title: Non-Motor Symptoms of Essential Tremor Are Independent of Tremor Severity and Have an Impact on Quality of Life.
abstract: BACKGROUND
  Several publications have focused on accompanying non-motor symptoms (NMS) in essential tremor (ET) patients; however, it remains unclear if NMS are an intrinsic part of the disease or secondary phenomena. We present the results of several neuropsychiatric tests and their impact on quality of life (QoL) in community-dwelling patients with ET.
  
  
  METHODS
  Participants were recruited via a newspaper article about ET published in the local media and on the internet. All participants completed several standard neuropsychiatric tests, including those that assess QoL. To compare differences between cases and controls, Student's t-tests with Bonferroni-Holm post hoc tests were performed. Spearman's correlation coefficients were also calculated.
  
  
  RESULTS
  We enrolled 110 patients with definite or probable ET. Highly significant changes were observed for apathy, anxiety, and cognition and negatively impacted QoL. Most aberrations were independent of tremor severity and duration.
  
  
  CONCLUSIONS
  The significant neuropsychiatric deficits and reduced QoL demonstrate a degree of illness that appears to be a non-motor phenotype rather than a secondary effect of ET. In the future, NMS should carefully be explored in ET patients as they may have an impact on QoL and treatment.
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Musacchio
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Purrer
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Papagianni
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Fleischer
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mackenrodt
authors.affiliation: Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Malsch
authors.affiliation: Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany; Clinical Trial Center, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Steigerwald
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Volkmann
authors.affiliation: Department of Neurology, University Hospital of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital of Freiburg, Freiburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Klebe
keywords: Essential tremor; non-motor symptoms; quality of life