Correlates of functional disability in essential tremor
Correlates of functional disability in essential tremor
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DOI：
10.1002/mds.1184
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发表时间：
2001-09-01
影响因子：
8.6
通讯作者：
Yu, QP
中科院分区：
文献类型：
--
作者：
Louis, ED;Barnes, L;Yu, QP
治疗特发性震颤(ET)的决定主要基于震颤的功能影响。除了震颤本身的严重程度外，功能障碍的相关性还没有被研究过。这项工作的目的是研究ET的功能残疾的相关性，并提供社区居住的ET病例中功能残疾程度的数据。ET病例和年龄匹配的对照受试者来自纽约曼哈顿北部社区哥伦比亚长老会医学中心的第三转诊中心。受试者接受了2.5小时的评估，包括震颤残疾问卷。由神经科医生评估的视频震颤检查，基于性能的功能测试，量化的计算机震颤分析，汉密尔顿焦虑评定量表。以及DSM-IV结构化临床访谈中的抑郁模块。89例患者中，76例(85.4%)的残疾程度大于或等于残疾问卷上的一项。在多元线性回归分析中，目前主要抑郁。汉密尔顿焦虑量表评分。年龄和震颤严重程度与基于表现的测试分数独立相关。37例社区受试者中，有27例(73.0%)在问卷中有大于或等于1项(平均数=8.4)的残疾，25例(67.6%)在成绩测验的TT(平均数4.2)任务上表现出中等或更大的困难。和年龄，与震颤的严重程度无关。与ET中更大的功能障碍相关，因此在评估ET中新治疗的影响时必须考虑这些因素。在一组社区居住的病例中，大约四分之三的人报告残疾，这表明可能从ET治疗的进步中受益的个人数量可能比之前认为的要多得多。(C)2001年行动失调社。
The decision to treat patients with essential tremor (ET) is based primarily on the functional impact of the tremor. Correlates of functional disability, apart from the severity of the tremor itself, have not been studied. The objective of this work was to study correlates of functional disability in ET, and to present data on the extent of functional disability in community-dwelling ET cases.ET cases and age-matched control subjects were ascertained from a tertiary referral center at Columbia-Presbyterian Medical Center an a community in northern Manhattan, N.Y. Subjects underwent a 2.5-hour evaluation, including a tremor disability questionnaire. a videotaped tremor examination rated by a neurologist, a performance-based test of function, quantitative computerized tremor analysis, the Hamilton Anxiety Rating Scale. and the depression module of the Structured Clinical Interview for DSM-IV.Seventy-six (85.4%) of 89 cases reported disability on greater than or equal to1 item on the disability questionnaire. In multivariate linear regression analyses, current major depression. Hamilton Anxiety Rating Scale score. age, and tremor severity were independently correlated with performance-based test scores. Twenty-seven (73.0%) of 37 community cases reported disability on greater than or equal to1 (mean = 8.4) item on the questionnaire, and 25 (67.6%) demonstrated moderate or greater difficulty on tt (mean 4.2) task in a performance-based test.Depression, anxiety. and age, independent of the severity of tremor. were associated with greater functional disability in ET, so that these factors must be considered when assessing the impact of new treatments in ET. Among a group of community-dwelling cases, approximately three-quarters reported disability, suggesting that the number of individuals who might receive some benefit from advances in the treatment of ET is probably a great deal larger than previously thought. (C) 2001 Movement Disorder Society.