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31-03-2022 | Tremor | Review Article

Essential tremor and cognitive impairment: who, how, and why

Authors: Sandy Maria Cartella, Alessandro Bombaci, Gaetano Gallo, Claudia Ledda, Marta Pengo, Antonia Pignolo, Federico Emanuele Pozzi, Emanuele Spina, Assunta Trinchillo, Giovanni Palermo, Carmen Terranova, on behaf of EduNet SIgN

Published in: Neurological Sciences | Issue 7/2022

Abstract

Background and aims

Recent years have witnessed the switch from considering essential tremor (ET) a monosymptomatic disorder to consider it as part of a spectrum, including other neurological signs, such as mild cognitive impairment and dementia, thus defining it as “ET plus.” There are few data on cognitive impairment in ET patients. The aim of this review is to analyze the clinical characteristics of ET patients developing cognitive impairment, their neuropsychological profile, the underpinning mechanisms, and the possible biomarkers.

Methods

The authors performed a narrative review on cognitive decline in essential tremor, including articles written in English since the year 2000.

Discussion

The most recent pathogenetic theories of cognitive impairment in ET rely on the cerebellar dysfunction, being part of the Cerebellar Cognitive Affective Syndrome spectrum. Cognitive impairment in ET patients could be assessed through many tests that demonstrate the involvement of different domains, such as attention, executive functions, and language. There are some clinical characteristics of ET that may indicate a greater risk of developing cognitive impairment, namely, cerebellar symptoms, falls, age at onset, and family history. However, there are no established clinical, neurophysiological, neuropathological, and fluid biomarkers of cognitive impairment in ET.

Conclusions

Increasing data are showing in ET the presence of cerebellar symptoms and cognitive impairment. Further studies are needed to better understand cognition in ET patients, and to define the boundary between ET and ET plus, since deeper phenotyping might have important clinical and therapeutic implications.

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Title: Essential tremor and cognitive impairment: who, how, and why
Authors: Sandy Maria Cartella
Alessandro Bombaci
Gaetano Gallo
Claudia Ledda
Marta Pengo
Antonia Pignolo
Federico Emanuele Pozzi
Emanuele Spina
Assunta Trinchillo
Giovanni Palermo
Carmen Terranova
on behaf of EduNet SIgN
Publication date: 31-03-2022
Publisher: Springer International Publishing
Keywords: Tremor
Mild Cognitive Impairment
Biomarkers
Published in: Neurological Sciences / Issue 7/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-022-06037-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Essential tremor and cognitive impairment: who, how, and why

Abstract

Background and aims

Methods

Discussion

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and aims

Methods

Discussion

Conclusions

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