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Background: Although managing symptoms is paramount for both essential tremor (ET) patients and their healthcare providers, studies of treatment satisfaction are surprisingly lacking. Objectives: We evaluated the satisfaction of patients who used a range of treatments and assessed the relation of a wide array of factors to satisfaction. Methods: One hundred four ET participants (age = 74.5 ± 10.2 years) completed a battery of self-report items. These included demographic information, measures of tremor and clinical history, psychological state, current ET treatment, and a series of questions about satisfaction with treatment. Results: Analyses of responses to the four current treatment satisfaction questions revealed that the proportion of participants who were satisfied ranged from 35.0% to 57.3% (i.e., approximately 1/3 to 1/2); conversely, the proportion who were dissatisfied ranged from 9.2% to 37.0%. The remainder were neutral. Higher satisfaction levels were observed in participants who were included in treatment selection and who had undergone deep brain stimulation surgery, p 's < 0.05. Lower levels of satisfaction were found in participants with a negative psychological state, higher self-rated tremor severity, head/voice/jaw tremors, and more severe physical side effects; and who used botulinum toxin therapy, p 's < 0.05. Conclusion: Between 1/3 and 1/2 of patients were satisfied with their treatment, whereas up to 1/3 were dissatisfied. In this initial exploration of correlates of treatment satisfaction in ET patients, we identified a number of associations between satisfaction and clinical, psychological and treatment variables. Additional research is warranted to further explore the nature of these relations over time. [ABSTRACT FROM AUTHOR]

Objective: Despite recent attention to cognitive impairment in essential tremor, few studies examine rates of conversion to diagnoses of mild cognitive impairment and dementia. Development of dementia in essential tremor is associated with loss of functional ability and a doubling of mortality rate. This prospective, longitudinal study comprehensively reports the prevalence and incidence of, and the annual rates of conversion to, mild cognitive impairment and dementia in an essential tremor cohort. Methods: Patients underwent detailed cognitive assessments and were assigned diagnoses of normal cognition, mild cognitive impairment, or dementia. There were 222 patients at baseline (mean age = 79.3 ± 9.7 years), and 177 patients participated in follow‐up evaluations at 18, 36, 54, and 72 months (mean years of observation = 5.1 ± 1.7). Data were compared to those of historical controls and Parkinson disease patients. Results: The cumulative prevalence of dementia and average annual conversion rate of mild cognitive impairment to dementia were 18.5% and 12.2%, nearly three times higher than rates in the general population, and approximately one half the magnitude of those reported for Parkinson disease patients. The cumulative prevalence of mild cognitive impairment (26.6%) was almost double that of the general population, but less than that in Parkinson disease populations. Interpretation: We present the most complete exposition of the longitudinal trajectory of cognitive impairment in an essential tremor cohort yet presented. The prevalence of and conversion rates to dementia in essential tremor fall between those associated with the natural course of aging and the more pronounced rates observed in Parkinson disease. ANN NEUROL 2024;95:1193–1204 [ABSTRACT FROM AUTHOR]

Background: Remote assessment of essential tremor (ET) is unverified. Objectives: To compare assigned tremor scores from a remote videotaped research protocol with those from an in‐person videotaped research protocol and assess the validity of remote and in‐person videotape‐based diagnoses when compared against the intake diagnosis (ET vs. control). Methods: Participants with intake diagnoses of ET (11) or controls (15) completed a tremor examination that was filmed both remotely and in person. Results: Agreement between the tremor ratings assigned during remote and in‐person videos was substantial (composite κw, 0.67; mean Gwet's AC2 score, 0.92; mean percent agreement, 63.7%). In ET cases with less severe tremor, agreement was lower (p = 0.008). Diagnostic validity was high for both remote and in‐person videos compared to the intake diagnosis. Conclusions: Remote video is a reasonable alternative to in‐person video for the assessment of tremor severity and assignment of ET diagnoses. However, at low tremor amplitudes, agreement declines. [ABSTRACT FROM AUTHOR]