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Increased risk of head tremor in women with essential tremor: Longitudinal data from the Rochester Epidemiology Project

Authors

  • David E. Hardesty MD,

    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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  • Demetrius M. Maraganore MD,

    1. Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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  • Joseph Y. Matsumoto MD,

    1. Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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  • Elan D. Louis MD, MS

    Corresponding author
    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    2. Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    3. The Taub Institute for Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    • Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032
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Abstract

In one cross-sectional study of a community in northern Manhattan, women with essential tremor (ET) were more likely to have head tremor than were men. In that study, patients were seen at one point in time, rather than followed longitudinally. Head tremor often develops after arm tremor, and its appearance in patients with ET may therefore be a function of duration of follow-up. In a second epidemiological study utilizing the Rochester Epidemiology Project, in which ET subjects were followed from disease diagnosis to death, we determined whether there was an association between female gender and head tremor. We utilized the records-linkage system of the Rochester Epidemiology Project to identify ET cases. Records were reviewed and clinical data abstracted by a neurologist specializing in movement disorders. A second neurologist reviewed a subsample of records. There were 107 ET cases (69 women, 38 men) followed for 10.1 ± 9.1 years from ET diagnosis to death. Head tremor was present in 37 (53.6%) women and 5 (13.2%) men (odds ratio [OR] = 7.6, 95% confidence interval [CI] = 2.7–21.9, P < 0.001). In a multivariate linear regression analysis, women remained at high risk for head tremor (OR = 6.5, 95% CI = 2.2–19.0, P = 0.001) independent of disease duration. We found in this longitudinal epidemiological study that women with ET were six times more likely to develop head tremor over the course of their illness than were men. The reason for the association between gender and head tremor, which has now been demonstrated in several studies, is not known, but it could reflect gender differences in the distribution of disease pathology within the brain. © 2004 Movement Disorder Society

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