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Dysautonomia and cognitive impairment in Essential Tremor: is there a link?

A. Rekik, A. Nasri, S. Mrabet, M. Bendjebara, A. Gargouri, I. Kacem, R. Gouider (Manouba, Tunisia)

Meeting: MDS Virtual Congress 2021

Abstract Number: 1360

Keywords: Autonomic dysfunction, Cognitive dysfunction, Essential tremor(ET)

Category: Tremor

Objective: To investigate the relationship between autonomic dysfunction and cognitive impairment in Essential Tremor (ET).

Background: Even though the term ‘essential’ was used to reflect the motor side of ET, it is now admitted that autonomic dysfunction and cognitive impairment are classic in these patients. However, their underlying mechanisms and potential dynamics remain unclear.

Method: We conducted a cross-sectional study in the department of Neurology in Razi University hospital including patients diagnosed with ET syndrome and ET-plus syndrome as defined by the classification of tremor by MDS 2018. Autonomic function was measured using the SCOPA-Aut questionnaire. All patients had a neuropsychological assessment including Mini Mental Status Examination (MMSE) to assess global cognitive function and the Frontal Assessment Battery (FAB) for executive function.

Results: We included 107 ET patients (sex ratio =1; mean age of onset = 56 + 16 years).Autonomic dysfunction was present in 75 % of cases (bladder dysfunction in 54.2%;cardiovascular dysfunction in 42 % and gastrointestinal dysfunction in 40%). Cognitive impairment was present in 39.3% of cases (dementia in 16.8% and mild cognitive impairment in 22.5%). Mean MMSE score was of 26.5 and mean FAB score was of 13. Memory was the main affected cognitive domain (48%) followed by executive function (44.3%). Memory impairment was positively correlated to gastrointestinal dysfunction (p=0.044). No other correlations were established between other dysautonomic signs and cognitive dysfunction findings.

Conclusion: We found a high prevalence of dysautonomic features and cognitive deficits in ET patients. The association between memory impairment and gastrointestinal dysfunction in ET patients, also established in early stages of Parkinson’s disease,may recall the progression pattern of neurodegenerative diseases.

To cite this abstract in AMA style:

A. Rekik, A. Nasri, S. Mrabet, M. Bendjebara, A. Gargouri, I. Kacem, R. Gouider. Dysautonomia and cognitive impairment in Essential Tremor: is there a link? [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/dysautonomia-and-cognitive-impairment-in-essential-tremor-is-there-a-link/. Accessed June 15, 2025.
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