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Essential tremor-plus: a controversial new concept.

Elan D Louis1, Martin Bares2, Julian Benito-Leon3

  • 1Department of Neurology and Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA.

The Lancet. Neurology
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Summary
This summary is machine-generated.

The term essential tremor-plus (ET-plus) lacks scientific basis, potentially representing advanced essential tremor (ET) rather than a distinct condition. Further research is needed to define ET subtypes based on pathology.

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Area of Science:

  • Neurology
  • Movement Disorders

Background:

  • The 2018 Movement Disorder Society consensus redefined essential tremor (ET).
  • A new term, essential tremor-plus (ET-plus), was introduced for ET with additional uncertain neurological signs.

Purpose of the Study:

  • To evaluate the scientific validity of the ET-plus classification.
  • To advocate for evidence-based categorization of tremor disorders.

Main Methods:

  • Critical analysis of the definition and rationale for ET-plus.
  • Comparison with established classifications like Parkinson-plus.

Main Results:

  • The definition of ET-plus lacks a clear basis in distinct pathology or prognosis.
  • ET-plus may represent a later stage of ET rather than a separate entity.

Conclusions:

  • The term ET-plus is scientifically questionable due to insufficient evidence.
  • Future research should focus on defining essential tremor subsets based on underlying pathophysiology and causes.