title: Does rate of progression run in essential tremor families? Slower vs. faster progressors.
abstract: BACKGROUND
  Essential tremor (ET) is a progressive disorder, worsening gradually with time in most patients. Yet there are few data on the factors that influence rate of progression. ET is a highly familial disorder, and physicians often care for patients who have other affected family members. Do ET families differ from one another with respect to rate of progression? Are some families slower progressors and other families faster progressors? We are unaware of published data.
  
  
  METHODS
  ET probands and relatives were enrolled in a cross-sectional genetic study at Columbia University. Rate of progression was calculated as total tremor score ÷ log disease duration.
  
  
  RESULTS
  There were 100 enrollees (28 probands, 72 relatives). Data from 78 enrollees (23 probands, 55 relatives) were selected for final analysis. The mean familial rate of progression ranged from as little as 8.4 to as much as 34.3, a > 4-fold difference. In an analysis of variance, we found significant evidence of heterogeneity in the log rate of progression across families (p < 0.001), with more than one-half (i.e., 55.4%) of the total variance in the log rate of progression explained by the family grouping.
  
  
  CONCLUSIONS
  Familial factors seem to affect rate of tremor progression in ET. There was a 4-fold difference across families in observed mean rate of progression; thus, some families seemed to be more rapid progressors than others. We hope these data may be used by clinicians to provide basic prognostic and family guidance information to their patients and families with ET.
authors.affiliation: GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA. EDL2@columbia.edu
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
authors.forename: Nora
authors.initials: N
authors.lastname: Hernandez
authors.forename: Iuliana
authors.initials: I
authors.lastname: Ionita-Laza
authors.forename: Ruth
authors.initials: R
authors.lastname: Ottman
authors.forename: Lorraine N
authors.initials: LN
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D018450:Disease Progression; D020329:Essential Tremor / Q000235:genetics; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult