Abstract Details

Title Clinical and Imaging Data in Essential Tremor with Parkinsonian Features

Topic Movement Disorders

Presentation(s) P06 - (-)

Poster/Presentation
Number 085

Objective

Background BACKGROUND: Multiple clinical, genetic and neuroimaging studies suggest overlap between ET and Parkinson's disease (PD) (Fekete R, Jankovic J. Mov Disord 2011;26:391-8). DaTscan has been recommended as a tool to assist in differentiating between ET and PD in clinically uncertain cases, but it is not clear whether dopamine transporter imaging can reliably delineate the two disorders.

Design/Methods DESIGN/METHODS: Twenty ET patients with or without parkinsonian features and 11 healthy volunteers were examined by a movement disorders neurologist, underwent smell test (University of Pennsylvania Smell Identification Test, UPSIT) and DaTscan studies. Visual and semi-quantitative (Region-of-Interest, ROI) DaTscan image analysis were performed.

Results RESULTS: Seven ET patients had no parkinsonian features ("pure ET group"), 5 patients had one or two mild parkinsonian features ("ET-parkinsonism group"), and 8 patients had 3 or more parkinsonian features ("ET-PD group"). All seven patients in pure ET group had normal DaTscan. Seven of 8 ET-PD patients had unilateral or asymmetric onset of tremor and abnormal DaTscan studies. ET patients with two mild parkinsonian features (N=2) or one parkinsonian feature (N=3) had normal DaTscan studies. Patients with 2 parkinsonian features had lower ROI values than patients with one parkinsonian feature. UPSIT score in pure ET group was lower than in healthy controls but higher than in ET with parkinsonism group.

Conclusions CONCLUSIONS: Patients with ET and parkinsonian symptoms are heterogeneous group of movement disorders consisting of a combination of ET and PD (ET-PD) and ET with parkinsonian features but without evidence of presynaptic dopaminergic deficit. DAT imaging can be helpful in clinically uncertain cases. Further studies of association between ET and PD are needed.

Authors/Disclosures
Olga Waln, MD (Methodist Neurological Institute) PRESENTER	Dr. Waln has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Joseph Jankovic, MD, FAAN (Baylor College of Medicine)	Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Revance. Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance, Allergan. The institution of Dr. Jankovic has received research support from Baylor College of Medicine. Dr. Jankovic has received research support from Abbvie. The institution of Dr. Jankovic has received research support from Abbvie.

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