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Tremor at Onset:  Predictor of Cognitive and Motor Outcome in Parkinson's Disease?

Linda A. Hershey, MD, PhD; Brian J. Feldman, MD; Kye Y. Kim, MD; Chris Commichau; David G. Lichter, MD
Arch Neurol. 1991;48(10):1049-1051. doi:10.1001/archneur.1991.00530220069021.
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• We examined 46 male patients with idiopathic Parkinson's disease to see whether tremor at onset was as useful a predictor of benign clinical outcome as tremor predominance after several years. When we compared patients with tremor at onset (n = 27) with those whose disease began with bradykinesia/rigidity (n = 9), or gait disorder (n = 10), we found no significant differences after a mean of 7 years in motor, cognitive, or affective status. Sixteen of the tremor-onset patients continued to have tremor predominance with minimal gait disorder after about 7 years. These tremor-predominant patients had significantly better motor outcome and somewhat better cognitive outcome than either tremor-onset patients who subsequently developed gait disorder (n =11) or patients without tremor at onset (n = 19). Tremor predominance after several years appears to be a better predictor of a benign clinical course of Parkinson's disease than tremor at onset.


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