Associations Between Cognitive Profiles and Balance in Essential Tremor

Area of Science:

• Neuroscience
• Movement Disorders
• Cognitive Neurology

Background:

• Essential Tremor (ET) is recognized as a heterogeneous disorder.
• ET can manifest with gait, balance, and cognitive impairments.
• Cerebellar-thalamic-cortical circuit disruption underlies ET's diverse symptoms.

Purpose of the Study:

• Identify cognitive subtypes in Essential Tremor (ET) patients.
• Examine the correlation between ET cognitive subtypes and gait/balance dysfunction.
• Hypothesize that greater cognitive difficulties in ET correlate with worse gait and balance.

Main Methods:

• Neuropsychological and physical therapy evaluations were performed on 71 ET individuals.
• Gait and balance were assessed using Mini-BESTest, Timed Up and Go, and SARA.
• ET participants were categorized into Cognitively Normal, Low Executive Function/Processing Speed, and Low Memory Multi-domain groups.

Main Results:

• Worse Mini-BESTest and SARA scores were observed in Low Memory and Low Executive Function groups compared to cognitively normal ET.
• The Timed Up and Go test showed poorer performance in the Low Executive Function group.
• Age and education were significant predictors for gait and balance measures; medication was not directly associated with clinical tests but predicted falls.

Conclusions:

• Cognitive dysfunction in ET can present as processing speed or immediate memory deficits.
• These ET cognitive subtypes are associated with increased gait and balance difficulties.
• The observed gait and balance impairments in ET subtypes are not explained by medication use.