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Frequency of tremor in people with multiple sclerosis: A systematic review and meta-analysis
Saeed Vaheb1, Danial Dehghani Firouzabadi2, Hamed Ghoshouni1
1Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Background:
Multiple sclerosis (MS) is a chronic neurodegenerative disorder causing various symptoms, including tremors, which significantly affect the quality of life and disability in people with MS (PwMS). Previous studies report a wide range of tremor frequency in PwMS, necessitating a comprehensive review for reliable estimates.
Objectives:
This review aimed to elucidate the frequency rate of tremor among PwMS.
Method:
A systematic search was conducted in PubMed/MEDLINE, Embase, Scopus, and Web of Science up to April 27, 2024, to identify studies evaluating various types of tremors in PwMS. The Meta-proportion method implemented in R software version 4.0.0, utilizing a random-effects model, was employed to estimate the pooled frequency rates of tremor, with its 95% confidence interval (CI), among PwMS.
Results:
From 3780 studies, 14 studies encompassing 17,458 PwMS (71.5 % female) were included. The mean age was 46.4 years, with a disease duration of 9.3 years and an Expanded Disability Status Scale (EDSS) score of 3.4. The pooled frequency of tremor was 33.32 % (95 % CI: 23.47 % to 44.88 %; I2 = 98 %; p-heterogeneity < 0.01). Subgroup analysis by sample size revealed that the pooled frequency of tremor in PwMS was significantly lower (p-value < 0.01) in studies with over 200 participants (22.46, 95 % CI: 15.69 % to 31.08 %, I2 = 99 %; p-heterogeneity < 0.01) compared to those with fewer than 200 participants (47.65, 95 % CI: 31.97 % to 63.81 %, I2 = 91 %; p-heterogeneity < 0.01).
Conclusion:
Tremor is a prevalent complaint in PwMS. These findings highlight the necessity for targeted supportive, therapeutic, and rehabilitative interventions to effectively address this prevalent issue in PwMS.
Insights
Tremor affects one-third of people with multiple sclerosis (PwMS), impacting their quality of life. This systematic review highlights the need for targeted interventions to manage tremor in PwMS.
Area of Science:
- Neurology
- Neurodegenerative Diseases
- Clinical Research
Background:
- Multiple sclerosis (MS) is a chronic neurodegenerative disorder.
- Tremor is a common and disabling symptom in people with MS (PwMS).
- Previous estimates of tremor frequency in PwMS vary widely.
Purpose of the Study:
- To systematically review and estimate the pooled frequency of tremor in people with MS.
- To provide reliable estimates of tremor prevalence for clinical and research purposes.
Main Methods:
- A systematic search was conducted across major databases (PubMed/MEDLINE, Embase, Scopus, Web of Science) up to April 27, 2024.
- 14 studies involving 17,458 PwMS were included in the meta-proportion analysis.
- A random-effects model was used to calculate the pooled tremor frequency and its 95% confidence interval (CI).
Main Results:
- The overall pooled frequency of tremor in PwMS was 33.32% (95% CI: 23.47%–44.88%).
- Tremor prevalence was significantly lower in studies with over 200 participants (22.46%) compared to those with fewer than 200 participants (47.65%).
- High heterogeneity was observed across studies (I² = 98%).
Conclusions:
- Tremor is a highly prevalent symptom experienced by a significant proportion of people with MS.
- The findings underscore the importance of developing and implementing targeted interventions for tremor management in PwMS.
- Further research may be needed to explore factors contributing to the heterogeneity in tremor prevalence estimates.
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