title: Cohort study of prevalence and phenomenology of tremor in dementia with Lewy bodies.
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.
authors: Department of Neuroscience and Imaging, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini, 66100 Chieti, Italy. onofrj@unich.it
authors: Marco
authors: M
authors: Onofrj
authors: Sara
authors: S
authors: Varanese
authors: Laura
authors: L
authors: Bonanni
authors: John-Paul
authors: JP
authors: Taylor
authors: Angelo
authors: A
authors: Antonini
authors: Enza Maria
authors: EM
authors: Valente
authors: Simona
authors: S
authors: Petrucci
authors: Fabrizio
authors: F
authors: Stocchi
authors: Astrid
authors: A
authors: Thomas
authors: Bernardo
authors: B
authors: Perfetti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D015897:Comorbidity; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D020961:Lewy Body Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014202:Tremor / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
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