Executive dysfunction and neuropsychiatric symptoms predict lower health status in essential tremor.
OBJECTIVE
To evaluate the hypothesis that increased neuropsychiatric distress and cognitive impairment are associated with lower perceived health status in essential tremor (ET).


BACKGROUND
Many patients with ET experience nonmotor complications, including lower perceived health status and poor health-related quality of life, which are associated with tremor severity, age, and personality factors. No studies, however, have examined the potential contribution of neuropsychiatric symptoms and cognitive deficits to health status in ET.


METHODS
Forty-five patients with ET underwent comprehensive neurologic and neuropsychologic evaluations, including self-report measures of physical and psychosocial health status (ie, the Sickness Impact Profile) and neuropsychiatric distress (ie, the Profile of Mood States).


RESULTS
A series of hierarchical multiple regressions showed that after considering the effects of ET disease severity, lower vigor, and deficits in executive functions were independently predictive of poorer physical health status, whereas increased symptoms of depression were uniquely associated with lower psychosocial health status.


CONCLUSIONS
Findings indicate that reduced vigor (ie, apathy), executive deficits, and depression are important predictors of poorer perceived health status in ET. Given the prevalence of such nonmotor symptoms, these data highlight the potential value of considering neuropsychiatric and neurocognitive assessments in the management of patients with ET.
Woods
Steven Paul
SP
Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA 92103, USA. spwoods@ucsd.edu
Scott
J Cobb
JC
Fields
Julie A
JA
Poquette
Amelia
A
Tröster
Alexander I
AI
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D046690:Deep Brain Stimulation; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D020329:Essential Tremor / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005221:Fatigue / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology; D018434:Sickness Impact Profile