Embarrassment in essential tremor: prevalence, clinical correlates and therapeutic implications.

Background: Embarrassment is a commonly described feature of essential tremor (ET) but has not been the focus of clinical research.

Objective: To estimate the prevalence, identify susceptible patient groups, and quantify the therapeutic correlates of reported embarrassment.

Methods: A total of 106 ET cases from a population-based sample and 349 ET cases from a clinical sample were asked, "Does your tremor often embarrass you?"

Results: In the clinical sample, the prevalence of embarrassment was high (58.

Fertility in essential tremor. Data from population-based and clinical sources.

Background: The view of essential tremor (ET) as a degenerative disorder, which is now gaining support from postmortem studies, is at odds with traditional views of ET as a 'super-healthy' condition characterized by increased longevity and fertility. Longevity has recently been re-examined in ET, yet fertility, measured by number of offspring, has never been critically assessed in this disease. The objective was to determine whether ET cases and controls differ in terms of number of children.

Historical underpinnings of the term essential tremor in the late 19th century.

Background: The term essential tremor has been in regular use since the second half of the 20th century. To modern neurologists, the word "essential" may seem cryptic. The historical underpinnings of this term have not been examined.

A novel approach to non-biased systematic random sampling: a stereologic estimate of Purkinje cells in the human cerebellum.

Non-biased systematic sampling using the principles of stereology provides accurate quantitative estimates of objects within neuroanatomic structures. However, the basic principles of stereology are not optimally suited for counting objects that selectively exist within a limited but complex and convoluted portion of the sample, such as occurs when counting cerebellar Purkinje cells. In an effort to quantify Purkinje cells in association with certain neurodegenerative disorders, we developed a new method for stereologic sampling of the cerebellar cortex, involving calculating the volume of the cerebellar tissues, identifying and isolating the Purkinje cell layer and using this information to extrapolate non-biased systematic sampling data to estimate the total number of Purkinje cells in the tissues.

Environmental epidemiology of essential tremor.

Background: Essential tremor (ET) is one of the most common neurological disorders. Despite this, the disease mechanisms and etiology are not well understood. While susceptibility genotypes undoubtedly underlie many ET cases, no ET genes have been identified thus far.

Cancer and blood concentrations of the comutagen harmane in essential tremor.

Blood concentrations of harmane, a tremor-producing neurotoxin, are elevated in essential tremor (ET). Harmane is also a comutagen. Using a case-control design, we compared the prevalence of cancer in ET cases vs.

High occurrence and low recognition of Parkinsonism (and possible PD) in old age homes in Bangalore, South India.

Background: The elderly population in developing countries is likely to increase by 200-280%. Age related diseases like Parkinsonism are also likely to increase in ageing population. The prevalence and awareness of Parkinsonism (and possible PD) amongst them are unknown.

Emergence of Parkinson's disease in essential tremor: a study of the clinical correlates in 53 patients.

Patients with essential tremor (ET) may develop Parkinson's disease (PD); however, few studies have examined the clinical features of this combination syndrome. Fifty-three patients with ET-PD were studied and compared to 53 PD and 150 ET patients. Although the latency from onset of ET to PD was brief (<5 years) in 38.

Columbia University Assessment of Disability in Essential Tremor (CADET): methodological issues in essential tremor research.

Essential tremor (ET) is one of the most prevalent neurological disorders, affecting between 0.4 and 3.9% of the population.

Isolated central nervous system Whipple's disease causing reversible frontotemporal-like dementia.

We report a patient with a syndrome resembling frontotemporal dementia (FTD); however, on further diagnostic testing, the diagnosis was Whipple's disease. Because Whipple's disease is treatable, it should be considered in the workup of patients with a FTD-like behavioural and cognitive syndrome.

Philadelphia Geriatric Morale Scale in essential tremor: a population-based study in three Spanish communities.

Essential tremor (ET) is associated with both functional disability and depression. Each could contribute to a poor sense of well-being and low morale. We hypothesized that morale would be lower in ET cases than controls.

Population-based prospective study of cigarette smoking and risk of incident essential tremor.

Background: Smoking cigarettes is associated with lower risk of Parkinson disease (PD). Despite the clinical links between PD and essential tremor (ET), there are few data on smoking in ET. One study showed an association between smoking and lower ET prevalence.

Higher blood harmane (1-methyl-9H-pyrido[3,4-b]indole) concentrations correlate with lower olfactory scores in essential tremor.

Background: Harmane (1-methyl-9H-pyrido[3,4-b]indole), a neurotoxin, may be an environmental risk factor for essential tremor (ET). Harmane and related chemicals are toxic to the cerebellum. Whether it is through this mechanism (cerebellar toxicity) that harmane leads to ET is unknown.

Risk of Parkinson disease in carriers of parkin mutations: estimation using the kin-cohort method.

Objective: To estimate the risk of Parkinson disease (PD) in individuals with mutations in the Parkin gene.

Design: We assessed point mutations and exon deletions and duplications in the Parkin gene in 247 probands with PD (age at onset < or =50 years) and 104 control probands enrolled in the Genetic Epidemiology of Parkinson's Disease (GEPD) study. For each first-degree relative, a consensus diagnosis of PD was established.

Spectrum of gait impairments in presymptomatic and symptomatic Huntington's disease.

The purpose of this study was to quantify gait impairments in presymptomatic and symptomatic Huntington's disease (HD) subjects, and examine sensitivity of gait measures. Our sample (n = 65) included presymptomatic mutation carriers (PMC) (n = 15), symptomatic HD subjects (SHD) (n = 30) and healthy controls (n = 20). Participants were requested to walk at their preferred speed on a computerized walkway that recorded spatiotemporal variables.

Dietary epidemiology of essential tremor: meat consumption and meat cooking practices.

Background/aim: Harmane [1-methyl-9H-pyrido(3,4-b)indole] is a tremor-producing neurotoxin. Blood harmane concentrations are elevated in essential tremor (ET) patients for unclear reasons. Potential mechanisms include increased dietary harmane intake (especially through well-cooked meat) or genetic-metabolic factors.

Weir Mitchell's 1859 demonstration of "a peculiar contraction" produced by a percussion hammer.

Background: The 1875 publications of Erb and Westphal brought widespread attention to the percussion of muscle stretch reflexes. Although the maneuver may have been observed before 1875, there is little concrete evidence of this.

Objectives: To bring to light an early report of percussion eliciting the muscle stretch response.

Elevated blood harmane (1-methyl-9H-pyrido[3,4-b]indole) concentrations in essential tremor.

Essential tremor (ET) is a widespread late-life neurological disease. Genetic and environmental factors likely play an etiological role. Harmane (1-methyl-9H-pyrido[3,4-b]indole) is a potent tremor-producing neurotoxin.

Reduced Purkinje cell number in essential tremor: a postmortem study.

Background: Clinical and functional imaging evidence suggests that cerebellar dysfunction occurs in essential tremor (ET). In recent postmortem studies, we documented increased numbers of torpedoes (Purkinje cell axonal swellings) in ET patients without Lewy bodies. Purkinje cell loss, however, has never been rigorously assessed.

Mild Parkinsonian signs are associated with lower olfactory test scores in the community-dwelling elderly.

Mild Parkinsonian signs (MPS, impaired gait, rigidity, bradykinesia, rest tremor) are commonly found during the clinical examination of older people and may be a precursor to Parkinson's disease (PD) or Alzheimer's disease (AD). Marked deficits in olfaction occur in PD and AD. The objective of this study was to determine whether University of Pennsylvania Smell Test (UPSIT) scores were lower in nondemented community-dwelling elderly with versus without MPS.

Reported hearing impairment in essential tremor: a population-based case-control study.

In a population-based sample, we determined whether a larger proportion of essential tremor (ET) cases reported hearing impairment compared with controls. Ninety-six (38.7%) of 248 ET cases versus 1,371 (29.

Anger in Parkinson's disease: a case-control study.

Unlabelled: Cognitive-psychiatric features of Parkinson's disease (PD) are common and they may be as disabling as the motor features of the disease. PD has been associated with stoic and inflexible personality traits. While many features of personality have been studied in PD, a systematic study of anger trait and anger expression in PD has not been performed.

Does age of onset in essential tremor have a bimodal distribution? Data from a tertiary referral setting and a population-based study.

Background/aims: The distribution of age of onset of essential tremor (ET) is unclear, with discrepancies in the literature. Some data suggest a bimodal distribution and other data 1 late-life peak. We studied age of ET onset in 2 distinct settings: a population-based study and a tertiary referral center.