruje, że drżenie samoistne może być najczęstszą chorobą neurodegeneracyjną. ¹ Ta wysoka częstość występowania, wraz z potencjalnym wpływem na jakość życia i funkcjonowanie, czyni drżenie samoistne istotnym problemem zdrowia publicznego.

Do 25% pacjentów zmienia zawód lub przechodzi na wcześniejszą emeryturę z powodu drżenia samoistnego, co wskazuje na znaczący wpływ ekonomiczny i społeczny tego schorzenia. ¹ Ponadto, niektóre badania sugerują, że osoby z drżeniem samoistnym mają wyższe niż przeciętne ryzyko rozwoju chorób neurologicznych, w tym choroby Parkinsona lub problemów sensorycznych, takich jak utrata słuchu, szczególnie u osób, u których drżenie pojawia się po 65. roku życia. ¹

Progresja i rokowanie

Drżenie samoistne jest generalnie uważane za chorobę neurodegeneracyjną. Czynniki przewidujące prawdopodobną progresję obejmują asymetryczne drżenie, jednostronne wystąpienie początkowego drżenia i wiek wystąpienia. ¹

Średni roczny wzrost nasilenia drżenia od wartości wyjściowej oszacowano na poziomie między 3,1% a 5,3%. ¹ Wraz z upływem czasu amplituda drżenia powoli się zwiększa, ale częstotliwość drżenia zmniejsza się wraz z wiekiem. ¹ Należy jednak zauważyć, że nie ma lekarstwa na drżenie samoistne, nic dostępnego nie spowalnia jego progresji, korzyść objawowa leku zmniejsza się z czasem, ale oczekiwana długość życia w drżeniu samoistnym jest normalna. ¹

Grupa wiekowa	Częstość występowania drżenia samoistnego	Uwagi
Poniżej 20 lat	0,04% (95% CI=0,00-0,29)	Najniższa częstość występowania, często związana z czynnikami genetycznymi
40 lat i starsi	~4%	Wzrost częstości występowania z wiekiem
60 lat i starsi	~5%	Znaczący wzrost częstości występowania
60-65 lat	5,9% (mediana), 8,0% (średnia)	Dane z badań opisowych
80 lat i starsi	2,87% (95% CI=1,07-7,49)	Wysoka częstość występowania w zaawansowanym wieku
90 lat i starsi	Do 20%	Najwyższa częstość występowania
Populacja ogólna (wszystkie grupy wiekowe)	0,32% – 1,33%	Znaczna zmienność między badaniami

¹²³

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Materiały źródłowe

#1 Differentiation and Diagnosis of Tremor | AAFP
https://www.aafp.org/pubs/afp/issues/2011/0315/p697.html
Tremor, an involuntary, rhythmic, oscillatory movement of a body part, is the most common movement disorder encountered in clinical practice. […] The most common pathologic tremor is essential tremor. In one-half of cases, it is transmitted in an autosomal dominant fashion, and it affects 0.4 to 6 percent of the population. […] More than 70 percent of patients with Parkinson disease have tremor as the presenting feature. […] The diagnosis of tremor is based on clinical information obtained from a thorough history and physical examination. […] A rest tremor is usually caused by parkinsonism. […] Tremor in children is potentially serious; patients should be promptly referred to a neurologist. […] The classic parkinsonian tremor begins as a low-frequency, pill-rolling motion of the fingers, progressing to forearm pronation/supination and elbow flexion/extension.
#1 Essential Tremor – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499986/
Tremors are the most common movement disorder, and essential tremor is the most common neurologic cause of postural or action tremor. […] Essential tremor is the most common neurologic disorder that affects postural or action tremors. The worldwide estimated prevalence is up to 5% of the population. Family history can be found in near 50% of cases and in 90% concordance in monozygotic twins. The incidence of essential tremor increases with age, although it often affects young individuals, especially when it is familial.
#1 How Common is Essential Tremor? Update on the Worldwide Prevalence of Essential Tremor | Tremor and Other Hyperkinetic Movements
https://tremorjournal.org/articles/10.5334/tohm.632
Essential tremor (ET) is among the most prevalent movement disorders. […] Comprehensive reviews of disease prevalence were published in 1998 and 2010 but not since then. […] We reviewed the prevalence of ET in population-based epidemiological studies, derived a precise summary estimate of prevalence from these studies, and examined differences in prevalence across studies. […] There were 42 population-based prevalence studies (23 countries and 6 continents). […] In a meta-analysis, pooled prevalence (all ages) = 1.33%, with statistically significant heterogeneity across studies (I2 = 99.3%, p 0.0001). […] Prevalence increased markedly with age, and especially with advanced age. […] In the meta-analysis, prevalence (age 65 years) = 5.79%, and in descriptive analyses, median crude prevalence (age 60-65) = 5.9% and mean = 8.0%.
#1 The global prevalence of essential tremor, with emphasis on age and sex: A meta-analysis
https://pmc.ncbi.nlm.nih.gov/articles/PMC8035980/
Essential tremor (ET) is one of the most common neurological disorders that impairs quality of life and leads to disability and social handicap. It was estimated that approximate 0.9% of people worldwide were affected by ET. […] The prevalence of ET increased dramatically with advancing age, where the prevalence estimate in people aged under 20 years was 0.04% (95% confidence interval [CI]=0.00-0.29) and that in elderly aged 80 years and above was 2.87% (95% CI=1.07-7.49). ET was consistently more common in males than in females. […] In 2020, the overall prevalence of ET in the general population was 0.32% (95% CI=0.12-0.91), and the prevalence was higher in males (0.36%, 95% CI=0.14-1.03) than in females (0.28%, 95% CI=0.11-0.79). […] In 2020, the number of people affected by ET was 24.91 million (95% CI=9.51-70.92), among whom 56% were males.
#1 Essential tremor: MedlinePlus GeneticsLock
https://medlineplus.gov/genetics/condition/essential-tremor/
Essential tremor is a movement disorder that causes involuntary, rhythmic shaking (tremor), especially in the hands. […] Essential tremor is a common disorder, affecting up to 10 million people in the United States. […] Some studies have suggested that people with essential tremor have a higher than average risk of developing neurological conditions including Parkinson’s disease or sensory problems such as hearing loss, especially in individuals whose tremor appears after age 65. […] The causes of essential tremor are unknown. […] Essential tremor can be passed through generations in families, but the inheritance pattern varies.
#1 Epidemiology, treatment patterns, and healthcare resource utilization of patients with Essential Tremor: A retrospective cohort analysis in the United Kingdom | CPRD
https://www.cprd.com/approved-studies/epidemiology-treatment-patterns-and-healthcare-resource-utilization-patients
Essential tremor is a common nervous system disorder affecting movement and the usual function of parts of the body, as well as the awareness and thinking capabilities. It is estimated that around 1,000,000 people in the UK have it. […] There is an increasing need for a comprehensive understanding of the effect and management of essential tremor (ET) in the real-world. This study aims to characterise ET patient profiles by describing i) epidemiology, ii) patient characteristics and treatment patterns iii) healthcare resource utilization (HCRU) and costs, and iv) specialties of diagnosing/treating physicians. […] Yearly ET epidemiology (point prevalence [2010 to 2021] and cumulative incidence [2011 to 2021]) will be determined and estimates standardized by age/sex will be extrapolated to the overall UK population. […] Completion of the proposed study will result in various public health benefits, including an up-to-date real-world epidemiologic profile and characterisation of patients with ET in the UK, describing the burden of disease and elucidating unmet needs.
#1 Essential Tremor: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/1150290-overview
Essential tremor affects both sexes with equal frequency. However, head tremor may be more frequent in women, and postural hand tremor may be more severe in men. […] The prevalence of essential tremor increases with age. Data has suggested bimodal peaks in age of onsetâone in late adolescence to early adulthood and a second in older adulthood. The mean age at presentation is 35-45 years. […] Essential tremor usually manifests by age 65 years and virtually always by age 70 years. Tremor amplitude slowly increases over time, but tremor frequency decreases with increasing age.
#1 How Common is Essential Tremor? Update on the Worldwide Prevalence of Essential Tremor | Tremor and Other Hyperkinetic Movements
https://tremorjournal.org/articles/10.5334/tohm.632
The prevalence increased by 74% for every decade increase in age (p 0.0001). […] Gender did not impact the prevalence of ET (p = 0.90). […] The prevalence of ET among those age 65 is similar to that reported for Alzheimer’s disease in elders, suggesting that ET may be the most common neurodegenerative disease.
#1 Essential tremor: Clinical features and diagnosis – UpToDate
https://www.uptodate.com/contents/essential-tremor-clinical-features-and-diagnosis/print
Essential tremor (ET) is the most common cause of action tremor in adults. […] ET is the most common cause of action tremor, with an estimated prevalence worldwide of 1 percent overall and approximately 5 percent in adults over the age of 60 years. […] The incidence of ET increases with age, although childhood and early adulthood presentations do occur, especially when ET is familial. […] The prevalence of ET is similar in males and females, although some studies report a slight male predominance.
#1 Pulsenotes | Essential tremor
https://app.pulsenotes.com/medicine/neurology/notes/essential-tremor
Essential tremor is associated with family history and often shows an autosomal dominant pattern of inheritance. […] The estimated prevalence of essential tremor is 1% worldwide. Development of this type of action tremor increases with age and there is often a family history. The inheritance is suspected to be autosomal dominant. There is thought to be a slight male predominance. […] A family history of essential tremor may be observed in 30-70% of cases.
#1 Tremor – almostadoctor
https://almostadoctor.co.uk/encyclopedia/tremor
Essential tremor is the common cause of tremor and one of the most common neurological disorders. […] Affects 50 per 1000 people over 60. […] Incidence increases with age. […] Associated with family history: 50% of cases have a family history. […] Can be inherited in an autosomal dominant pattern. […] Age of onset is often much younger (40 22 yrs) in those with family history compared to those without (57 18 yrs). […] Relative risk is approx 5x higher if first degree relative and 10x higher if first degree relative has early onset.
#1 Epidemiology of pediatric essential tremor in the United States: a systematic literature review from 2010 to 2020 | Tremor and Other Hyperkinetic Movements
https://tremorjournal.org/articles/10.5334/tohm.681
No studies reported information on pediatric prevalence or incidence of ET, or age of diagnosis of ET. […] There is a notable lack of recent data describing the incidence and prevalence of pediatric ET in the United States. […] A literature review published in 2009 was unable to identify published epidemiological survey data from any country that focused on ET exclusively in children, and found only 5 studies that reported prevalence data in age-based subgroups that included children. […] Overall, this systematic review revealed a considerable data gap for US-based pediatric ET epidemiology in the literature.
#1 Essential Tremor – Child Neurology Foundation
https://www.childneurologyfoundation.org/disorder/essential-tremor/
Essential tremor is a neurological condition that causes hands to shake rhythmically. […] The tremors tend to be worse during movement and better at rest. They can be disabling and slowly worsen over time. […] ET is the most common movement disorder. It affects up to 10 million people in the U.S. […] In many children, the symptoms of ET are mild. Treatments may be worse than the symptoms. However, tremors can worsen with age. […] Tremors can affect daily life by affecting fine motor activities. They can cause problems with: Eating, Writing, Speaking, Balance. […] ET can be confused with: Parkinsons disease, Cerebellar tremor, Metabolic disorders, Drug-induced tremors.
#1 Essential Tremor: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/1150290-overview
Epidemiology has shown that the prevalence of essential tremor has been reported to differ considerably in individuals living in various regions of the United States (New York, Mississippi, and Arizona), with estimates for ages 60 years ranging widely, from 1.3% to 20.5%. […] In 2020, the global prevalence of essential tremor in the general population was estimated to be 0.32%, ranging from 0.04% in people younger than 20 years to 2.87% in those aged 80 years and older. The total number of people suffering from essential tremor worldwide was 24.91 million in 2020. […] Race has not been extensively studied in essential tremor. One evaluation of a multiethnic group (White, African American, Hispanic) found differences in the presence or absence of head tremor and a variable tremor score among the subgroups.
#1 Population-scale hand tremor analysis via anonymized mouse cursor signals | npj Digital Medicine
https://www.nature.com/articles/s41746-019-0171-4
Tremors are a common movement disorder with a spectrum of benign and pathological causes, including neurodegenerative disease, alcohol withdrawal, and physical overexertion. […] Overall, the study finds evidence for the validity of harnessing anonymized mouse cursor motion as a population-scale tremor sensor for epidemiologic studies. […] The availability of large-scale, longitudinal computer mouse cursor movement data presents an opportunity to study hand tremors in ways that are infeasible in limited-duration laboratory settings or brief bedside evaluations. […] The findings of this feasibility study demonstrate alignment between cursor tremor events and both self-reported interest in tremors and findings of clinical studies, providing evidence in support of using cursor movements as a population-scale sensor of cursor tremor events.
#1 Population-scale hand tremor analysis via anonymized mouse cursor signals | npj Digital Medicine
https://www.nature.com/articles/s41746-019-0171-4
The alignment between cursor tremor distributions from searchers issuing experiential diagnostic queries and tremor distributions from clinical studies further supports the use of mouse cursor motion for tremor estimation. […] Future work includes exploring the application of these methods to additional tremor types and other conditions with motor symptoms, as well as studying environmental sources of vibration. […] Cursor tremor events were observed for 73.1% of participants who self-reported hand tremors versus 3.4% of controls.
#1 The global prevalence of essential tremor, with emphasis on age and sex: A meta-analysis
https://pmc.ncbi.nlm.nih.gov/articles/PMC8035980/
This study provides an up-to-date estimation of ET prevalence in the general population throughout the whole life span, with emphasis on age and sex. […] The findings in our study have both clinical and public health implications. The lack of agreed and shared tools and definitions in studies on ET has been highlighted, emphasising the need for adopting an internationally acknowledged diagnostic approach in future epidemiological investigations in ET.
#1 Essential Tremor
https://mobile.fpnotebook.com/Neuro/Tremor/EsntlTrmr.htm
Prevalence: 0.4 to 6% […] Most common pathologic Tremor cause in world […] Age of onset 20-60 years (bimodal distribution) […] Likely has onset for most patients in ages 20-30 years but is mild initially […] Later presentation at age 60-70 years coincides with the natural progression in severity […] Essential Tremor is a diagnosis of exclusion made on clinical grounds […] Second or alternative Tremor diagnosis is identified in up to 30-50% of patients over time […] Tremor with other neurologic changes suggests alternative diagnosis […] Effective in only 30-50% of Essential Tremor cases […] Medications typically fail for control […] Up to 25% of patients change career or retire early due to Essential Tremor.
#1 Essential Tremor | Peter O’Donnell Jr. Brain Institute | Condition | UT Southwestern Medical Center
https://utswmed.org/conditions-treatments/essential-tremor/
UT Southwestern Medical Centers movement disorders specialists have expertise in diagnosing and treating essential tremor, the most common movement disorder. […] Our Movement Disorders Program is a major regional referral center for disorders such as essential tremor. […] UT Southwestern offers patients access to innovations in essential tremor care through clinical trials. […] Current clinical trials include: Environmental Epidemiology of Essential Tremor.
#1 Tremor (Essential Tremor, Physiological Tremor, and Intention Tremor)
https://patient.info/doctor/tremor-pro
Essential tremor is one of the most common neurological disorders. […] Essential tremor is thought to affect 0.4-6% of the population. […] Men and women are equally affected. […] Approximately 50% of ET cases are familial with autosomal dominant inheritance. […] The onset of familial ET is usually during childhood, whereas sporadic ET usually occurs in those over 40 years of age. […] Essential tremor is generally considered to be a neurodegenerative disease. […] Factors predicting likely progression include asymmetric tremor, unilateral onset of the initial tremor and age of onset. […] The average annual increase in tremor severity from baseline has been estimated to be between 3.1% and 5.3%. […] However, there is no cure for essential tremor, nothing available slows its progression, the symptomatic drug benefit declines with time and the life expectancy in ET is normal.
#2 Tremor – Knowledge @ AMBOSS
https://www.amboss.com/us/knowledge/tremor/
Tremor is an involuntary, rhythmic, oscillatory movement of one or more body parts. […] It is the most common movement disorder and is classified into resting tremor and action tremor (e.g., postural tremor, intention tremor). […] Resting tremor is typical in Parkinson disease and manifests as an asymmetrical tremor that occurs at rest. […] Diagnosis is typically clinical, but laboratory tests and imaging may be required to determine the underlying cause. […] Treatment is based on the type of tremor and the underlying condition. […] Epidemiology: Onset typically 60 years. […] Most common cause of resting tremor. […] The most common cause of resting tremor is Parkinson disease. […] Tremor that is apparent at rest but does not decrease with target-directed movement is unlikely to be due to parkinsonism.
#2 Essential tremor: Clinical features and diagnosis – UpToDate
https://www.uptodate.com/contents/essential-tremor-clinical-features-and-diagnosis/print
Essential tremor (ET) is the most common cause of action tremor in adults. […] ET is the most common cause of action tremor, with an estimated prevalence worldwide of 1 percent overall and approximately 5 percent in adults over the age of 60 years. […] The incidence of ET increases with age, although childhood and early adulthood presentations do occur, especially when ET is familial. […] The prevalence of ET is similar in males and females, although some studies report a slight male predominance.
#2 Essential Tremor: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/1150290-overview
Epidemiology has shown that the prevalence of essential tremor has been reported to differ considerably in individuals living in various regions of the United States (New York, Mississippi, and Arizona), with estimates for ages 60 years ranging widely, from 1.3% to 20.5%. […] In 2020, the global prevalence of essential tremor in the general population was estimated to be 0.32%, ranging from 0.04% in people younger than 20 years to 2.87% in those aged 80 years and older. The total number of people suffering from essential tremor worldwide was 24.91 million in 2020. […] Race has not been extensively studied in essential tremor. One evaluation of a multiethnic group (White, African American, Hispanic) found differences in the presence or absence of head tremor and a variable tremor score among the subgroups.
#2 2016 Archive – New Study Shows Breakthrough Treatment for Essential Tremor Using Focused Ultrasound | University of Maryland School of Medicine
https://www.medschool.umaryland.edu/news/2016/New-Study-Shows-Breakthrough-Treatment-for-Essential-Tremor-Using-Focused-Ultrasound.html
University of Maryland School of Medicine (UM SOM) researchers, along with an international group of investigators, have discovered for the first time that treatment with MRI-guided focused ultrasound can effectively treat patients with essential tremor (ET), a neurological movement disorder that affects an estimated 10 million people in the U.S. […] Currently, ET affects an estimated 3 percent of Americans, and up to the present, has been treated by medication, surgical procedures or deep brain stimulation (DBS). […] This groundbreaking study clearly demonstrates that focused ultrasound can be transmitted with precision through the human skull to target areas deep with the brain and improve the quality of life of patients with essential tremor who have difficulty performing tasks that most of us take for granted.
#2 Tremor – Knowledge @ AMBOSS
https://www.amboss.com/us/knowledge/tremor/
Epidemiology: Most common pathologic form of tremor. […] Bimodal distribution: adolescence or early adulthood and adults aged 60 years (most common in older adults). […] Enhanced physiologic tremor occurs when reversible conditions (e.g., stress, fatigue) magnify physiologic tremor. […] Epidemiology: may occur at any age. […] Orthostatic tremor: Rare. […] Onset 60 years.
#2 Essential Tremor: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/1150290-overview
Essential tremor affects both sexes with equal frequency. However, head tremor may be more frequent in women, and postural hand tremor may be more severe in men. […] The prevalence of essential tremor increases with age. Data has suggested bimodal peaks in age of onsetâone in late adolescence to early adulthood and a second in older adulthood. The mean age at presentation is 35-45 years. […] Essential tremor usually manifests by age 65 years and virtually always by age 70 years. Tremor amplitude slowly increases over time, but tremor frequency decreases with increasing age.
#2 Tremor (Essential Tremor, Physiological Tremor, and Intention Tremor)
https://patient.info/doctor/tremor-pro
Essential tremor is one of the most common neurological disorders. […] Essential tremor is thought to affect 0.4-6% of the population. […] Men and women are equally affected. […] Approximately 50% of ET cases are familial with autosomal dominant inheritance. […] The onset of familial ET is usually during childhood, whereas sporadic ET usually occurs in those over 40 years of age. […] Essential tremor is generally considered to be a neurodegenerative disease. […] Factors predicting likely progression include asymmetric tremor, unilateral onset of the initial tremor and age of onset. […] The average annual increase in tremor severity from baseline has been estimated to be between 3.1% and 5.3%. […] However, there is no cure for essential tremor, nothing available slows its progression, the symptomatic drug benefit declines with time and the life expectancy in ET is normal.
#2 Essential tremor | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/essential-tremor?lang=us
Essential tremor is one of the most common movement disorders. Its prevalence increases with age, and is estimated to affect up to 5% of the population over the age of 65 years. However, the condition can also be seen in younger patients, including in the pediatric demographic, albeit rarely. There is thought to be either no gender predilection or a slight male predominance. […] Essential tremor describes a chronic, progressive, predominantly bilateral upper limb, action tremor syndrome, present without parkinsonism, dystonia and ataxia. Essential tremor associated with other 'soft’ neurological signs is known as essential tremor plus.
#2 Essential tremor – Wikipedia
https://en.wikipedia.org/wiki/Essential_tremor
Essential tremor (ET) is a common neurological disorder, affecting up to 5% of the global population, with approximately 24.91 million people affected worldwide in 2020. The prevalence of ET increases significantly with age, particularly in individuals aged 60 and above. […] It affects around 4% of people aged 40 and older, and the prevalence rises to 2.87% in those over 80, reaching up to 20% in individuals in their 90s and beyond. […] ET is more common in males than females across all age groups. […] Family history plays a significant role in the development of ET, with around 50% of cases being hereditary and a 90% concordance rate in identical twins. […] While the likelihood of developing ET increases with age, it can also occur in younger individuals, especially if there is a family history of the disorder. […] ET is one of the most common types of tremor, aside from enhanced physiological tremor, and is among the most frequently observed movement disorders.
#2 Population-scale hand tremor analysis via anonymized mouse cursor signals | npj Digital Medicine
https://www.nature.com/articles/s41746-019-0171-4
Tremors are a common movement disorder with a spectrum of benign and pathological causes, including neurodegenerative disease, alcohol withdrawal, and physical overexertion. […] Overall, the study finds evidence for the validity of harnessing anonymized mouse cursor motion as a population-scale tremor sensor for epidemiologic studies. […] The availability of large-scale, longitudinal computer mouse cursor movement data presents an opportunity to study hand tremors in ways that are infeasible in limited-duration laboratory settings or brief bedside evaluations. […] The findings of this feasibility study demonstrate alignment between cursor tremor events and both self-reported interest in tremors and findings of clinical studies, providing evidence in support of using cursor movements as a population-scale sensor of cursor tremor events.
#2 How Common is Essential Tremor? Update on the Worldwide Prevalence of Essential Tremor | Tremor and Other Hyperkinetic Movements
https://tremorjournal.org/articles/10.5334/tohm.632
Essential tremor (ET) is among the most prevalent movement disorders. […] Comprehensive reviews of disease prevalence were published in 1998 and 2010 but not since then. […] We reviewed the prevalence of ET in population-based epidemiological studies, derived a precise summary estimate of prevalence from these studies, and examined differences in prevalence across studies. […] There were 42 population-based prevalence studies (23 countries and 6 continents). […] In a meta-analysis, pooled prevalence (all ages) = 1.33%, with statistically significant heterogeneity across studies (I2 = 99.3%, p 0.0001). […] Prevalence increased markedly with age, and especially with advanced age. […] In the meta-analysis, prevalence (age 65 years) = 5.79%, and in descriptive analyses, median crude prevalence (age 60-65) = 5.9% and mean = 8.0%.
#3 Tremor | The BMJ
https://www.bmj.com/content/347/bmj.f7200
A middle aged man presents complaining of excessive shaking of his hand. Physical examination reveals bilateral hand tremor, right more so than the left, and worse when holding his arms outstretched. The remainder of the physical and neurological examinations are normal. […] Tremor is the most common involuntary movement encountered in clinical practice. It is an unintentional, rhythmic muscle movement that usually affects the hands but can also affect the arms, head, legs, and rarely the trunk. Essential tremor is the commonest form, but tremor may sometimes be a symptom of an underlying neurological disorder or a manifestation of systemic disease, and patients are often worried about a diagnosis of Parkinsons disease. […] A tremor that appears first in one hand and subsequently the other, perhaps spreading to one or both legs, is suggestive of Parkinsons disease. […] A tremor that appears in both hands symmetrically, perhaps also involving a head tremor or a tremulous voice, is suggestive of essential tremor.
#3 What Causes Shaky Hands and How Is It Treated?
https://www.webmd.com/brain/shaky-hands
Tremor is the name experts give to those shaky hands (and sometimes voice, head, mouth, and feet). […] Essential Tremor is the most common tremor disorder. […] ET is different because it affects your hands when theyre already moving. […] Age is another risk factor. Although Essential Tremor can happen at any age, its more likely in people over 40. […] Tremor is an early sign of Parkinsons disease, which affects 10 million people worldwide, 60,000 of them in the U.S.. […] Most of the time, the tremor affects only one side of your body. […] This disease, which targets your immune system, brain, nerves, and spinal cord, can also make your hands shake. […] Tremor is one of the first signs [of Alcohol Withdrawal]. […] Shaky hands dont always mean youre ill. […] Because the causes and treatments vary widely for different types of tremors, its important to talk with your doctor about your history and symptoms.
#3 Essential Tremor: Practice Essentials, Background, Etiology
https://emedicine.medscape.com/article/1150290-overview
Essential tremor affects both sexes with equal frequency. However, head tremor may be more frequent in women, and postural hand tremor may be more severe in men. […] The prevalence of essential tremor increases with age. Data has suggested bimodal peaks in age of onsetâone in late adolescence to early adulthood and a second in older adulthood. The mean age at presentation is 35-45 years. […] Essential tremor usually manifests by age 65 years and virtually always by age 70 years. Tremor amplitude slowly increases over time, but tremor frequency decreases with increasing age.
#3 Essential Tremor
https://mobile.fpnotebook.com/Neuro/Tremor/EsntlTrmr.htm
Prevalence: 0.4 to 6% […] Most common pathologic Tremor cause in world […] Age of onset 20-60 years (bimodal distribution) […] Likely has onset for most patients in ages 20-30 years but is mild initially […] Later presentation at age 60-70 years coincides with the natural progression in severity […] Essential Tremor is a diagnosis of exclusion made on clinical grounds […] Second or alternative Tremor diagnosis is identified in up to 30-50% of patients over time […] Tremor with other neurologic changes suggests alternative diagnosis […] Effective in only 30-50% of Essential Tremor cases […] Medications typically fail for control […] Up to 25% of patients change career or retire early due to Essential Tremor.
#3 Tremor (Essential Tremor, Physiological Tremor, and Intention Tremor)
https://patient.info/doctor/tremor-pro
Essential tremor is one of the most common neurological disorders. […] Essential tremor is thought to affect 0.4-6% of the population. […] Men and women are equally affected. […] Approximately 50% of ET cases are familial with autosomal dominant inheritance. […] The onset of familial ET is usually during childhood, whereas sporadic ET usually occurs in those over 40 years of age. […] Essential tremor is generally considered to be a neurodegenerative disease. […] Factors predicting likely progression include asymmetric tremor, unilateral onset of the initial tremor and age of onset. […] The average annual increase in tremor severity from baseline has been estimated to be between 3.1% and 5.3%. […] However, there is no cure for essential tremor, nothing available slows its progression, the symptomatic drug benefit declines with time and the life expectancy in ET is normal.
#3 Advice for Patients With Tremor
https://www.uspharmacist.com/article/advice-for-patients-with-tremor
Tremor can affect any age group, but the primary sufferers are those who are middle-aged or older. There is no gender difference, although some types of tremor appear to be genetically inherited. […] Most tremors have no cure (e.g., cerebellar tremor). However, the potential for ameliorating the condition depends on the cause of the tremor. Therefore, the obvious first step for patients asking about tremor is referral to a physician. […] In order to rule out serious underlying causes of tremor, it is advisable to seek a physician for a diagnosis. Your doctor can also help you locate sources that can assist in coping with daily activities if tremor is disabling.
#3 Pulsenotes | Essential tremor
https://app.pulsenotes.com/medicine/neurology/notes/essential-tremor
Essential tremor is associated with family history and often shows an autosomal dominant pattern of inheritance. […] The estimated prevalence of essential tremor is 1% worldwide. Development of this type of action tremor increases with age and there is often a family history. The inheritance is suspected to be autosomal dominant. There is thought to be a slight male predominance. […] A family history of essential tremor may be observed in 30-70% of cases.
#3 Essential tremor – Wikipedia
https://en.wikipedia.org/wiki/Essential_tremor
Essential tremor (ET) is a common neurological disorder, affecting up to 5% of the global population, with approximately 24.91 million people affected worldwide in 2020. The prevalence of ET increases significantly with age, particularly in individuals aged 60 and above. […] It affects around 4% of people aged 40 and older, and the prevalence rises to 2.87% in those over 80, reaching up to 20% in individuals in their 90s and beyond. […] ET is more common in males than females across all age groups. […] Family history plays a significant role in the development of ET, with around 50% of cases being hereditary and a 90% concordance rate in identical twins. […] While the likelihood of developing ET increases with age, it can also occur in younger individuals, especially if there is a family history of the disorder. […] ET is one of the most common types of tremor, aside from enhanced physiological tremor, and is among the most frequently observed movement disorders.