Abstract
BackgroundFacial (lip and jaw) tremor (FT) is associated with Parkinson’s disease (PD) but few studies have been conducted to explore its clinical profile. We performed this study to investigate the prevalence and clinical correlates of FT in PD, and further to evaluate its effect on disease progression.MethodsA retrospective, cross-sectional (n = 2224) and longitudinal (n = 674) study was conducted. The presence of FT was based on a ≥ 1 score in the United PD Rating Scale (UPDRS) item 20A. Group comparisons were conducted, followed by a forward binary logistic regression analysis. Inverse probability of treatment weighting (IPTW) based on the propensity score and weighted or unweighted Cox regression models were used to explore the impact of FT on five clinical milestones including death, UPDRS III 11-point increase, Hoehn and Yahr (H&Y) stage reaching 3, dyskinesia development, and Montreal Cognitive Assessment 3-point decrease.ResultsFT was presented in 403 patients (18.1%), which showed increasing trends with disease duration and H&Y score. Age (P < 0.001), female (P < 0.001), disease duration (P = 0.001), speech (P = 0.011), rigidity (P = 0.026), rest tremor on limbs (P < 0.001), kinetic tremor on hands (P < 0.001), and axial symptoms (P = 0.013) were independent factors associated with FT. Both unweighted and weighted Cox regression models indicated that baseline FT and FT as the initial symptom were not associated with the five outcomes.ConclusionsOur study suggested that FT was not uncommon and provided a deeper insight into the characteristics of FT in PD. The predict value of FT on long-term progronis of PD may need future longer follwe-up study.
Highlights
Facial tremor (FT) is associated with Parkinson’s disease (PD) but few studies have been conducted to explore its clinical profile
The smooth curves indicated that the prevalence of FT along with limbs tremor at rest or action/postural tremor of hands showed an increasing tendency with increased disease duration and Hoehn and Yahr (H&Y) stage (Fig. 1)
In looking for the clinical correlates of FT with other motor symptoms, we found that both rest and kinetic tremors on limbs were positively correlated with FT
Summary
Facial (lip and jaw) tremor (FT) is associated with Parkinson’s disease (PD) but few studies have been conducted to explore its clinical profile. We performed this study to investigate the prevalence and clinical correlates of FT in PD, and further to evaluate its effect on disease progression. Rest tremor is often less responsive to dopamine replacement therapy than bradykinesia and rigidity, and its responsiveness to dopaminergic treatment is quite variable among PD patients [8]. There is evidence that FT can respond to dopaminergic therapy and has predictive value for clinical PD diagnosis [4]. These controversial results suggest that dopamine deficiency alone may do not determine FT severity, and its response to dopaminergic therapy is likely influenced by multiple factors
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