Objective: To assess the impact of Covid-19 on Essential and Dystonic Tremor, with regard on non-motor symptoms, social aspects and everyday life.

Background: Covid-19 had a negative impact on motor and non-motor aspects of movement disorders, but there are no studies on ET and DT. The only present studies regard the management of DBS in ET and of botulinum toxin in dystonic patients.

Method: Self-administered survey, based on Hamilton Depression and Anxiety Rating Scale, SARA scale, Hospital Anxiety and Depression Scale. All the questions are referred to the Italian lockdown period during which our outpatient clinic was closed. Every patient underwent a motor evaluation (TETRAS) before and after lockdown.

Results: We analysed 26 patients (20 ET, 6 DT). Depression worsened in 57,7% of them whereas anxiety in 26,9% and sleep quality in 34,6%, as well as fear. For 15,4% sexual life worsened. All these features are related between them and with the patient’s level of education: 80-100% of patient who felt more depressed and had a worse sleep quality have a high level of education. Sleep quality is related to an increase in depression as well (88,9%). 19,2% of patients felt their difficulty in concentration increased during lockdown. This is related to the increase in anxiety (71,4%). None of the features is related to TETRAS score or to years of age or of disease, nor to the type of disease. A minority of patients had difficulty in finding their doctors, or their drugs. 38,4% of patients know what telemedicine is, but only 15,3% used it for a teleconsultation. 15,3% of patients said their health decreased, whereas 42,3% said quality of life did. 15,3% managed to practice physiotherapy during lockdown, and no one started playing videogames in substitution. Only one patient followed a physiotherapy video lesson. For most patients (15,3%) the major problems during lockdown were the impossibility to go to the hospital and the lack of social relationships. Most people emailed our centre to postpone appointments or to seek medical advice, while only 1% asked for Covid-19 related issues and telemedicine consultations.

Conclusion: Despite the little number of patients analysed, we can highlight Covid-19 had both a negative direct impact on non-motor symptoms of ET and DT, and an indirect one, with quality of life repercussions. Telemedicine was not useful in our centre since most patients did not know how to use it.

References: 1. Papa SM, Brundin P, Fung VSC, Kang UJ, Burn DJ, Colosimo C, Chiang HL, Alcalay RN, Trenkwalder C, MDS Scientific Issues Committee, Impact of the COVID-19 Pandemic on Parkinson’s Disease and Movement Disorders, Mov Disord 2020 May; 35(5): 711-715 2. Fasano A, Cereda E, Barichella M, Cassani E, Ferri V, Zecchinelli AL, Pezzoli G, COVID-19 in Parkinson’s Disease Patients Living in Lombardy, Italy. Mov Disord. 2020 Jul;35(7):1089-1093 3. Fasano A, Antonini A, Katzenschlager R, Krack P, Odin P, Evans AH, Foltynie T, Volkmann J, Merello M, Management of Advanced Therapies in Parkinson’s Disease Patients in Times of Humanitarian Crisis: The COVID-19 Experience. Mov Disord Clin Pract. 2020 May 4;7(4):361-372 4. https://www.movementdisorders.org/MDS/About/Committees–Other-Groups/Telemedicine-in-Your-Movement-Disorders-Practice-A-Step-by-Step-Guide.htm 5. Dressler D, Adib Saberi F. Botulinum toxin therapy in the SARS-CoV-2 pandemic: patient perceptions from a German cohort. J Neural Transm (Vienna). 2020 Sep;127(9):1271-1274

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