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Motor features associated with cognition in non-demented individuals with essential tremor

Journal of the Neurological Sciences, ISSN: 0022-510X, Vol: 439, Page: 120323
2022
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Article Description

Essential tremor (ET) is a clinically heterogeneous disease characterized by motor and non-motor features, including cognitive impairment. In a cross-sectional analysis, we determined whether the presence and severity of motor features of ET are associated with cognitive performance. Participants enrolled in a study that used motor and neuropsychological measures to characterize a cohort of ET subjects. Action tremor severity and additional motor features (rest tremor, intention tremor, cranial tremor, dystonia, tandem gait missteps) were assessed in non-demented participants. Participants completed a cognitive test protocol assessing domains of memory, executive function, attention, visuospatial ability, and language. An average z-score was calculated to represent global cognition. There were 204 ET participants (mean age 78.6, range 55–95). Participants with 10 missteps were more likely to have MCI than those with 0 or 1 misstep ( p  < 0.001). In unadjusted linear regression models, action tremor severity ( p  = 0.010), rest tremor (p < 0.001), and tandem gait missteps (p < 0.001) were negatively associated with global cognition. In adjusted models, only tandem gait missteps were negatively associated with global cognition ( p  < 0.001). Missteps were also negatively associated with memory (p < 0.001), executive function (p < 0.001), attention ( p  = 0.011), and visuospatial function ( p  = 0.043). No other motor features were associated with global cognition in adjusted models ( p  > 0.05). Among non-demented participants with ET, there is an association between cognitive performance and tandem gait missteps, but no other motor features of ET. This is a first step in establishing impaired tandem gait as a possible indicator of cognitive impairment in patients with ET.

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