title: Tremor in progressive supranuclear palsy.
abstract: Tremor is thought to be a rare feature of progressive supranuclear palsy (PSP).
  
  
  
  We retrospectively reviewed the database of the CurePSP brain bank at Mayo Clinic Florida to retrieve all available clinical information for PSP patients. All patients underwent a standard neuropathological assessment and an immunohistochemical evaluation for tau and α-synuclein. DNA was genotyped for the MAPT H1/H2 haplotype.
  
  
  
  Of the 375 PSP patients identified, 344 had a documented presence or absence of tremor, which included 146 (42%) with tremor, including 29 (20%) with postural/action tremors, 16 (11%) with resting tremor, 7 (5%) with intention tremor, 20 (14%) with a combination of different types of tremor, and 74 (51%) patients who had tremor at some point during their illness, but details were unavailable. The tremor severity of 96% of the patients (54/55) who had this data was minimal to mild. The probability of observing a tremor during a neurological examination during the patient's illness was estimated to be ∼22%. PSP patients with postural/action tremors and PSP patients with resting tremor responded to carbidopa-levodopa therapy more frequently than PSP patients without tremor, although the therapy response was always transient. There were no significant differences in pathological findings between the tremor groups.
  
  
  
  Tremor is an inconspicuous feature of PSP; however, 42% (146/344) of the PSP patients in our study presented some form of tremor. Because there is no curative therapy for PSP, carbidopa/levodopa therapy should be tried for patients with postural, action, and resting tremor.
authors.affiliation: Department of Neurology, 4500 San Pablo Road, Jacksonville, FL 32224, USA; Department of Neuropathology, 4500 San Pablo Road, Jacksonville, FL 32224, USA; Department of Neuroscience Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA; Department of Neurology, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Fukuoka 814-0180, Japan. Electronic address: shinsuke@cis.fukuoka-u.ac.jp.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Fujioka
authors.affiliation: Department of Neurology, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: aaalgom@yahoo.com.
authors.forename: Avi A
authors.initials: AA
authors.lastname: Algom
authors.affiliation: Department of Neuropathology, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: murray.melissa@mayo.edu.
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Murray
authors.affiliation: Department of Neuroscience Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: sanchezcontreras.monica@mayo.edu.
authors.forename: Monica Y
authors.initials: MY
authors.lastname: Sanchez-Contreras
authors.affiliation: Department of Neurology, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: Tacik.Pawel@mayo.edu.
authors.forename: Pawel
authors.initials: P
authors.lastname: Tacik
authors.affiliation: Department of Neurology, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Fukuoka 814-0180, Japan. Electronic address: tsuboi@cis.fukuoka-u.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tsuboi
authors.affiliation: Department of Neurology, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: vangerpen.jay@mayo.edu.
authors.forename: Jay A
authors.initials: JA
authors.lastname: Van Gerpen
authors.affiliation: Department of Neurology, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: uitti@mayo.edu.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Uitti
authors.affiliation: Department of Neuroscience Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: Rademakers.rosa@mayo.edu.
authors.forename: Rosa
authors.initials: R
authors.lastname: Rademakers
authors.affiliation: Department of Neuroscience Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: ross.owen@mayo.edu.
authors.forename: Owen A
authors.initials: OA
authors.lastname: Ross
authors.affiliation: Department of Neurology, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: wszolek.zbigniew@mayo.edu.
authors.forename: Zbigniew K
authors.initials: ZK
authors.lastname: Wszolek
authors.affiliation: Department of Neuropathology, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: dickson.dennis@mayo.edu.
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Dickson
mesh_terms: D000368:Aged; D002230:Carbidopa / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D014202:Tremor / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D015259:Dopamine Agents; D007980:Levodopa; D002230:Carbidopa
keywords: Carbidopa/levodopa therapy; MAPT H1/H2 haplotype; Neuropathology; Progressive supranuclear palsy; Tremor