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October 1991

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

Author Affiliations

From the Departments of Neurology (Drs Hershey and Lichter) and Psychiatry (Dr Kim), Department of Veterans Affairs Medical Center and State University of New York at Buffalo. Dr Feldman and Mr Commichau were students working in the Neurology Department at the time of this study.

Arch Neurol. 1991;48(10):1049-1051. doi:10.1001/archneur.1991.00530220069021

• 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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