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Author(s): Marcel Falkiewicz

Journal: Neuropsychiatria i Neuropsychologia
ISSN 1896-6764

Volume: 5;
Issue: 1;
Start page: 18;
Date: 2010;
Original page

Keywords: essential tremor | cerebellum | cognitive functions

ABSTRACT
Essential tremor is one of the most common neurologicaldisorders. Its most recognizable feature is a kinetictremor of upper limbs, but it can also affect other partsof the body. For many years essential tremor has beentreated as a benign, monosymptomatic disorder withlittle progression. A vast number of research in the lastdecade underpinned this view. The tremor can beaccompanied with a broad spectrum of other motor andnon-motor features. The latter include psychiatricsymptoms and cognitive dysfunction. The configurationof these features varies between cases. The etiology,progression and underlying neuropathology of thedisease is also heterogeneous. Thus, essential tremorshould be rather treated as a complex and progressiveneurodegenerative disease. In the cognitive domain themost common deficits are found in memory andexecutive functions, but deficits are also noted inattention, language and visuospatial functions. Similarpattern emerges in Parkinson’s disease. This indicatesdysfunctions of the frontal system, which includes theprefrontal cortex and subcortical structures like basalganglia and cerebellum. The magnitude of cognitivedysfunction is partially independent from othermanifestations of the disease, which indicates differentunderlying neuropathology of motor and non-motorfeatures. Determination of the relationship betweensigns of the disease and underlying neuropathologicalmechanisms is an important goal of future research. Themagnitude of cognitive deficits might have moresignificant influence on the quality of life in ET patientsthan the magnitude of motor signs. Despite that factassessment of cognitive functions is omitted in standarddiagnostic procedures. Presented data suggest that thispractice should be revised.

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