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© 2006 American Academy of Neurology Population-based case-control study of cognitive function in essential tremorFrom the Department of Neurology (J.B.-L.), Móstoles General Hospital, Móstoles, Madrid, Spain; the G.H. Sergievsky Center, Department of Neurology, and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY (E.D.L.); and the Department of Neurology (F.B.-P.), University Hospital "12 de Octubre," Madrid, Spain. Address correspondence and reprint requests to Dr. Julián Benito-León, Avda. de la Constitución 73, portal 3, 7° Izquierda, E-28820 Coslada, Madrid, Spain; e-mail: jbenitol{at}meditex.es Objectives: To determine whether patients with essential tremor (ET) have cognitive deficits when compared with controls and whether the types of cognitive deficits reported previously are also found in this large sampling of patients with ET. Methods: A total of 232 patients with ET and 696 matched controls age 65 years or older (median 75 years) living in central Spain (the Neurologic Diseases in Central Spain study) underwent a neuropsychological assessment, including tests of global cognitive performance, frontal executive function, verbal fluency, and memory. Subjects also were asked whether they had forgetfulness. Results: Fifty-six patients with ET were previously undiagnosed; only 14 (6%) were taking medication for tremor. Adjusted for age, gender, education, premorbid intelligence, medications, and depressive symptoms, cases performed less well on most neuropsychological tests and especially tests of global cognitive performance (37-item Mini-Mental State Examination = 27.0 ± 6.7 in cases vs 28.9 ± 5.9 in controls, p < 0.001) and frontal executive function (Trail Making Test number of errors = 8.7 ± 11.0 in cases vs 3.8 ± 7.6 in controls, p < 0.001). Forgetfulness was reported in 117 (50.4%) patients with ET vs 300 (43.1%) controls (p = 0.05). Conclusions: In a population-based sample of largely untreated patients with essential tremor, cases performed more poorly on formal neuropsychological testing than did their counterparts without tremor. A complaint of forgetfulness was also marginally more common in patients with essential tremor.
*See the Appendix for a list of Group members. Supported by the Spanish Health Research Agency (FIS 03/10008), the Spanish Office of Science and Technology and Novartis (for some statistical analysis). Dr. Louis is supported by NIH R01 NS042859 and R01 NS039422 from the NIH, Bethesda, MD. Disclosure: The authors report no conflicts of interest. Received May 10, 2005. Accepted in final form October 5, 2005.
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