Cohort study of prevalence and phenomenology of tremor in dementia with Lewy bodies

Marco Onofrj, Sara Varanese, Laura Bonanni, John Paul Taylor, Angelo Antonini, Enza Maria Valente, Simona Petrucci, Fabrizio Stocchi, Astrid Thomas, Bernardo Perfetti

Research output: Contribution to journalArticlepeer-review

Abstract

To study prevalence, specific patterns and response to treatment of tremor in dementia with Lewy bodies (DLB), in comparison with other tremulous disorders prevalence, qualitative and quantitative features of tremor were studied in an incident cohort of 67 dopaminergic treatment naive DLB, 111 Parkinson's Disease (PD) and 34 Essential Tremor (ET) patients. Tremulous DLB patients (tDLB) were compared with tremulous PD (tPD) and ET patients and followed for 2 years. Double blind placebo-controlled acute drug challenge with l-Dopa and alcohol was performed in all ET, 24 tDLB and 27 tPD. Effects of dopaminergic chronic treatment in all tDLB and tPD patients and primidone in 8 tDLB were also assessed. Tremor occurred in 44.76 % of DLB patients. The tDLB patients presented a complex pattern of mixed tremors, characterized by rest and postural/action tremor, including walking tremor and standing overflow in 50 % tDLB. Standing tremor with overflow was characteristic of tDLB (p <0.001). Head tremor was more frequent in tDLB than tPD and ET (p = 0.001). The tDLB tremors were reduced by acute and chronic dopaminergic treatments (p <0.01) but not by alcohol or primidone. Tremor occurs commonly in DLB patients with a complex mixed tremor pattern which shows a significant response to acute and chronic dopaminergic treatments. Recognizing that there is a clinical category of tremulous DLB may help the differential diagnosis of tremors.

Original languageEnglish
Pages (from-to)1731-1742
Number of pages12
JournalJournal of Neurology
Volume260
Issue number7
DOIs
Publication statusPublished - Jul 2013

Keywords

  • Dementia with Lewy bodies
  • EMG
  • Parkinson's disease
  • Tremor

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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