Longitudinal evaluation of patients with isolated head tremor

Gina Ferrazzano; Daniele Belvisi; Maria Ilenia De Bartolo; Viola Baione; Matteo Costanzo; Giovanni Fabbrini; Giovanni Defazio; Alfredo Berardelli; Antonella Conte

doi:10.1016/j.parkreldis.2021.11.018

Longitudinal evaluation of patients with isolated head tremor

Parkinsonism Relat Disord. 2022 Jan:94:10-12. doi: 10.1016/j.parkreldis.2021.11.018. Epub 2021 Nov 26.

Authors

Gina Ferrazzano¹, Daniele Belvisi², Maria Ilenia De Bartolo³, Viola Baione⁴, Matteo Costanzo⁵, Giovanni Fabbrini⁶, Giovanni Defazio⁷, Alfredo Berardelli⁸, Antonella Conte⁹

Affiliations

¹ Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. Electronic address: gina.ferrazzano@uniroma1.it.
² Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077, Pozzilli, Italy. Electronic address: daniele.belvisi@uniroma1.it.
³ IRCCS NEUROMED, Via Atinense 18, 86077, Pozzilli, Italy. Electronic address: mariaileniadebartolo@gmail.com.
⁴ Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. Electronic address: viola.baione@uniroma1.it.
⁵ Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. Electronic address: matteo.costanzo@uniroma1.it.
⁶ Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077, Pozzilli, Italy. Electronic address: giovanni.fabbrini@uniroma1.it.
⁷ Department of Medical Sciences and Public Health, University of Cagliari, SS 554 bivio Sestu, 09042, Monserrato, CA, Italy. Electronic address: giovanni.defazio@unica.it.
⁸ Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077, Pozzilli, Italy. Electronic address: alfredo.berardelli@uniroma1.it.
⁹ Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077, Pozzilli, Italy. Electronic address: antonella.conte@uniroma1.it.

PMID: 34861560
DOI: 10.1016/j.parkreldis.2021.11.018

Abstract

Introduction: Isolated head tremor, a pathological condition characterized by head tremor without dystonic postures or tremor in other body parts, has recently been suggested to be a form of dystonia. It is however still unclear whether isolated head tremor precedes dystonia or remains unmodified overtime.

Methods: We enrolled 20 patients with isolated head tremor. For each patient, we assessed videos recorded at enrollment and after 5 years. The videotapes were reviewed by two independent experienced movement disorder specialists who evaluated and scored tremor and CD severity using the Fahn-Tolosa-Marin Clinical Rating Scale for Tremor and the revised Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), respectively.

Results: Upon enrollment, all 20 patients showed isolated head tremor. Mean tremor severity was 2.7 ± 0.9 as measured using the Fahn-Tolosa-Marin Clinical Rating Scale for Tremor total score. At the 5-year follow-up examination, 15 (75%) of the 20 patients with isolated head tremor showed dystonic postures in the neck, while the remaining 5 patients (25%) had only isolated head tremor. Mean severity of dystonia as measured using the TWSTRS-2 total score was 11.8 ± 3.6. Head tremor severity was unchanged between baseline and the 5-year follow-up examination (p > 0.05). At the follow-up examination, no patients had tremor or dystonia in a body part other than the neck, nor did they develop bradykinesia or other parkinsonian signs.

Conclusions: Our longitudinal study demonstrated that patients with isolated head tremor may develop cervical dystonia over time.

Keywords: Cervical dystonia; Isolated head tremor; Longitudinal study; Movement disorders.

MeSH terms

Dystonic Disorders*
Humans
Longitudinal Studies
Neck
Torticollis* / diagnosis
Tremor / diagnosis
Tremor / etiology