Head tremor in Parkinson´s Disease, clinical Associations and response to therapy

Background: Tremor is frequently observed in patients with Parkinsońs disease (PD). Tremor most commonly affects the upper limbs but may also affect the axial muscles in PD. Head tremor (HT) is usually identified in patients with essential tremor (ET) and cervical dystonia (CD), but rarely reported...

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Main Authors: José Fidel Baizabal-Carvallo, Marlene Alonso-Juarez, Robert Fekete
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Clinical Parkinsonism & Related Disorders
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590112525000325
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author José Fidel Baizabal-Carvallo
Marlene Alonso-Juarez
Robert Fekete
author_facet José Fidel Baizabal-Carvallo
Marlene Alonso-Juarez
Robert Fekete
author_sort José Fidel Baizabal-Carvallo
collection DOAJ
description Background: Tremor is frequently observed in patients with Parkinsońs disease (PD). Tremor most commonly affects the upper limbs but may also affect the axial muscles in PD. Head tremor (HT) is usually identified in patients with essential tremor (ET) and cervical dystonia (CD), but rarely reported in PD. Objectives Methods: We aimed to assess the frequency, clinical features, correlates, and underlying mechanisms of HT in PD. Results: Among 229 patients with PD, we identified 19 (8.3 %) of patients with HT. There were 11 males and 8 females with a median age at evaluation of 62.0 years. Five patients had slight, ten had mild and four had moderately severe HT. Yes-yes HT was the most common type. HT was associated with PD in 13 patients, eight of them had severe tremor-dominant presentation. In 3 patients there were signs suggesting underlying ET, while 3 patients had CD. Complete resolution of HT was observed with levodopa and/or deep brain stimulation (DBS) in patients with PD only, but inconsistent improvement was observed with comorbid ET or CD. Longer evolution time since PD onset (P = 0.024), rest tremor (P = 0.001) and CD (P = 0.003) were independently associated with HT in the multivariate analysis. Conclusions: HT was identified in 8.3% of patients with PD. It associated with longer evolution since PD onset, the severity of rest tremor and presence of CD. HT is observed in the context of PD only, particularly in those with severe tremor-dominant presentation, comorbid ET or CD. Most patients improve with dopaminergic therapy or DBS.
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spelling doaj-art-52a0efbc7db64e939d48e09972435fce2025-08-20T02:17:29ZengElsevierClinical Parkinsonism & Related Disorders2590-11252025-01-011210032810.1016/j.prdoa.2025.100328Head tremor in Parkinson´s Disease, clinical Associations and response to therapyJosé Fidel Baizabal-Carvallo0Marlene Alonso-Juarez1Robert Fekete2Department of Sciences and Engineering, University of Guanajuato, León, México; Corresponding author.Instituto Politécnico Nacional, MexicoNew York Medical College, Valhalla, NY, USABackground: Tremor is frequently observed in patients with Parkinsońs disease (PD). Tremor most commonly affects the upper limbs but may also affect the axial muscles in PD. Head tremor (HT) is usually identified in patients with essential tremor (ET) and cervical dystonia (CD), but rarely reported in PD. Objectives Methods: We aimed to assess the frequency, clinical features, correlates, and underlying mechanisms of HT in PD. Results: Among 229 patients with PD, we identified 19 (8.3 %) of patients with HT. There were 11 males and 8 females with a median age at evaluation of 62.0 years. Five patients had slight, ten had mild and four had moderately severe HT. Yes-yes HT was the most common type. HT was associated with PD in 13 patients, eight of them had severe tremor-dominant presentation. In 3 patients there were signs suggesting underlying ET, while 3 patients had CD. Complete resolution of HT was observed with levodopa and/or deep brain stimulation (DBS) in patients with PD only, but inconsistent improvement was observed with comorbid ET or CD. Longer evolution time since PD onset (P = 0.024), rest tremor (P = 0.001) and CD (P = 0.003) were independently associated with HT in the multivariate analysis. Conclusions: HT was identified in 8.3% of patients with PD. It associated with longer evolution since PD onset, the severity of rest tremor and presence of CD. HT is observed in the context of PD only, particularly in those with severe tremor-dominant presentation, comorbid ET or CD. Most patients improve with dopaminergic therapy or DBS.http://www.sciencedirect.com/science/article/pii/S2590112525000325Parkinsońs diseaseTremorJawClinical correlationsHead tremor
spellingShingle José Fidel Baizabal-Carvallo
Marlene Alonso-Juarez
Robert Fekete
Head tremor in Parkinson´s Disease, clinical Associations and response to therapy
Clinical Parkinsonism & Related Disorders
Parkinsońs disease
Tremor
Jaw
Clinical correlations
Head tremor
title Head tremor in Parkinson´s Disease, clinical Associations and response to therapy
title_full Head tremor in Parkinson´s Disease, clinical Associations and response to therapy
title_fullStr Head tremor in Parkinson´s Disease, clinical Associations and response to therapy
title_full_unstemmed Head tremor in Parkinson´s Disease, clinical Associations and response to therapy
title_short Head tremor in Parkinson´s Disease, clinical Associations and response to therapy
title_sort head tremor in parkinson´s disease clinical associations and response to therapy
topic Parkinsońs disease
Tremor
Jaw
Clinical correlations
Head tremor
url http://www.sciencedirect.com/science/article/pii/S2590112525000325
work_keys_str_mv AT josefidelbaizabalcarvallo headtremorinparkinsonsdiseaseclinicalassociationsandresponsetotherapy
AT marlenealonsojuarez headtremorinparkinsonsdiseaseclinicalassociationsandresponsetotherapy
AT robertfekete headtremorinparkinsonsdiseaseclinicalassociationsandresponsetotherapy