TY - JOUR
T1 - Essential tremor-plus
T2 - a controversial new concept
AU - Louis, Elan D.
AU - Bares, Martin
AU - Benito-Leon, Julian
AU - Fahn, Stanley
AU - Frucht, Steven J.
AU - Jankovic, Joseph
AU - Ondo, William G.
AU - Pal, Pramod K.
AU - Tan, Eng King
N1 - Funding Information:
EDL received research support from the US National Institutes of Health as principal investigator for trials (NINDS #R01 NS094607, NINDS #R01 NS085136, NINDS #R01 NS073872, NINDS #R01 NS085136, and NINDS #R01 NS088257); received research support from the Claire O'Neil Essential Tremor Research Fund (Yale University, New Haven, CT, USA); serves on the clinical advisory boards of SAGE Therapeutics and CADENT Therapeutics; and receives publishing royalties from Elsevier for Merritt's Neurology. JJ received research and training funding from Allergan, CHDI Foundation, Dystonia Coalition, F Hoffmann-La Roche, Huntington Study Group, Medtronic Neuromodulation, Merz Pharmaceuticals, Michael J Fox Foundation for Parkinson Research, US National Institutes of Health, Neurocrine Biosciences, Parkinson's Foundation, Nuvelution, Parkinson Study Group, Revance Therapeutics, and Teva Pharmaceutical Industries; served on the consultant and advisory boards of Abide, Lundbeck, Retrophin, Parexel, Teva Pharmaceutical Industries, and Allergan; and received royalties from Cambridge University (Cambridge, UK), Elsevier, Future Science Group, Hodder Arnold, Medlink Neurology, Lippincott Williams and Wilkins, and Wiley-Blackwell. WGO received personal fees from ACADIA, TEVA, Accorda, and Neurocrine, and grants from TEVA, Sunovian, Biogen, and Lilly, outside the submitted work. PKP received personal fees as honoraria for participating as faculty and giving lectures for movement disorders teaching courses from International Parkinson and Movement Disorder Society; received reimbursement of travel expenses and honoraria to participate as faculty and give lectures at scientific meetings from Taiwan Movement Disorder Society, Asian Oceanian Association of Neurology, and Korean Movement Disorders Society; received reimbursement of travel expenses to participate as faculty and give lectures at scientific meetings from International Association of Parkinsonism and Related Disorders, Hunter Postgraduate Medical Institute (University of Newcastle, NSW, Australia), International Parkinson and Movement Disorder Society, and Society of Neurologists of Bangladesh; received grants from Indian Council of Medical Research, Department of Science and Technology, Department of Biotechnology, and Science and Engineering Research Board (India) paid to his institute, all outside the submitted work. E-KT received support from National Medical Research Council (Singapore), and honoraria from Wiley for editorial work. All other authors declare no competing interests.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/3
Y1 - 2020/3
N2 - In addition to redefining essential tremor (ET), the 2018 consensus statement of the Movement Disorder Society on tremor coined a new term: essential tremor-plus (ET-plus). This term is uncertainly defined as tremor with the characteristics of ET, with additional neurological signs of uncertain clinical significance. If ET-plus had been defined on the basis of a difference in underlying pathology or an appreciable difference in prognosis, it would have a valid, scientific rationale, as does the term Parkinson-plus. However, there is no such evidence, so the basis for the term is questionable. In fact, ET-plus might only represent a state condition (ie, patients with ET might develop these additional clinical features when the disease is at a more advanced stage). We caution against coining new terms that are not supported by a firm scientific basis and encourage research into the creation of essential tremor subsets that are defined with respect to differences in underlying causes or pathophysiology.
AB - In addition to redefining essential tremor (ET), the 2018 consensus statement of the Movement Disorder Society on tremor coined a new term: essential tremor-plus (ET-plus). This term is uncertainly defined as tremor with the characteristics of ET, with additional neurological signs of uncertain clinical significance. If ET-plus had been defined on the basis of a difference in underlying pathology or an appreciable difference in prognosis, it would have a valid, scientific rationale, as does the term Parkinson-plus. However, there is no such evidence, so the basis for the term is questionable. In fact, ET-plus might only represent a state condition (ie, patients with ET might develop these additional clinical features when the disease is at a more advanced stage). We caution against coining new terms that are not supported by a firm scientific basis and encourage research into the creation of essential tremor subsets that are defined with respect to differences in underlying causes or pathophysiology.
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U2 - 10.1016/S1474-4422(19)30398-9
DO - 10.1016/S1474-4422(19)30398-9
M3 - Review article
C2 - 31767343
AN - SCOPUS:85079548830
SN - 1474-4422
VL - 19
SP - 266
EP - 270
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 3
ER -