title: Cognitive and neuropsychiatric features of orthostatic tremor: A case-control comparison.
abstract: BACKGROUND
  Evidence suggests that the cerebellum could play a role in the pathophysiology of orthostatic tremor. The link between orthostatic tremor and the cerebellum is of interest, especially in light of the role the cerebellum plays in cognition, and it raises the possibility that orthostatic tremor patients could have cognitive deficits consistent with cerebellar dysfunction. Our aim was to examine whether orthostatic tremor patients had cognitive deficits and distinct personality profiles when compared with matched controls.
  
  
  METHODS
  Sixteen consecutive orthostatic tremor patients (65.7 ± 13.3 years) and 32 healthy matched controls underwent a neuropsychological battery and the Personality Assessment Inventory. In linear regression models, the dependent variable was each one of the neuropsychological test scores or the Personality Assessment Inventory subscales and the independent variable was orthostatic tremor vs.
  
  
  RESULTS
  Adjusted for age in years, sex, years of education, comorbidity index, current smoker, and depressive symptoms, diagnosis (orthostatic tremor vs. healthy control) was associated with poor performance on tests of executive function, visuospatial ability, verbal memory, visual memory, and language tests, and on a number of the Personality Assessment Inventory subscales (somatic concerns, anxiety related disorders, depression, and antisocial features). Older-onset OT (>60 years) patients had poorer scores on cognitive and personality testing compared with their younger-onset OT counterparts.
  
  
  CONCLUSIONS
  Orthostatic tremor patients have deficits in specific aspects of neuropsychological functioning, particularly those thought to rely on the integrity of the prefrontal cortex, which suggests involvement of frontocerebellar circuits. Cognitive impairment and personality disturbances could be disease-associated nonmotor manifestations of orthostatic tremor.
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, (CIBERNED), Madrid, Spain; Department of Medicine, Complutense University, Madrid, Spain. Electronic address: jbenitol67@gmail.com.
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
authors.affiliation: Department of Neurology, Yale School of Medicine, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine and Yale School of Public Health, New Haven, CT, USA.
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Verónica
authors.initials: V
authors.lastname: Puertas-Martín
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Faculty of Biosanitary Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Madrid, Spain.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Romero
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Michele
authors.initials: M
authors.lastname: Matarazzo
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Molina-Arjona
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Domínguez-González
authors.affiliation: Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA; HM CINAC, HM Hospitales, Móstoles, Madrid, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Sánchez-Ferro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology*; D004244:Dizziness / Q000523:psychology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010551:Personality / Q000502:physiology*; D010552:Personality Assessment; D014202:Tremor / Q000523:psychology*
keywords: Case–control study; Cognitive impairment; Orthostatic tremor; Personality
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