Personality in essential tremor: Further evidence of non-motor manifestations of the disease

Objective: To ascertain whether patients with essential tremor have distinct definable personality traits. Methods: A case-control study of patients with essential tremor was carried out to look for differences in personality characteristics. The controls were derived from the same source population. Using the tridimensional personality questionnaire (TPQ), personality traits were assessed in three dimensions: harm avoidance (HA), novelty seeking (NS), and reward dependence (RD). Additional analyses were conducted to address the possibility of selection bias among the patients with essential tremor. Results: There were 55 patients and 61 controls. There was a difference between patients and controls in HA subscale scores (p = 0.005) but not in NS or RD scores. The difference remained significant in analyses that adjusted for age, sex, race, and education (p = 0.005). HA subscale scores did not correlate with subjective or objective measures of disability or with indices of severity of tremor. Conclusions: Patients with essential tremor scored higher on the harm avoidance subscale scores than control subjects. HA subscale scores did not correlate with the severity of tremor or with subjective and objective scales of disability, suggesting that the personality profile observed was not entirely related to functional disability caused by the tremor. Longitudinal studies of personality in essential tremor are needed to characterise the stability and evolution of these personality traits within the natural history of the disease process.