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From the G.H. Sergievsky Center (Drs. Louis, Levy, Andrews, Ottman, and Marder, H. Mejia-Santana), Department of Neurology (Drs. Louis, Cote, Harris, Waters, Ford, Frucht, Fahn, and Marder, H. Mejia-Santana), Taub Institute for Alzheimer’s Disease and the Aging Brain (Drs. Louis and Marder), Department of Epidemiology (Dr. Ottman), and Department of Psychiatry (Drs. Andrews and Marder), Columbia University, New York, NY; and the Epidemiology of Brain Disorders Department (Dr. Ottman), New York State Psychiatric Institute, New York, NY.
Address correspondence and reprint requests to Dr. Elan Louis, Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032; e-mail: EDL2{at}columbia.edu
Background: Action tremor may be more prevalent in relatives of patients with Parkinson’s disease (PD) than in relatives of control subjects. This tremor could represent mild PD or essential tremor. An estimate of the risk of this condition in families of patients with PD is important when studying the genetics of PD.
Objectives: To determine the risk of action tremor in first-degree relatives of probands with tremor-dominant PD (TD-PD) and postural instability gait disorder PD (PIGD-PD) compared with first-degree relatives of control probands.
Methods: PD and control probands participated in a familial aggregation study of PD. The presence of action tremor in their relatives was ascertained from reports of one or more informants. Relatives who met diagnostic criteria for PD were excluded. Cox proportional hazards models adjusting for gender, education, race, and vital status (dead vs alive) of the relatives were used to assess the relative risk (RR) of action tremor in first-degree relatives of PD probands vs first-degree relatives of control probands.
Results: There were 487 PD probands, 409 control probands, and 5,563 relatives. The risk of action tremor was higher in the relatives of TD-PD probands than in the relatives of control probands (RR = 2.14; 95% CI = 1.53 to 2.98) but not in the relatives of PIGD-PD probands compared with the relatives of control probands (RR = 1.81; 95% CI = 0.66 to 5.02).
Conclusion: The risk of action tremor was increased in the relatives of PD probands, particularly when they had TD-PD. Whether the tremor in these relatives represents essential tremor or an isolated manifestation of PD requires further investigation.
Received March 19, 2003. Accepted in final form June 18, 2003.
This article has been cited by other articles:
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  J Benito-Leon, E D Louis, F Bermejo-Pareja, and on behalf of the Neurological Disorders in Central Risk of incident Parkinson's disease and parkinsonism in essential tremor: a population based study J. Neurol. Neurosurg. Psychiatry, April 1, 2009; 80(4): 423 - 425. [Abstract] [Full Text] [PDF]
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 J. E. Axelrad, E. D. Louis, L. S. Honig, I. Flores, G. W. Ross, R. Pahwa, K. E. Lyons, P. L. Faust, and J. P. G. Vonsattel Reduced Purkinje Cell Number in Essential Tremor: A Postmortem Study Arch Neurol, January 1, 2008; 65(1): 101 - 107. [Abstract] [Full Text] [PDF]
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 E. D. Louis, P. L. Faust, J.-P. G. Vonsattel, L. S. Honig, A. Rajput, C. A. Robinson, A. Rajput, R. Pahwa, K. E. Lyons, G.W. Ross, et al. Neuropathological changes in essential tremor: 33 cases compared with 21 controls Brain, December 1, 2007; 130(12): 3297 - 3307. [Abstract] [Full Text] [PDF]
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 M. A. Kilmore, E. P. Finnerty, W. H. Terry, and L. Shen A departmental outcome assessment to evaluate educational achievement. J Am Podiatr Med Assoc, September 1, 2006; 96(5): 448 - 454. [Abstract] [Full Text] [PDF]
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E. D. Louis, L. S. Honig, J. P. G. Vonsattel, D. M. Maraganore, S. Borden, and C. B. Moskowitz Essential Tremor Associated With Focal Nonnigral Lewy Bodies: A Clinicopathologic Study Arch Neurol, June 1, 2005; 62(6): 1004 - 1007. [Abstract] [Full Text] [PDF]
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K R. Chaudhuri, M Buxton-Thomas, V Dhawan, R Peng, C Meilak, and D J Brooks Long duration asymmetrical postural tremor is likely to predict development of Parkinson's disease and not essential tremor: clinical follow up study of 13 cases J. Neurol. Neurosurg. Psychiatry, January 1, 2005; 76(1): 115 - 117. [Abstract] [Full Text] [PDF]
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 R. Lencer, G. Eismann, M. Kasten, K. Kabakci, V. Geithe, J. Grimm, and C. Klein Family history of primary movement disorders as a predictor for neuroleptic-induced extrapyramidal symptoms The British Journal of Psychiatry, December 1, 2004; 185(6): 465 - 471. [Abstract] [Full Text] [PDF]
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 J. Jankovic, A. H. Rajput, C. A. Robinson, and A. H. Rajput Essential tremor course and disability: A clinicopathologic study of 20 cases Neurology, October 26, 2004; 63(8): 1541 - 1542. [Full Text] [PDF]
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G. Levy, E. D. Louis, H. Mejia-Santana, L. Cote, H. Andrews, J. Harris, C. Waters, B. Ford, S. Frucht, S. Fahn, et al. Lack of Familial Aggregation of Parkinson Disease and Alzheimer Disease Arch Neurol, July 1, 2004; 61(7): 1033 - 1039. [Abstract] [Full Text] [PDF]
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