Increased Prevalence of Non-motor Symptoms in Essential Tremor
Identifieur interne : 000B46 ( Pmc/Corpus ); précédent : 000B45; suivant : 000B47Increased Prevalence of Non-motor Symptoms in Essential Tremor
Auteurs : Annie Lacerte ; Sylvain Chouinard ; Nicolas Jodoin ; Geneviève Bernard ; Guy A. Rouleau ; Michel PanissetSource :
- Tremor and Other Hyperkinetic Movements [ 2160-8288 ] ; 2014.
Abstract
Cases with essential tremor (ET) have been described with Lewy body inclusions, the hallmark of Parkinson disease (PD). Patients with PD may suffer from anosmia, depression, constipation, and rapid eye movement sleep behavior disorder (RBD), sometimes years before the appearance of their motor syndrome. The objective of this study was to evaluate the prevalence of these non-motor Parkinson's associated symptoms in patients with ET.
Fifty ET subjects were contacted by phone and given questionnaires evaluating the presence or absence of anosmia, depression, constipation, and RBD. Frequencies of these symptoms were compared with their published prevalence in the general population.
Of the patients with ET, 4.5% reported having anosmia or hyposmia and 21.7% reported being constipated, similar to what is observed in the general population. Using a screening questionnaire for RBD, 43.5% of ET patients are possibly suffering from RBD, whereas in the general population prevalence is estimated to be 0.5%. Finally, depression was detected in 21.7% of ET patients; in the general population, prevalence is 5%.
Patients with ET seem to have more RBD and more depression than found in the general population. Prospective studies with normal control groups are needed to confirm these findings.
Url:
DOI: 10.7916/D82V2D91
PubMed: 25247108
PubMed Central: 4159683
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Increased Prevalence of Non-motor Symptoms in Essential Tremor</title><author><name sortKey="Lacerte, Annie" sort="Lacerte, Annie" uniqKey="Lacerte A" first="Annie" last="Lacerte">Annie Lacerte</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Chouinard, Sylvain" sort="Chouinard, Sylvain" uniqKey="Chouinard S" first="Sylvain" last="Chouinard">Sylvain Chouinard</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Jodoin, Nicolas" sort="Jodoin, Nicolas" uniqKey="Jodoin N" first="Nicolas" last="Jodoin">Nicolas Jodoin</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Bernard, Genevieve" sort="Bernard, Genevieve" uniqKey="Bernard G" first="Geneviève" last="Bernard">Geneviève Bernard</name><affiliation><nlm:aff id="aff2"><addr-line>Division of Pediatric Neurology, Montreal Children Hospital, McGill University, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Rouleau, Guy A" sort="Rouleau, Guy A" uniqKey="Rouleau G" first="Guy A." last="Rouleau">Guy A. Rouleau</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="aff3"><addr-line>CENUM, Centre de recherche du Centre Hospitalier de l’Université de Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25247108</idno><idno type="pmc">4159683</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159683</idno><idno type="RBID">PMC:4159683</idno><idno type="doi">10.7916/D82V2D91</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000B46</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000B46</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Increased Prevalence of Non-motor Symptoms in Essential Tremor</title><author><name sortKey="Lacerte, Annie" sort="Lacerte, Annie" uniqKey="Lacerte A" first="Annie" last="Lacerte">Annie Lacerte</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Chouinard, Sylvain" sort="Chouinard, Sylvain" uniqKey="Chouinard S" first="Sylvain" last="Chouinard">Sylvain Chouinard</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Jodoin, Nicolas" sort="Jodoin, Nicolas" uniqKey="Jodoin N" first="Nicolas" last="Jodoin">Nicolas Jodoin</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Bernard, Genevieve" sort="Bernard, Genevieve" uniqKey="Bernard G" first="Geneviève" last="Bernard">Geneviève Bernard</name><affiliation><nlm:aff id="aff2"><addr-line>Division of Pediatric Neurology, Montreal Children Hospital, McGill University, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Rouleau, Guy A" sort="Rouleau, Guy A" uniqKey="Rouleau G" first="Guy A." last="Rouleau">Guy A. Rouleau</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="aff3"><addr-line>CENUM, Centre de recherche du Centre Hospitalier de l’Université de Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author><author><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name><affiliation><nlm:aff id="aff1"><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></nlm:aff></affiliation></author></analytic><series><title level="j">Tremor and Other Hyperkinetic Movements</title><idno type="eISSN">2160-8288</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Cases with essential tremor (ET) have been described with Lewy body inclusions, the hallmark of Parkinson disease (PD). Patients with PD may suffer from anosmia, depression, constipation, and rapid eye movement sleep behavior disorder (RBD), sometimes years before the appearance of their motor syndrome. The objective of this study was to evaluate the prevalence of these non-motor Parkinson's associated symptoms in patients with ET.</p></sec><sec><title>Methods</title><p>Fifty ET subjects were contacted by phone and given questionnaires evaluating the presence or absence of anosmia, depression, constipation, and RBD. Frequencies of these symptoms were compared with their published prevalence in the general population.</p></sec><sec><title>Results</title><p>Of the patients with ET, 4.5% reported having anosmia or hyposmia and 21.7% reported being constipated, similar to what is observed in the general population. Using a screening questionnaire for RBD, 43.5% of ET patients are possibly suffering from RBD, whereas in the general population prevalence is estimated to be 0.5%. Finally, depression was detected in 21.7% of ET patients; in the general population, prevalence is 5%.</p></sec><sec><title>Discussion</title><p>Patients with ET seem to have more RBD and more depression than found in the general population. Prospective studies with normal control groups are needed to confirm these findings.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Benito Leon, J" uniqKey="Benito Leon J">J Benito-Leon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Benito Leon, J" uniqKey="Benito Leon J">J Benito-Leon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bermejo Pareja, F" uniqKey="Bermejo Pareja F">F Bermejo-Pareja</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koller, Wc" uniqKey="Koller W">WC Koller</name></author><author><name sortKey="Rubino, Fa" uniqKey="Rubino F">FA Rubino</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rajput, Ah" uniqKey="Rajput A">AH Rajput</name></author><author><name sortKey="Rozdilsky, B" uniqKey="Rozdilsky B">B Rozdilsky</name></author><author><name sortKey="Ang, L" uniqKey="Ang L">L Ang</name></author><author><name sortKey="Rajput, A" uniqKey="Rajput A">A Rajput</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cohen, O" uniqKey="Cohen O">O Cohen</name></author><author><name sortKey="Pullman, S" uniqKey="Pullman S">S Pullman</name></author><author><name sortKey="Jurewicz, E" uniqKey="Jurewicz E">E Jurewicz</name></author><author><name sortKey="Watner, D" uniqKey="Watner D">D Watner</name></author><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chouinard, S" uniqKey="Chouinard S">S Chouinard</name></author><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author><author><name sortKey="Fahn, S" uniqKey="Fahn S">S Fahn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jain, S" uniqKey="Jain S">S Jain</name></author><author><name sortKey="Lo, Se" uniqKey="Lo S">SE Lo</name></author><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Benito Leon, J" uniqKey="Benito Leon J">J Benito-Leon</name></author><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Applegate, Lm" uniqKey="Applegate L">LM Applegate</name></author><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author><author><name sortKey="Rios, E" uniqKey="Rios E">E Rios</name></author><author><name sortKey="Pellegrino, Km" uniqKey="Pellegrino K">KM Pellegrino</name></author><author><name sortKey="Jiang, W" uniqKey="Jiang W">W Jiang</name></author><author><name sortKey="Factor Litvak, P" uniqKey="Factor Litvak P">P Factor-Litvak</name></author><author><name sortKey="Zheng, W" uniqKey="Zheng W">W Zheng</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Quagliato, L" uniqKey="Quagliato L">L Quagliato</name></author><author><name sortKey="Viana, M" uniqKey="Viana M">M Viana</name></author><author><name sortKey="Quagliato, E" uniqKey="Quagliato E">E Quagliato</name></author><author><name sortKey="Simis, S" uniqKey="Simis S">S Simis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shah, M" uniqKey="Shah M">M Shah</name></author><author><name sortKey="Muhammed, N" uniqKey="Muhammed N">N Muhammed</name></author><author><name sortKey="Findley, Lj" uniqKey="Findley L">LJ Findley</name></author><author><name sortKey="Hawkes, Ch" uniqKey="Hawkes C">CH Hawkes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Busenbark, Kl" uniqKey="Busenbark K">KL Busenbark</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Miller, Km" uniqKey="Miller K">KM Miller</name></author><author><name sortKey="Okun, Ms" uniqKey="Okun M">MS Okun</name></author><author><name sortKey="Fernandez, Hf" uniqKey="Fernandez H">HF Fernandez</name></author><author><name sortKey="Jacobson, Ce" uniqKey="Jacobson C">CE Jacobson</name></author><author><name sortKey="Rodriguez, Rl" uniqKey="Rodriguez R">RL Rodriguez</name></author><author><name sortKey="Bowers, D" uniqKey="Bowers D">D Bowers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author><author><name sortKey="Benito Leon, J" uniqKey="Benito Leon J">J Benito-Leon</name></author><author><name sortKey="Bermejo Pareja, F" uniqKey="Bermejo Pareja F">F Bermejo-Pareja</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dogu, O" uniqKey="Dogu O">O Dogu</name></author><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author><author><name sortKey="Sevim, S" uniqKey="Sevim S">S Sevim</name></author><author><name sortKey="Kaleagasi, H" uniqKey="Kaleagasi H">H Kaleagasi</name></author><author><name sortKey="Aral, M" uniqKey="Aral M">M Aral</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Adler, Ch" uniqKey="Adler C">CH Adler</name></author><author><name sortKey="Hentz, Jg" uniqKey="Hentz J">JG Hentz</name></author><author><name sortKey="Shill, Ha" uniqKey="Shill H">HA Shill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koller, Wc" uniqKey="Koller W">WC Koller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lou, Js" uniqKey="Lou J">JS Lou</name></author><author><name sortKey="Jankovic, J" uniqKey="Jankovic J">J Jankovic</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Geraghty, Jj" uniqKey="Geraghty J">JJ Geraghty</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Benito Leon, J" uniqKey="Benito Leon J">J Benito-Leon</name></author><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author><author><name sortKey="Bermejo Pareja, F" uniqKey="Bermejo Pareja F">F Bermejo-Pareja</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vilari O Guell, C" uniqKey="Vilari O Guell C">C Vilariño-Güell</name></author><author><name sortKey="Ross, Oa" uniqKey="Ross O">OA Ross</name></author><author><name sortKey="Wider, C" uniqKey="Wider C">C Wider</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haubenberger, D" uniqKey="Haubenberger D">D Haubenberger</name></author><author><name sortKey="Hotzy, C" uniqKey="Hotzy C">C Hotzy</name></author><author><name sortKey="Pirker, W" uniqKey="Pirker W">W Pirker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Findley, Lj" uniqKey="Findley L">LJ Findley</name></author><author><name sortKey="Koller, Wc" uniqKey="Koller W">WC Koller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stiasny Kolster, K" uniqKey="Stiasny Kolster K">K Stiasny-Kolster</name></author><author><name sortKey="Mayer, G" uniqKey="Mayer G">G Mayer</name></author><author><name sortKey="Sch Fer, S" uniqKey="Sch Fer S">S Schäfer</name></author><author><name sortKey="Moller, Jc" uniqKey="Moller J">JC Möller</name></author><author><name sortKey="Heinzel Gutenbrunner, M" uniqKey="Heinzel Gutenbrunner M">M Heinzel-Gutenbrunner</name></author><author><name sortKey="Oertel, Wh" uniqKey="Oertel W">WH Oertel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suares, Nc" uniqKey="Suares N">NC Suares</name></author><author><name sortKey="Ford, Ac" uniqKey="Ford A">AC Ford</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thompson, Aw" uniqKey="Thompson A">AW Thompson</name></author><author><name sortKey="Liu, H" uniqKey="Liu H">H Liu</name></author><author><name sortKey="Hays, Rd" uniqKey="Hays R">RD Hays</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tumas, V" uniqKey="Tumas V">V Tumas</name></author><author><name sortKey="Rodrigues, Gg" uniqKey="Rodrigues G">GG Rodrigues</name></author><author><name sortKey="Farias, Tl" uniqKey="Farias T">TL Farias</name></author><author><name sortKey="Crippa, Ja" uniqKey="Crippa J">JA Crippa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schrag, A" uniqKey="Schrag A">A Schrag</name></author><author><name sortKey="Barone, P" uniqKey="Barone P">P Barone</name></author><author><name sortKey="Brown, Rg" uniqKey="Brown R">RG Brown</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mullol, J" uniqKey="Mullol J">J Mullol</name></author><author><name sortKey="Alobid, I" uniqKey="Alobid I">I Alobid</name></author><author><name sortKey="Marino Snachez, F" uniqKey="Marino Snachez F">F Marino-Snachez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ohayon, Mm" uniqKey="Ohayon M">MM Ohayon</name></author><author><name sortKey="Caulet, M" uniqKey="Caulet M">M Caulet</name></author><author><name sortKey="Priest, Rg" uniqKey="Priest R">RG Priest</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rihmer, Z" uniqKey="Rihmer Z">Z Rihmer</name></author><author><name sortKey="Angst, J" uniqKey="Angst J">J Angst</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gagnon, Jf" uniqKey="Gagnon J">JF Gagnon</name></author><author><name sortKey="Bedard, Ma" uniqKey="Bedard M">MA Bedard</name></author><author><name sortKey="Fantini, Ml" uniqKey="Fantini M">ML Fantini</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gjerstad, Md" uniqKey="Gjerstad M">MD Gjerstad</name></author><author><name sortKey="Boeve, B" uniqKey="Boeve B">B Boeve</name></author><author><name sortKey="Wentzel Larsen, T" uniqKey="Wentzel Larsen T">T Wentzel-Larsen</name></author><author><name sortKey="Aarsland, D" uniqKey="Aarsland D">D Aarsland</name></author><author><name sortKey="Larsen, Jp" uniqKey="Larsen J">JP Larsen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Plazzi, G" uniqKey="Plazzi G">G Plazzi</name></author><author><name sortKey="Corsini, R" uniqKey="Corsini R">R Corsini</name></author><author><name sortKey="Provini, F" uniqKey="Provini F">F Provini</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mckinnon, J" uniqKey="Mckinnon J">J McKinnon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author><author><name sortKey="Jurewicz, Ec" uniqKey="Jurewicz E">EC Jurewicz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Louis, Ed" uniqKey="Louis E">ED Louis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Doty, Rl" uniqKey="Doty R">RL Doty</name></author><author><name sortKey="Shaman, P" uniqKey="Shaman P">P Shaman</name></author><author><name sortKey="Dann, M" uniqKey="Dann M">M Dann</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Tremor Other Hyperkinet Mov (N Y)</journal-id><journal-id journal-id-type="iso-abbrev">Tremor Other Hyperkinet Mov (N Y)</journal-id><journal-id journal-id-type="publisher-id">TOHM</journal-id><journal-title-group><journal-title>Tremor and Other Hyperkinetic Movements</journal-title></journal-title-group><issn pub-type="epub">2160-8288</issn><publisher><publisher-name>Columbia University Libraries/Information Services</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25247108</article-id><article-id pub-id-type="pmc">4159683</article-id><article-id pub-id-type="doi">10.7916/D82V2D91</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Increased Prevalence of Non-motor Symptoms in Essential Tremor</article-title><alt-title alt-title-type="running-head">Non-motor Symptoms in Essential Tremor</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Lacerte</surname><given-names>Annie</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Chouinard</surname><given-names>Sylvain</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jodoin</surname><given-names>Nicolas</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bernard</surname><given-names>Geneviève</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Rouleau</surname><given-names>Guy A.</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Panisset</surname><given-names>Michel</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>André-Barbeau Movement Disorders Unit Service of Neurology, Centre Hospitalier de l’Université de Montréal and Department of Medicine, Université de Montréal, Montréal, Québec, Canada</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Division of Pediatric Neurology, Montreal Children Hospital, McGill University, Québec, Canada</addr-line></aff><aff id="aff3"><label>3</label><addr-line>CENUM, Centre de recherche du Centre Hospitalier de l’Université de Montréal, Québec, Canada</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Louis</surname><given-names>Elan D.</given-names></name></contrib></contrib-group><aff id="edit1"><addr-line>Columbia University, USA</addr-line></aff><author-notes><corresp id="cor1">*To whom correspondence should be addressed. E-mail: <email>michel.panisset@umontreal.ca</email></corresp></author-notes><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>2</day><month>9</month><year>2014</year></pub-date><volume>4</volume><elocation-id>162</elocation-id><history><date date-type="received"><day>27</day><month>2</month><year>2013</year></date><date date-type="accepted"><day>12</day><month>8</month><year>2014</year></date></history><permissions><copyright-year>2014</copyright-year><copyright-holder>Lacerte et al</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution–Noncommerical–No Derivatives License, which permits the user to copy, distribute, and transmit the work provided that the original author and source are credited; that no commercial use is made of the work; and that the work is not altered or transformed.</license-p></license></permissions><abstract><sec><title>Background</title><p>Cases with essential tremor (ET) have been described with Lewy body inclusions, the hallmark of Parkinson disease (PD). Patients with PD may suffer from anosmia, depression, constipation, and rapid eye movement sleep behavior disorder (RBD), sometimes years before the appearance of their motor syndrome. The objective of this study was to evaluate the prevalence of these non-motor Parkinson's associated symptoms in patients with ET.</p></sec><sec><title>Methods</title><p>Fifty ET subjects were contacted by phone and given questionnaires evaluating the presence or absence of anosmia, depression, constipation, and RBD. Frequencies of these symptoms were compared with their published prevalence in the general population.</p></sec><sec><title>Results</title><p>Of the patients with ET, 4.5% reported having anosmia or hyposmia and 21.7% reported being constipated, similar to what is observed in the general population. Using a screening questionnaire for RBD, 43.5% of ET patients are possibly suffering from RBD, whereas in the general population prevalence is estimated to be 0.5%. Finally, depression was detected in 21.7% of ET patients; in the general population, prevalence is 5%.</p></sec><sec><title>Discussion</title><p>Patients with ET seem to have more RBD and more depression than found in the general population. Prospective studies with normal control groups are needed to confirm these findings.</p></sec></abstract><kwd-group><kwd>Essential tremor</kwd><kwd>depression</kwd><kwd>constipation</kwd><kwd>rapid eye movement sleep behavior disorder</kwd><kwd>anosmia</kwd></kwd-group><counts><page-count count="5"></page-count></counts></article-meta></front><body><sec sec-type="intro" id="s1"><title>Introduction</title><p>Essential tremor (ET) is the most prevalent movement disorder, with a prevalence of 4–5.6% (age ≥40 years) that increases with age,<xref rid="b01" ref-type="bibr">1</xref>,<xref rid="b02" ref-type="bibr">2</xref> yet some aspects of its clinical manifestations need clarification. ET is classically defined as a disease with exclusively motor features. The cornerstone characteristic of ET is an 8–12 Hz kinetic tremor of both upper limbs (90–95%), which can be asymmetrical, and may be accompanied by head (30%), legs (10–15%), and voice (20%) tremors.<xref rid="b03" ref-type="bibr">3</xref> The population of ET patients is phenotypically heterogeneous; not every patient develops head tremor, and some patients even develop rest tremor,<xref rid="b04" ref-type="bibr">4</xref>–<xref rid="b06" ref-type="bibr">6</xref> a feature highly characteristic of PD patients. In fact, ET is so heterogeneous that it is probably the most commonly misdiagnosed neurological disorder.<xref rid="b07" ref-type="bibr">7</xref> Some studies have found that up to 30–50% of patients with an ET diagnosis actually do not have ET.<xref rid="b08" ref-type="bibr">8</xref></p><p>Recently, several studies have uncovered non-motor features of ET,<xref rid="b09" ref-type="bibr">9</xref> including decreased olfaction, depression, and rapid eye movement sleep behavior disorder (RBD). Amongst the studies that evaluated olfaction in ET patients, some have found a decrease,<xref rid="b10" ref-type="bibr">10</xref>,<xref rid="b11" ref-type="bibr">11</xref> although others did not.<xref rid="b12" ref-type="bibr">12</xref>–<xref rid="b14" ref-type="bibr">14</xref> The co-occurrence of ET and depression has been observed with a high frequency.<xref rid="b15" ref-type="bibr">15</xref>–<xref rid="b18" ref-type="bibr">18</xref> Only one study has evaluated the prevalence of RBD in ET patients<xref rid="b19" ref-type="bibr">19</xref> and found no evidence of an increased incidence of RBD. Finally, no study has evaluated the occurrence of constipation in ET patients.</p><p>Recent analysis of ET brains has unveiled two types of changes that possibly indicate two different mechanisms for the pathogenesis of ET.<xref rid="b20" ref-type="bibr">20</xref> Approximately 75% of the studied brains have cerebellar changes (torpedo cells), whereas other brains had Lewy bodies in the locus ceruleus, defining a “Lewy bodies ET” subtype. A link between PD and ET has been debated for years and the relationship between the two disorders is still unclear. Pre-existing ET is a risk factor for the development of PD, the risk being slightly to highly increased depending on the study,<xref rid="b21" ref-type="bibr">21</xref>–<xref rid="b23" ref-type="bibr">23</xref> with a fourfold increased risk being a figure commonly accepted.<xref rid="b24" ref-type="bibr">24</xref> The two diseases may have a common genetic background: genome-wide association studies have found specific single nucleotide polymorphism in the <italic>leucine-rich repeat and Ig containing</italic> 1 gene (<italic>LINGO1</italic>) as a risk for both PD and ET,<xref rid="b25" ref-type="bibr">25</xref> providing a genetic link between the two disorders, whereas others studies did not.<xref rid="b26" ref-type="bibr">26</xref></p><p>Obviously, even though ET is the most prevalent movement disorder, we have limited knowledge regarding its pathogenesis, its relationship to PD, and its non-motor features are just starting to be unveiled. We thus hypothesized that ET patients may have a higher prevalence of pre-clinical features that are associated with PD, namely depression, anosmia, constipation, and RBD.</p></sec><sec sec-type="methods" id="s2"><title>Methods</title><sec id="s2a"><title>Study population</title><p>Consecutive patients from a list of patients who had previously participated in a field survey about ET were contacted by phone and verbal informed consent was obtained. Diagnosis of ET had been previously made by a movement disorder specialist, based on specific criteria according to the Tremor Investigation Group (TRIG),<xref rid="b27" ref-type="bibr">27</xref> which classify the degree of diagnosis certainty as confirmed, probable, or possible. Only participants who received a diagnosis of ET were contacted. Calls were carried out from June 30, 2011, to July 15, 2011. This study was approved by the research and ethics board of the University of Montreal Health Centre.</p></sec><sec id="s2b"><title>Evaluation of subjects</title><p>The following information was updated and recorded for each contacted subject, either from patient records or direct questioning: brief medical history, current drugs, alcohol intake, and smoking status. In order to evaluate olfactory function, RBD, constipation, and depression, the following questionnaires were performed by telephone interview.</p><sec id="s2b1"><title>Olfaction</title><p>Since no questionnaire is available to evaluate olfaction, we evaluated olfaction by simply asking patients if they have noted a change in their ability to smell or taste.</p></sec><sec id="s2b2"><title>Rapid eye movement sleep behavior disorder</title><p>We used the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ).<xref rid="b28" ref-type="bibr">28</xref> The RBDSQ is a 10-item instrument that assesses the subject's sleep behavior with short questions that have to be answered by yes or no. This questionnaire addresses 1) the frequency and contents of dreams and their relationship to movements during sleep, 2) self-injuries and injuries to the bed partner, 3) motor behavior while asleep (talking, sudden movements), 4) awakening and disturbed sleep and finally, 5) the presence of any neurological disorder. The cut-off for a positive test result is ≥5 with a sensitivity of 96% and a specificity of 92%.</p></sec><sec id="s2b3"><title>Constipation</title><p>The diagnosis of functional constipation was based on the Rome III diagnostic criteria.<xref rid="b29" ref-type="bibr">29</xref> The diagnosis criteria must include two or more of the following items for at least 25% of defecations: 1) straining, 2) lumpy or hard stools, 3) sensation of incomplete evacuation, 4) sensation of anorectal obstruction/blockade, 5) manual maneuvers to facilitate defecations, 6) fewer than three defecations per week. Moreover, loose stools are merely present without laxative use. The symptoms above should be present for the last 3 months and have started at least 6 months prior to diagnosis. Participants who received a diagnosis of constipation and were treated with laxatives were also considered as having constipation.</p></sec><sec id="s2b4"><title>Depression</title><p>We used the geriatric depression scale-15 (GDS-15)<xref rid="b30" ref-type="bibr">30</xref>,<xref rid="b31" ref-type="bibr">31</xref> to screen for the presence of current depression in ET patients. This is a 15-item yes/no questionnaire that does not focus on somatic symptoms and has no question on suicide. A score between 5 and 9 was categorized as a minor depressive disorder and a score of 10 and above as a major depressive disorder.<xref rid="b32" ref-type="bibr">32</xref> We also asked whether patients were diagnosed with depression in their past.</p><p>Prevalence of anosmia, depression, constipation and RBD were obtained through a literature review. These data were thus used as a historical control.</p></sec></sec><sec id="s2c"><title>Statistical analysis</title><p>Statistical analyses were performed in SPSS (Version 17.0), using Student's t-tests and chi-square tests to compare female and male subjects.</p></sec></sec><sec sec-type="results" id="s3"><title>Results</title><sec id="s3a"><title>Study sample description</title><p>We contacted 63 patients. One patient was not able to complete the telephone interview because of a hearing deficit. Another patient refused to participate and did not provide any reason. One patient was deceased, and, finally, 14 patients did not return our calls. Of these there were 10 males and four females. The mean age of these 14 patients was 50±17 years. Forty-six participants completed the questionnaires. More females (33 [71.7%]) were interviewed than males (13 [28.3%]). The mean age of the participants was 57.17±19.48 years, with a range of 13–86 years. Mean duration of ET of our subjects was 24.67±19.80 years and mean age of onset of ET was 31.49±22.57. There were no significant differences between female and male subgroups (<xref ref-type="table" rid="t01">Table 1</xref>) in terms of age at the time of the interview (p = 0.395), duration of ET (p = 0.102), age of onset of ET (p = 0.426), ET diagnosis (p = 0.559), dominance (p = 0.788), alcohol intake (p = 0.496), caffeine consumption (p = 0.523), and tobacco use (p = 0.351).</p><p><table-wrap id="t01" orientation="portrait" position="float"><label>Table 1</label><caption><title>Demographic Data</title></caption><table frame="hsides" rules="groups" width="95%"><thead style="border-bottom: thin solid; border-top: thin solid; border-color: #000000"><tr><th rowspan="1" colspan="1">Variables</th><th rowspan="1" colspan="1">Female (71.7%) (n = 33)</th><th rowspan="1" colspan="1">Male (28.3%) (n = 13)</th><th rowspan="1" colspan="1">Total (n = 46)</th></tr></thead><tbody style="border-color: #000000; border-bottom: thin solid"><tr><td align="center" rowspan="1" colspan="1">Age in years, m±s (range)</td><td align="center" rowspan="1" colspan="1">58.73±19.55 (13–86)</td><td align="center" rowspan="1" colspan="1">53.23±19.48 (20–75)</td><td align="center" rowspan="1" colspan="1">57.17±19.48 (13–86)</td></tr><tr><td align="center" rowspan="1" colspan="1">Duration of ET, m±s (range)</td><td align="center" rowspan="1" colspan="1">27.84±19.32 (3–66)</td><td align="center" rowspan="1" colspan="1">17.54±17.23 (3–59)</td><td align="center" rowspan="1" colspan="1">24.87±19.14 (3–66)</td></tr><tr><td align="center" rowspan="1" colspan="1">Age of onset, m±s (range)</td><td align="center" rowspan="1" colspan="1">29.78±22.97 (1–75)</td><td align="center" rowspan="1" colspan="1">35.69±21.84 (10–69)</td><td align="center" rowspan="1" colspan="1">31.49±22.57 (1–75)</td></tr><tr><td align="center" rowspan="1" colspan="1">ET diagnosis, n (%)</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="center" rowspan="1" colspan="1">•Confirmed</td><td align="center" rowspan="1" colspan="1">14 (42.42)</td><td align="center" rowspan="1" colspan="1">5 (38.46)</td><td align="center" rowspan="1" colspan="1">19 (41.3)</td></tr><tr><td align="center" rowspan="1" colspan="1">•Probable</td><td align="center" rowspan="1" colspan="1">6 (18.18)</td><td align="center" rowspan="1" colspan="1">5 (38.46)</td><td align="center" rowspan="1" colspan="1">11 (23.9)</td></tr><tr><td align="center" rowspan="1" colspan="1">•Possible</td><td align="center" rowspan="1" colspan="1">10 (30.30)</td><td align="center" rowspan="1" colspan="1">3 (23.07)</td><td align="center" rowspan="1" colspan="1">13 (28.3)</td></tr><tr><td align="center" rowspan="1" colspan="1">•Others</td><td align="center" rowspan="1" colspan="1">3 (9.09)</td><td align="center" rowspan="1" colspan="1">0 (0)</td><td align="center" rowspan="1" colspan="1">3 (6.5)</td></tr><tr><td align="center" rowspan="1" colspan="1">Dominance, n (%)</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="center" rowspan="1" colspan="1">•Right</td><td align="center" rowspan="1" colspan="1">26 (78.8)</td><td align="center" rowspan="1" colspan="1">11 (84.6)</td><td align="center" rowspan="1" colspan="1">37 (80.4)</td></tr><tr><td align="center" rowspan="1" colspan="1">•Left</td><td align="center" rowspan="1" colspan="1">5 (15.2)</td><td align="center" rowspan="1" colspan="1">1 (7.7)</td><td align="center" rowspan="1" colspan="1">6 (13)</td></tr><tr><td align="center" rowspan="1" colspan="1">•Ambidextrous</td><td align="center" rowspan="1" colspan="1">2 (6.1)</td><td align="center" rowspan="1" colspan="1">1 (7.7)</td><td align="center" rowspan="1" colspan="1">3 (6.5)</td></tr><tr><td align="center" rowspan="1" colspan="1">Alcohol consumers, n (%)</td><td align="center" rowspan="1" colspan="1">22 (66.7)</td><td align="center" rowspan="1" colspan="1">10 (76.9)</td><td align="center" rowspan="1" colspan="1">32 (69.6)</td></tr><tr><td align="center" rowspan="1" colspan="1">Caffeine consumers, n (%)</td><td align="center" rowspan="1" colspan="1">28 (84.8)</td><td align="center" rowspan="1" colspan="1">10 (76.9)</td><td align="center" rowspan="1" colspan="1">38 (82.6)</td></tr><tr><td align="center" rowspan="1" colspan="1">Smokers, n (%)</td><td align="center" rowspan="1" colspan="1">6 (18.2)</td><td align="center" rowspan="1" colspan="1">4 (30.8)</td><td align="center" rowspan="1" colspan="1">10 (21.7)</td></tr></tbody></table><table-wrap-foot><fn id="TFN01t01"><p>ET, Essential Tremor; m, Mean, s, Standard Deviation.</p></fn></table-wrap-foot></table-wrap></p></sec><sec id="s3b"><title>Non-motor symptoms</title><p><xref ref-type="table" rid="t02">Table 2</xref> summarizes the non-motor symptoms. In our sample of 46 patients, two participants reported olfaction change or loss (4.5%). A substantial number of subjects (20 patients or 43.5% of the sample) reach the positive cut-off of 5 at the RBDSQ, suggesting that they might be affected by RBD. When looking at the sex of the RBD-positive subjects, 14 (70%) were females while 6 (30%) were males.</p><p><table-wrap id="t02" orientation="portrait" position="float"><label>Table 2</label><caption><title>Non-Motor Symptoms in Participants with Essential Tremor</title></caption><table frame="hsides" rules="groups" width="95%"><thead style="border-bottom: thin solid; border-top: thin solid; border-color: #000000"><tr><th rowspan="1" colspan="1">Non-Motor Symptoms</th><th rowspan="1" colspan="1">Total (n = 46)</th><th rowspan="1" colspan="1">General Population (% only)</th></tr></thead><tbody style="border-color: #000000; border-bottom: thin solid"><tr><td align="center" rowspan="1" colspan="1">Olfaction change/loss, n (%)</td><td align="center" rowspan="1" colspan="1">2 (4.5)</td><td align="center" rowspan="1" colspan="1">1.6%<xref rid="b33" ref-type="bibr">33</xref></td></tr><tr><td align="center" rowspan="1" colspan="1">RBD, n (%)</td><td align="center" rowspan="1" colspan="1">20 (43.5)</td><td align="center" rowspan="1" colspan="1">0.5%<xref rid="b34" ref-type="bibr">34</xref></td></tr><tr><td align="center" rowspan="1" colspan="1">Constipation, n (%)</td><td align="center" rowspan="1" colspan="1">10 (21.7)</td><td align="center" rowspan="1" colspan="1">19.4%<xref rid="b29" ref-type="bibr">29</xref></td></tr><tr><td align="center" rowspan="1" colspan="1">Depression, n (%)</td><td align="center" rowspan="1" colspan="1">10 (21.7)</td><td align="center" rowspan="1" colspan="1">5%<xref rid="b35" ref-type="bibr">35</xref></td></tr><tr><td align="center" rowspan="1" colspan="1">Previous depression, n (%)</td><td align="center" rowspan="1" colspan="1">17 (37)</td><td align="center" rowspan="1" colspan="1">17%<xref rid="b35" ref-type="bibr">35</xref></td></tr></tbody></table><table-wrap-foot><fn id="TFN01t02"><p>RBD, Rapid Eye Movement Sleep Behavior Disorder.</p></fn></table-wrap-foot></table-wrap></p><p>Regarding the occurrence of constipation in our sample, nine subjects met the ROME III criteria while one patient reported using laxatives (without a concomitant constipation history), for a total of 10 subjects (21.7%). More women (eight) suffered from constipation than men (two).</p><p>Nine participants (19.6%) scored between five and nine on the GDS-15 test, suggesting a minor depressive disorder, whereas one patient (2.2%) scored above 10, suggesting major depressive disorder. The male/female ratio in our sample was 3:7. In addition, 17 patients (37%) reported previous diagnosis of depression, 14 of them being female patients.</p></sec></sec><sec sec-type="discussion" id="s4"><title>Discussion</title><p>In our sample of 46 patients with ET, we found a higher prevalence of RBD, and depression but not of anosmia or constipation.</p><p>A positive score for RBD was obtained in 43.5% of the subjects. Of note, two of our patients reported suffering from sleep apnea; the effect of this concomitant condition on the specificity of the RBDSQ is currently unknown.<xref rid="b28" ref-type="bibr">28</xref></p><p>Interestingly, this number is very high compared to the prevalence in the general population which is estimated at 0.5%.<xref rid="b34" ref-type="bibr">34</xref> So far, only one other group has evaluated the prevalence of RBD in ET patients, using a different questionnaire, and found no evidence of an increased frequency of RBD.<xref rid="b19" ref-type="bibr">19</xref> In this study, probable RBD diagnosis was assigned to subjects on the basis of a unique question assessing dream acting only. As the questionnaire used in our study evaluates most aspects of RBD, its sensitivity and specificity are high, as determined by Stiasny-Kolster.<xref rid="b28" ref-type="bibr">28</xref></p><p>The prevalence of RBD is of course also much higher in patients with α-synucleinopathies: Parkinson's disease (between 14.6% and 33%<xref rid="b36" ref-type="bibr">36</xref>,<xref rid="b37" ref-type="bibr">37</xref>), and multiple system atrophy (69%<xref rid="b38" ref-type="bibr">38</xref>). This is comparable with the prevalence that we obtained in our survey and could support involvement of the same brainstem structures that are responsible for this sleep disorder, or perhaps similar synuclein pathology.</p><p>In our subjects, 21.7% were depressed and 37% had a depression history, which is higher than the 5% and 17% lifetime prevalence in the general population.<xref rid="b35" ref-type="bibr">35</xref> Most patients with a history of depression developed ET at a young age (before 41). A twofold greater depression prevalence in females than in males was observed in our sample, which is also commonly reported in the general population.<xref rid="b35" ref-type="bibr">35</xref> A previous study had found that 34% of ET patients were at least mildly depressed, according to the Beck Depression Inventory (BDI).<xref rid="b15" ref-type="bibr">15</xref> In the same study, 48% of PD patients were found to be depressed. In our cohort, the prevalence of depression is thus in between that of the general population and the PD population.</p><p>In our study, two patients out of 46 (4.5%) reported anosmia/hyposmia whereas in the general population, self-reported prevalence of anosmia/hyposmia is 1.6%.<xref rid="b33" ref-type="bibr">33</xref> Most studies have not found hyposmia in ET patients,<xref rid="b12" ref-type="bibr">12</xref>,<xref rid="b13" ref-type="bibr">13</xref>,<xref rid="b39" ref-type="bibr">39</xref> whereas other studies have shown a small diminution of olfaction,<xref rid="b10" ref-type="bibr">10</xref>,<xref rid="b11" ref-type="bibr">11</xref>,<xref rid="b40" ref-type="bibr">40</xref>,<xref rid="b41" ref-type="bibr">41</xref> albeit to a lesser degree than in PD patients. The number that we found may be an underestimate since decreased olfactory function is likely often subclinical.<xref rid="b10" ref-type="bibr">10</xref>,<xref rid="b11" ref-type="bibr">11</xref>,<xref rid="b40" ref-type="bibr">40</xref>,<xref rid="b41" ref-type="bibr">41</xref></p><p>We also did not find different rates of constipation in our patients compared to the general population: 21.7% of our subjects presented constipation, whereas constipation occurs in up to 27% of people depending on demographic factors, and the constipation definition used to perform the study.<xref rid="b29" ref-type="bibr">29</xref></p><p>It remains unclear why both depression and RBD are so common in ET patients. Are these markers more specific to ET than constipation and olfaction deficit? Are they specific to brainstem structures involved in ET by Lewy bodies?</p><p>This study has a number of important limitations but we feel it provides some preliminary data that would be interesting to pursue with prospective studies using a larger number of patients, including a matched control group for age and sex, among other things. Also, using a validated questionnaire against more definitive measures such as polysomnography to confirm RBD and smell tests for anosmia would increase the reliability.<xref rid="b42" ref-type="bibr">42</xref></p></sec></body><back><fn-group><fn fn-type="supported-by"><p><bold>Funding:</bold> None.</p></fn><fn fn-type="financial-disclosure"><p><bold>Financial Disclosures:</bold> G.A.R. holds the Canada Research Chair and a Jeanne-et-J.-Louis-Levesque Chair for the Genetics of Brain Diseases.</p></fn><fn fn-type="conflict"><p><bold>Conflict of Interests:</bold> The authors report no conflict of interest.</p></fn></fn-group><ref-list><title>References</title><ref id="b01"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Benito-Leon</surname><given-names>J</given-names></name></person-group><article-title>Incidence of essential tremor in three elderly populations of central Spain</article-title><source>Neurology</source><year>2005</year><volume>64</volume><fpage>1721</fpage><lpage>5</lpage><pub-id pub-id-type="doi">10.1212/01.WNL.0000161852.70374.01</pub-id><pub-id pub-id-type="pmid">15911798</pub-id></element-citation></ref><ref id="b02"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Benito-Leon</surname><given-names>J</given-names></name></person-group><article-title>Prevalence of essential tremor in three elderly populations of central Spain</article-title><source>Mov Disord</source><year>2003</year><volume>18</volume><fpage>389</fpage><lpage>94</lpage><pub-id pub-id-type="doi">10.1002/mds.10376</pub-id><pub-id pub-id-type="pmid">12671944</pub-id></element-citation></ref><ref id="b03"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bermejo-Pareja</surname><given-names>F</given-names></name></person-group><article-title>Essential tremor–a neurodegenerative disorder associated with cognitive defects?</article-title><source>Nat Rev Neurol</source><year>2011</year><volume>7</volume><fpage>273</fpage><lpage>82</lpage><pub-id pub-id-type="doi">10.1038/nrneurol.2011.44</pub-id><pub-id pub-id-type="pmid">21487422</pub-id></element-citation></ref><ref id="b04"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Koller</surname><given-names>WC</given-names></name><name><surname>Rubino</surname><given-names>FA</given-names></name></person-group><article-title>Combined resting-postural tremors</article-title><source>Arch Neurol</source><year>1985</year><volume>42</volume><fpage>683</fpage><lpage>4</lpage><pub-id pub-id-type="doi">10.1001/archneur.1985.04060070073019</pub-id><pub-id pub-id-type="pmid">4015465</pub-id></element-citation></ref><ref id="b05"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rajput</surname><given-names>AH</given-names></name><name><surname>Rozdilsky</surname><given-names>B</given-names></name><name><surname>Ang</surname><given-names>L</given-names></name><name><surname>Rajput</surname><given-names>A</given-names></name></person-group><article-title>Significance of parkinsonian manifestations in essential tremor</article-title><source>Can J Neurol Sci</source><year>1993</year><volume>20</volume><fpage>114</fpage><lpage>7</lpage><pub-id pub-id-type="pmid">8334571</pub-id></element-citation></ref><ref id="b06"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cohen</surname><given-names>O</given-names></name><name><surname>Pullman</surname><given-names>S</given-names></name><name><surname>Jurewicz</surname><given-names>E</given-names></name><name><surname>Watner</surname><given-names>D</given-names></name><name><surname>Louis</surname><given-names>ED</given-names></name></person-group><article-title>Rest tremor in patients with essential tremor: Prevalence, clinical correlates, and electrophysiologic characteristics</article-title><source>Arch Neurol</source><year>2003</year><volume>60</volume><fpage>405</fpage><lpage>10</lpage><pub-id pub-id-type="doi">10.1001/archneur.60.3.405</pub-id><pub-id pub-id-type="pmid">12633153</pub-id></element-citation></ref><ref id="b07"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chouinard</surname><given-names>S</given-names></name><name><surname>Louis</surname><given-names>ED</given-names></name><name><surname>Fahn</surname><given-names>S</given-names></name></person-group><article-title>Agreement among movement disorder specialists on the clinical diagnosis of essential tremor</article-title><source>Movement Disorders</source><year>1997</year><volume>12</volume><fpage>973</fpage><lpage>6</lpage><pub-id pub-id-type="doi">10.1002/mds.870120621</pub-id><pub-id pub-id-type="pmid">9399223</pub-id></element-citation></ref><ref id="b08"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jain</surname><given-names>S</given-names></name><name><surname>Lo</surname><given-names>SE</given-names></name><name><surname>Louis</surname><given-names>ED</given-names></name></person-group><article-title>Common misdiagnosis of a common neurological disorder: How are we misdiagnosing essential tremor?</article-title><source>Arch Neurol</source><year>2006</year><volume>63</volume><fpage>1100</fpage><lpage>4</lpage><pub-id pub-id-type="doi">10.1001/archneur.63.8.1100</pub-id><pub-id pub-id-type="pmid">16908735</pub-id></element-citation></ref><ref id="b09"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Benito-Leon</surname><given-names>J</given-names></name><name><surname>Louis</surname><given-names>ED</given-names></name></person-group><article-title>Essential tremor: Emerging views of a common disorder</article-title><source>Nat Clin Pract Neurol</source><year>2006</year><volume>2</volume><fpage>666</fpage><lpage>78</lpage><pub-id pub-id-type="doi">10.1038/ncpneuro0347</pub-id><pub-id pub-id-type="pmid">17117170</pub-id></element-citation></ref><ref id="b10"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Applegate</surname><given-names>LM</given-names></name><name><surname>Louis</surname><given-names>ED</given-names></name></person-group><article-title>Essential tremor: Mild olfactory dysfunction in a cerebellar disorder</article-title><source>Parkinsonism Relat Disord</source><year>2005</year><volume>11</volume><fpage>399</fpage><lpage>402</lpage><pub-id pub-id-type="doi">10.1016/j.parkreldis.2005.03.003</pub-id><pub-id pub-id-type="pmid">16102998</pub-id></element-citation></ref><ref id="b11"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Louis</surname><given-names>ED</given-names></name><name><surname>Rios</surname><given-names>E</given-names></name><name><surname>Pellegrino</surname><given-names>KM</given-names></name><name><surname>Jiang</surname><given-names>W</given-names></name><name><surname>Factor-Litvak</surname><given-names>P</given-names></name><name><surname>Zheng</surname><given-names>W</given-names></name></person-group><article-title>Higher blood harmane (1-methyl-9H-pyrido[3,4-b]indole) concentrations correlate with lower olfactory scores in essential tremor</article-title><source>Neurotoxicology</source><year>2008</year><volume>29</volume><fpage>460</fpage><lpage>5</lpage><pub-id pub-id-type="doi">10.1016/j.neuro.2008.02.013</pub-id><pub-id pub-id-type="pmid">18417221</pub-id></element-citation></ref><ref id="b12"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Quagliato</surname><given-names>L</given-names></name><name><surname>Viana</surname><given-names>M</given-names></name><name><surname>Quagliato</surname><given-names>E</given-names></name><name><surname>Simis</surname><given-names>S</given-names></name></person-group><article-title>Olfaction and essential tremor</article-title><source>Arq Neuropsiquiatr</source><year>2009</year><volume>67</volume><fpage>21</fpage><lpage>4</lpage><pub-id pub-id-type="doi">10.1590/S0004-282X2009000100006</pub-id><pub-id pub-id-type="pmid">19330204</pub-id></element-citation></ref><ref id="b13"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Shah</surname><given-names>M</given-names></name><name><surname>Muhammed</surname><given-names>N</given-names></name><name><surname>Findley</surname><given-names>LJ</given-names></name><name><surname>Hawkes</surname><given-names>CH</given-names></name></person-group><article-title>Olfactory tests in the diagnosis of essential tremor</article-title><source>Parkinsonism Relat Disord</source><year>2008</year><volume>14</volume><fpage>563</fpage><lpage>8</lpage><pub-id pub-id-type="doi">10.1016/j.parkreldis.2007.12.006</pub-id><pub-id pub-id-type="pmid">18321760</pub-id></element-citation></ref><ref id="b14"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Busenbark</surname><given-names>KL</given-names></name></person-group><article-title>Olfactory dysfunction in essential tremor</article-title><source>Neurology</source><year>1992</year><volume>42</volume><fpage>1631</fpage><lpage>2</lpage><pub-id pub-id-type="doi">10.1212/WNL.42.8.1631</pub-id><pub-id pub-id-type="pmid">1641163</pub-id></element-citation></ref><ref id="b15"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Miller</surname><given-names>KM</given-names></name><name><surname>Okun</surname><given-names>MS</given-names></name><name><surname>Fernandez</surname><given-names>HF</given-names></name><name><surname>Jacobson</surname><given-names>CE</given-names></name><name><surname>Rodriguez</surname><given-names>RL</given-names></name><name><surname>Bowers</surname><given-names>D</given-names></name></person-group><article-title>Depression symptoms in movement disorders: Comparing Parkinson's disease, dystonia, and essential tremor</article-title><source>Movement Disorders</source><year>2007</year><volume>22</volume><fpage>666</fpage><lpage>72</lpage><pub-id pub-id-type="doi">10.1002/mds.21376</pub-id><pub-id pub-id-type="pmid">17266084</pub-id></element-citation></ref><ref id="b16"><label>16</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Louis</surname><given-names>ED</given-names></name><name><surname>Benito-Leon</surname><given-names>J</given-names></name><name><surname>Bermejo-Pareja</surname><given-names>F</given-names></name></person-group><article-title>Self-reported depression and anti-depressant medication use in essential tremor: Cross-sectional and prospective analyses in a population-based study</article-title><source>Eur J Neurol</source><year>2007</year><volume>14</volume><fpage>1138</fpage><lpage>46</lpage><pub-id pub-id-type="doi">10.1111/j.1468-1331.2007.01923.x</pub-id><pub-id pub-id-type="pmid">17708753</pub-id></element-citation></ref><ref id="b17"><label>17</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dogu</surname><given-names>O</given-names></name><name><surname>Louis</surname><given-names>ED</given-names></name><name><surname>Sevim</surname><given-names>S</given-names></name><name><surname>Kaleagasi</surname><given-names>H</given-names></name><name><surname>Aral</surname><given-names>M</given-names></name></person-group><article-title>Clinical characteristics of essential tremor in Mersin, Turkey–a population-based door-to-door study</article-title><source>J Neurol</source><year>2005</year><volume>252</volume><fpage>570</fpage><lpage>4</lpage><pub-id pub-id-type="doi">10.1007/s00415-005-0700-8</pub-id><pub-id pub-id-type="pmid">15778813</pub-id></element-citation></ref><ref id="b18"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Louis</surname><given-names>ED</given-names></name></person-group><article-title>Correlates of functional disability in essential tremor</article-title><source>Mov Disord</source><year>2001</year><volume>16</volume><fpage>914</fpage><lpage>20</lpage><pub-id pub-id-type="doi">10.1002/mds.1184</pub-id><pub-id pub-id-type="pmid">11746622</pub-id></element-citation></ref><ref id="b19"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Adler</surname><given-names>CH</given-names></name><name><surname>Hentz</surname><given-names>JG</given-names></name><name><surname>Shill</surname><given-names>HA</given-names></name><etal>et al</etal></person-group><article-title>Probable RBD is increased in Parkinson's disease but not in essential tremor or restless legs syndrome</article-title><source>Parkinsonism Relat Disord</source><year>2011</year></element-citation></ref><ref id="b20"><label>20</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Louis</surname><given-names>ED</given-names></name></person-group><article-title>Essential tremor: Evolving clinicopathological concepts in an era of intensive post-mortem enquiry</article-title><source>Lancet Neurol</source><year>2010</year><volume>9</volume><fpage>613</fpage><lpage>22</lpage><pub-id pub-id-type="doi">10.1016/S1474-4422(10)70090-9</pub-id><pub-id pub-id-type="pmid">20451458</pub-id></element-citation></ref><ref id="b21"><label>21</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Koller</surname><given-names>WC</given-names></name></person-group><article-title>The relationship of essential tremor to other movement disorders: Report of 678 patients</article-title><source>Ann Neurol</source><year>1994</year><volume>35</volume><fpage>717</fpage><lpage>23</lpage><pub-id pub-id-type="doi">10.1002/ana.410350613</pub-id><pub-id pub-id-type="pmid">8210229</pub-id></element-citation></ref><ref id="b22"><label>22</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lou</surname><given-names>JS</given-names></name><name><surname>Jankovic</surname><given-names>J</given-names></name></person-group><article-title>Essential tremor: Clinical correlates in 350 patients</article-title><source>Neurology</source><year>1991</year><volume>41</volume><fpage>234</fpage><lpage>8</lpage><pub-id pub-id-type="doi">10.1212/WNL.41.2_Part_1.234</pub-id><pub-id pub-id-type="pmid">1992367</pub-id></element-citation></ref><ref id="b23"><label>23</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Geraghty</surname><given-names>JJ</given-names></name></person-group><article-title>Association between essential tremor and Parkinson's disease</article-title><source>Ann Neurol</source><year>1985</year><volume>17</volume><fpage>329</fpage><lpage>33</lpage><pub-id pub-id-type="doi">10.1002/ana.410170404</pub-id><pub-id pub-id-type="pmid">4004153</pub-id></element-citation></ref><ref id="b24"><label>24</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Benito-Leon</surname><given-names>J</given-names></name><name><surname>Louis</surname><given-names>ED</given-names></name><name><surname>Bermejo-Pareja</surname><given-names>F</given-names></name></person-group><article-title>Risk of incident Parkinson's disease and parkinsonism in essential tremor: A population based study</article-title><source>J Neurol Neurosurg Psychiatry</source><year>2009</year><volume>80</volume><fpage>423</fpage><lpage>5</lpage><pub-id pub-id-type="doi">10.1136/jnnp.2008.147223</pub-id><pub-id pub-id-type="pmid">19289477</pub-id></element-citation></ref><ref id="b25"><label>25</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Vilariño-Güell</surname><given-names>C</given-names></name><name><surname>Ross</surname><given-names>OA</given-names></name><name><surname>Wider</surname><given-names>C</given-names></name><etal>et al</etal></person-group><article-title>LINGO1 rs9652490 is associated with essential tremor and Parkinson disease</article-title><source>Parkinsonism Relat Disord</source><year>2010</year><volume>16</volume><fpage>109</fpage><lpage>11</lpage><pub-id pub-id-type="doi">10.1016/j.parkreldis.2009.08.006</pub-id><pub-id pub-id-type="pmid">19720553</pub-id></element-citation></ref><ref id="b26"><label>26</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Haubenberger</surname><given-names>D</given-names></name><name><surname>Hotzy</surname><given-names>C</given-names></name><name><surname>Pirker</surname><given-names>W</given-names></name><etal>et al</etal></person-group><article-title>Role of LINGO1 polymorphisms in Parkinson's disease</article-title><source>Mov Disord</source><year>2009</year><volume>24</volume><fpage>2404</fpage><lpage>7</lpage><pub-id pub-id-type="pmid">19908305</pub-id></element-citation></ref><ref id="b27"><label>27</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Findley</surname><given-names>LJ</given-names></name><name><surname>Koller</surname><given-names>WC</given-names></name></person-group><article-title>Handbook of tremor disorders</article-title><person-group person-group-type="editor"><name><surname>Findley</surname><given-names>LJ</given-names></name><name><surname>Koller</surname><given-names>WC</given-names></name></person-group><publisher-loc>New York</publisher-loc><publisher-name>Dekker</publisher-name><year>1995</year><comment>p</comment><fpage>1</fpage><lpage>5</lpage></element-citation></ref><ref id="b28"><label>28</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stiasny-Kolster</surname><given-names>K</given-names></name><name><surname>Mayer</surname><given-names>G</given-names></name><name><surname>Schäfer</surname><given-names>S</given-names></name><name><surname>Möller</surname><given-names>JC</given-names></name><name><surname>Heinzel-Gutenbrunner</surname><given-names>M</given-names></name><name><surname>Oertel</surname><given-names>WH</given-names></name></person-group><article-title>The REM Sleep Behavior Disorder Screening Questionnaire—A new diagnostic instrument</article-title><source>Movement Disord</source><year>2007</year><volume>22</volume><fpage>2386</fpage><lpage>93</lpage><pub-id pub-id-type="doi">10.1002/mds.21740</pub-id><pub-id pub-id-type="pmid">17894337</pub-id></element-citation></ref><ref id="b29"><label>29</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Suares</surname><given-names>NC</given-names></name><name><surname>Ford</surname><given-names>AC</given-names></name></person-group><article-title>Prevalence of, and risk factors for, chronic idiopathic constipation in the community: Systematic review and meta-analysis</article-title><source>Am J Gastroenterol</source><year>2011</year><volume>106</volume><fpage>1582</fpage><lpage>1591</lpage><pub-id pub-id-type="doi">10.1038/ajg.2011.164</pub-id><pub-id pub-id-type="pmid">21606976</pub-id></element-citation></ref><ref id="b30"><label>30</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thompson</surname><given-names>AW</given-names></name><name><surname>Liu</surname><given-names>H</given-names></name><name><surname>Hays</surname><given-names>RD</given-names></name><etal>et al</etal></person-group><article-title>Diagnostic accuracy and agreement across three depression assessment measures for Parkinson's disease</article-title><source>Parkinsonism Relat Disord</source><year>2011</year><volume>17</volume><fpage>40</fpage><lpage>5</lpage><pub-id pub-id-type="doi">10.1016/j.parkreldis.2010.10.007</pub-id><pub-id pub-id-type="pmid">21084211</pub-id></element-citation></ref><ref id="b31"><label>31</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tumas</surname><given-names>V</given-names></name><name><surname>Rodrigues</surname><given-names>GG</given-names></name><name><surname>Farias</surname><given-names>TL</given-names></name><name><surname>Crippa</surname><given-names>JA</given-names></name></person-group><article-title>The accuracy of diagnosis of major depression in patients with Parkinson's disease: A comparative study among the UPDRS, the geriatric depression scale and the Beck depression inventory</article-title><source>Arq Neuropsiquiatr</source><year>2008</year><volume>66</volume><fpage>152</fpage><lpage>6</lpage><pub-id pub-id-type="doi">10.1590/S0004-282X2008000200002</pub-id><pub-id pub-id-type="pmid">18545773</pub-id></element-citation></ref><ref id="b32"><label>32</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Schrag</surname><given-names>A</given-names></name><name><surname>Barone</surname><given-names>P</given-names></name><name><surname>Brown</surname><given-names>RG</given-names></name><etal>et al</etal></person-group><article-title>Depression rating scales in Parkinson's disease: Critique and recommendations</article-title><source>Mov Disord</source><year>2007</year><volume>22</volume><fpage>1077</fpage><lpage>92</lpage><pub-id pub-id-type="doi">10.1002/mds.21333</pub-id><pub-id pub-id-type="pmid">17394234</pub-id></element-citation></ref><ref id="b33"><label>33</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mullol</surname><given-names>J</given-names></name><name><surname>Alobid</surname><given-names>I</given-names></name><name><surname>Marino-Snachez</surname><given-names>F</given-names></name><etal>et al</etal></person-group><article-title>Furthering the understanding of olfaction, prevalence of loss of smell and risk factors: A population-based survey (OLFACAT study)</article-title><source>BMJ Open</source><year>2012</year><volume>2</volume><fpage>e001256</fpage><pub-id pub-id-type="doi">10.1136/bmjopen-2012-001256</pub-id></element-citation></ref><ref id="b34"><label>34</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ohayon</surname><given-names>MM</given-names></name><name><surname>Caulet</surname><given-names>M</given-names></name><name><surname>Priest</surname><given-names>RG</given-names></name></person-group><article-title>Violent behavior during sleep</article-title><source>J Clin Psychiatry</source><year>1997</year><volume>58</volume><fpage>369</fpage><lpage>376</lpage><pub-id pub-id-type="doi">10.4088/JCP.v58n0808</pub-id><pub-id pub-id-type="pmid">9515980</pub-id></element-citation></ref><ref id="b35"><label>35</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Rihmer</surname><given-names>Z</given-names></name><name><surname>Angst</surname><given-names>J</given-names></name></person-group><article-title>Mood disorders: Epidemiology</article-title><comment>In: <italic>Kaplan & Sadock's</italic> Comprehensive textbook of psychiatry. 8th <italic>edition, Sadock, BJ, Sadock VA, editors</italic></comment><publisher-name>Philadelphia Lippincott Williams and Wilkins</publisher-name><year>2005</year></element-citation></ref><ref id="b36"><label>36</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gagnon</surname><given-names>JF</given-names></name><name><surname>Bedard</surname><given-names>MA</given-names></name><name><surname>Fantini</surname><given-names>ML</given-names></name><etal>et al</etal></person-group><article-title>REM sleep behavior disorder and REM sleep without atonia in Parkinson's disease</article-title><source>Neurology</source><year>2002</year><volume>59</volume><fpage>585</fpage><lpage>9</lpage><pub-id pub-id-type="doi">10.1212/WNL.59.4.585</pub-id><pub-id pub-id-type="pmid">12196654</pub-id></element-citation></ref><ref id="b37"><label>37</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gjerstad</surname><given-names>MD</given-names></name><name><surname>Boeve</surname><given-names>B</given-names></name><name><surname>Wentzel-Larsen</surname><given-names>T</given-names></name><name><surname>Aarsland</surname><given-names>D</given-names></name><name><surname>Larsen</surname><given-names>JP</given-names></name></person-group><article-title>Occurrence and clinical correlates of REM sleep behaviour disorder in patients with Parkinson's disease over time</article-title><source>J Neurol Neurosurg Psychiatry</source><year>2008</year><volume>79</volume><fpage>387</fpage><lpage>91</lpage><pub-id pub-id-type="doi">10.1136/jnnp.2007.116830</pub-id><pub-id pub-id-type="pmid">17557796</pub-id></element-citation></ref><ref id="b38"><label>38</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Plazzi</surname><given-names>G</given-names></name><name><surname>Corsini</surname><given-names>R</given-names></name><name><surname>Provini</surname><given-names>F</given-names></name><etal>et al</etal></person-group><article-title>REM sleep behavior disorders in multiple system atrophy</article-title><source>Neurology</source><year>1997</year><volume>48</volume><fpage>1094</fpage><lpage>7</lpage><pub-id pub-id-type="doi">10.1212/WNL.48.4.1094</pub-id><pub-id pub-id-type="pmid">9109907</pub-id></element-citation></ref><ref id="b39"><label>39</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>McKinnon</surname><given-names>J</given-names></name></person-group><article-title>Olfaction in the elderly: A cross-sectional analysis comparing Parkinson's disease with controls and other disorders</article-title><source>Int J Neurosci</source><year>2010</year><volume>120</volume><fpage>36</fpage><lpage>9</lpage><pub-id pub-id-type="pmid">20128670</pub-id></element-citation></ref><ref id="b40"><label>40</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Louis</surname><given-names>ED</given-names></name><name><surname>Jurewicz</surname><given-names>EC</given-names></name></person-group><article-title>Olfaction in essential tremor patients with and without isolated rest tremor</article-title><source>Mov Disord</source><year>2003</year><volume>18</volume><fpage>1387</fpage><lpage>9</lpage><pub-id pub-id-type="doi">10.1002/mds.10603</pub-id><pub-id pub-id-type="pmid">14639689</pub-id></element-citation></ref><ref id="b41"><label>41</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Louis</surname><given-names>ED</given-names></name></person-group><article-title>Olfactory dysfunction in essential tremor: A deficit unrelated to disease duration or severity</article-title><source>Neurology</source><year>2002</year><volume>59</volume><fpage>1631</fpage><lpage>3</lpage><pub-id pub-id-type="doi">10.1212/01.WNL.0000033798.85208.F2</pub-id><pub-id pub-id-type="pmid">12451211</pub-id></element-citation></ref><ref id="b42"><label>42</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Doty</surname><given-names>RL</given-names></name><name><surname>Shaman</surname><given-names>P</given-names></name><name><surname>Dann</surname><given-names>M</given-names></name></person-group><article-title>Development of the University of Pennsylvania Smell Identification Test: A standardized microencapsulated test of olfactory function</article-title><source>Physiol Behav</source><year>1984</year><volume>32</volume><fpage>489</fpage><lpage>502</lpage><pub-id pub-id-type="doi">10.1016/0031-9384(84)90269-5</pub-id><pub-id 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