TY - JOUR
T1 - Profiles of Normal Cognition in Essential Tremor
AU - Cersonsky, Tess E.K.
AU - Kellner, Sarah
AU - Chapman, Silvia
AU - Huey, Edward D.
AU - Louis, Elan D.
AU - Cosentino, Stephanie
N1 - Funding Information:
No conflicts of interest or competing financial interests are held by any of the authors. The National Institutes of Health supported this work (grant number NINDSR01NS086736) but played no role in the design of the study, the collection, analysis, and interpretation of data, or the writing of the manuscript.
Publisher Copyright:
Copyright © INS. Published by Cambridge University Press, 2019.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Objectives: Patients with essential tremor exhibit heterogeneous cognitive functioning. Although the majority of patients fall under the broad classification of cognitively normal, essential tremor is associated with increased risk for mild cognitive impairment and dementia. It is possible that patterns of cognitive performance within the wide range of normal functioning have predictive utility for mild cognitive impairment or dementia. These cross-sectional analyses sought to determine whether cognitive patterns, or clusters, could be identified among individuals with essential tremor diagnosed as cognitively normal. We also determined whether such clusters, if identified, were associated with demographic or clinical characteristics of patients.Methods: Elderly subjects with essential tremor (age >55 years) underwent comprehensive neuropsychological testing. Domain means (memory, executive function, attention, visuospatial abilities, and language) from 148 individuals diagnosed as cognitively normal were partitioned using k-means cluster analysis. Individuals in each cluster were compared according to cognitive functioning (domain means and test scores), demographic factors, and clinical variables.Results: There were three clusters. Cluster 1 (n = 64) was characterized by comparatively low memory scores (p <.001), Cluster 2 (n = 39) had relatively low attention and visuospatial scores (p <.001), and Cluster 3 (n = 45) exhibited consistently high performance across all domains. Cluster 1 had lower Montreal Cognitive Assessment scores and reported more prescription medication use and lower balance confidence.Conclusions: Three patterns of cognitive functioning within the normal range were evident and tracked with certain clinical features. Future work will examine the extent to which such patterns predict conversion to mild cognitive impairment and/or dementia.
AB - Objectives: Patients with essential tremor exhibit heterogeneous cognitive functioning. Although the majority of patients fall under the broad classification of cognitively normal, essential tremor is associated with increased risk for mild cognitive impairment and dementia. It is possible that patterns of cognitive performance within the wide range of normal functioning have predictive utility for mild cognitive impairment or dementia. These cross-sectional analyses sought to determine whether cognitive patterns, or clusters, could be identified among individuals with essential tremor diagnosed as cognitively normal. We also determined whether such clusters, if identified, were associated with demographic or clinical characteristics of patients.Methods: Elderly subjects with essential tremor (age >55 years) underwent comprehensive neuropsychological testing. Domain means (memory, executive function, attention, visuospatial abilities, and language) from 148 individuals diagnosed as cognitively normal were partitioned using k-means cluster analysis. Individuals in each cluster were compared according to cognitive functioning (domain means and test scores), demographic factors, and clinical variables.Results: There were three clusters. Cluster 1 (n = 64) was characterized by comparatively low memory scores (p <.001), Cluster 2 (n = 39) had relatively low attention and visuospatial scores (p <.001), and Cluster 3 (n = 45) exhibited consistently high performance across all domains. Cluster 1 had lower Montreal Cognitive Assessment scores and reported more prescription medication use and lower balance confidence.Conclusions: Three patterns of cognitive functioning within the normal range were evident and tracked with certain clinical features. Future work will examine the extent to which such patterns predict conversion to mild cognitive impairment and/or dementia.
KW - Attention
KW - Cerebellar diseases
KW - Cognitive aging
KW - Memory
KW - Movement disorders
KW - Postural balance
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U2 - 10.1017/S1355617719001140
DO - 10.1017/S1355617719001140
M3 - Article
C2 - 31581969
AN - SCOPUS:85073123312
SN - 1355-6177
VL - 26
SP - 197
EP - 209
JO - Journal of the International Neuropsychological Society
JF - Journal of the International Neuropsychological Society
IS - 2
ER -