Objective: To evaluate the prevalence and the clinical features of re-emergent tremor (RET) in a large sample of consecutive patients with Parkinson’s disease (PD) and to compare the demographic and clinical features of PD patients with and without RET.

Background: RET is a tremor which appears after a variable latency of one to several seconds when a PD patient with resting tremor extends the upper limbs (Jankovic et al., 1999). So far, no studies have assessed the prevalence of RET in PD and it is still unclear whether PD patients with RET may represent a distinct PD clinical subtype.

Methods: We consecutively enrolled 210 patients with PD, from January 2015 for a period of six months. We collected PD patients’ demographic and clinical data. The severity of the disease was assessed by means of MDS – Unified Parkinson’s disease rating scale (MDS – UPDRS).We assessed the presence of different types of tremor in each patient, including RET, resting tremor, postural and kinetic tremor (action tremor). RET was defined as a tremor that appears in the outstretched upper limbs after at least 1 second while maintaining the posture. Latency and severity of RET were evaluated and we also investigated possible relationship with demographic and clinical features.

Results: RET was present in 42/210 patients. The mean latency of RET was 7.20 ± 6.5 seconds. The mean severity was 2.5 ± 1.9. RET was unilateral in 21/42 patients. By comparing patients with and without RET, we found that the two groups showed similar demographic features. Patients with RET showed less severe axial symptoms (speech and gait), upper limbs and global bradykinesia in comparison with patients without RET. Similar results were also present comparing patients with RET with patients with resting tremor associated with action tremor and without tremor.

Conclusions: Twenty percent of patients with PD showed RET. PD patients with RET have a less severe disease. Reference: Jankovic J, Schwartz KS, Ondo W. Re-emergent tremor of Parkinson’s disease. J NeurolNeurosurg Psychiatry 1999; 67:646-50.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/re-emergent-tremor-in-parkinsons-disease-epidemiological-and-clinical-features/