Association of Essential Tremor With Dementia and Affective Disorders: A Meta-Analysis

Yajun Shang; Xinjie Chen; Mingda Ai; Xiaoran Gao; Shujuan Dai; Mingjie Zhao; Cen Yang; Liangfeng Wang; Junyan Zhang; Lianmei Zhong; Tianhao Bao; Xiaolei Liu

doi:10.3389/fneur.2022.842732

Association of Essential Tremor With Dementia and Affective Disorders: A Meta-Analysis

Front Neurol. 2022 Mar 17:13:842732. doi: 10.3389/fneur.2022.842732. eCollection 2022.

Authors

Yajun Shang^{1

2}, Xinjie Chen^{2

3}, Mingda Ai^{2

4}, Xiaoran Gao⁵, Shujuan Dai^{2

4}, Mingjie Zhao^{2

4}, Cen Yang⁵, Liangfeng Wang⁶, Junyan Zhang⁷, Lianmei Zhong^{2

4}, Tianhao Bao^{8

9}, Xiaolei Liu^{2

4}

Affiliations

¹ Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
² Yunnan Provincial Clinical Research Center for Neurological Diseases, Kunming, China.
³ Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China.
⁴ Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
⁵ Department of Surgery, Shenzhen University, Shenzhen, China.
⁶ Department of Anesthesiology, The First Clinical Medical College of Kunming Medical University, Kunming, China.
⁷ Bothwin Clinical Study Consultant, Shanghai, China.
⁸ Department of Geriatrics, Kunming Medical University Affiliated Mental Health Center, Kunming, China.
⁹ West China Hospital, Sichuan University, Chengdu, China.

Abstract

Background: The dementia and affective disorders are common non-motor features in patients with essential tremor (ET). However, the relationship of ET with cognitive impairments and affective disorders remains controversial. This meta-analysis aimed to analyze the association of ET with dementia and affective disorders.

Methods: Original studies published from January 1999 to October 2019 were systematically searched from the database of Medline (OvidSP), EMBASE (OvidSP), and the Cochrane Central Register of Controlled Trials. Pooled standard mean difference (SMD, random effect model), odds ratios (ORs), relative risk (RR), and 95% CI were calculated.

Results: Compared with the Non-ET group, patients with ET had significantly lower Mini-Mental State Examination (MMSE) score (SMD, -1.16; 95% CI, -1.75 to -0.58; p = 0.0001) and had significantly higher depressive and anxiety symptoms scale score (SMD, 0.55; 95% CI, 0.22-0.87; p = 0.0009). The OR for dementia and affective disorders in individuals with ET compared with individuals without ET was 2.49 (95% CI, 2.17-2.85, p < 0.00001). While there was no significant difference in Montreal Cognitive Assessment (MoCA) score between ET and Non-ET groups (SMD, -0.52; 95% CI, -0.16 to 0.13; p = 0.23), there was a significant difference in the risk of mortality between ET and Non-ET groups (RR = 4.69, 95% CI, 2.18-10.07).

Conclusion: The non-motor symptoms should not be neglected among patients with ET. However, the causal relationship between ET and dementia, depression, and anxiety is unclear.

Keywords: anxiety; dementia; depression; essential tremor; movement disorders.