TY - JOUR
T1 - The effect of tremor on disability assessment in chronic inflammatory demyelinating polyradiculoneuropathy
AU - van Veen, R.
AU - Pallada, G.
AU - Wieske, L.
AU - ten Holter, S. E. M.
AU - van Rootselaar, A. F.
AU - Verhamme, C.
AU - de Bie, R. M. A.
AU - van Schaik, I. N.
AU - Merkies, I. S. J.
AU - Dijk, J. M.
AU - Eftimov, Filip
PY - 2022
Y1 - 2022
N2 - Tremor in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is common, often unresponsive to treatment, and may contribute to disability. We aim to investigate whether tremor is associated with disability as measured in daily practice and clinical trials, independent of other impairments. We included 76 CIDP patients in this cross-sectional study. We assessed tremor with the Tremor Research Group essential tremor rating assessment scale (TETRAS) and the Fahn?Tolosa?Marin clinical rating scale (FTM). Disability was measured with the inflammatory Rasch-built overall disability scale (I-RODS) and the adjusted Inflammatory Neuropathy Cause and Treatment disability scale (INCAT-DS, categorized separately in arm score, or total score). Impairments including strength, sensory impairment, and fatigue were measured using specific impairment scales. We tested whether ?the presence of a clinically relevant tremor? (based on TETRAS and FTM) or ?tremor severity? (FTM part B sum score) was associated with disability scores (I-RODS, INCAT-DS total score, and INCAT-DS arm score), independent of the impairment scores, using multivariate regression. Both ?the presence of a clinically relevant tremor? and ?tremor severity? were significantly associated with disability measured by the INCAT-DS (arm score and total score), but not the I-RODS, independent of strength, sensory impairment, and fatigue. The explained variances were low. Clinically relevant tremor can (partly) explain disability in CIDP, as measured with the INCAT-DS, independent of muscle strength, sensory deficits, and fatigue. To assess disease activity in CIDP patients with tremor, both impairment and disability outcomes should be assessed, as disability is caused partly by tremor while the effect of immunotherapy on tremor seems limited.
AB - Tremor in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is common, often unresponsive to treatment, and may contribute to disability. We aim to investigate whether tremor is associated with disability as measured in daily practice and clinical trials, independent of other impairments. We included 76 CIDP patients in this cross-sectional study. We assessed tremor with the Tremor Research Group essential tremor rating assessment scale (TETRAS) and the Fahn?Tolosa?Marin clinical rating scale (FTM). Disability was measured with the inflammatory Rasch-built overall disability scale (I-RODS) and the adjusted Inflammatory Neuropathy Cause and Treatment disability scale (INCAT-DS, categorized separately in arm score, or total score). Impairments including strength, sensory impairment, and fatigue were measured using specific impairment scales. We tested whether ?the presence of a clinically relevant tremor? (based on TETRAS and FTM) or ?tremor severity? (FTM part B sum score) was associated with disability scores (I-RODS, INCAT-DS total score, and INCAT-DS arm score), independent of the impairment scores, using multivariate regression. Both ?the presence of a clinically relevant tremor? and ?tremor severity? were significantly associated with disability measured by the INCAT-DS (arm score and total score), but not the I-RODS, independent of strength, sensory impairment, and fatigue. The explained variances were low. Clinically relevant tremor can (partly) explain disability in CIDP, as measured with the INCAT-DS, independent of muscle strength, sensory deficits, and fatigue. To assess disease activity in CIDP patients with tremor, both impairment and disability outcomes should be assessed, as disability is caused partly by tremor while the effect of immunotherapy on tremor seems limited.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85146320127&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36571466
U2 - https://doi.org/10.1111/jns.12528
DO - https://doi.org/10.1111/jns.12528
M3 - Article
C2 - 36571466
SN - 1085-9489
JO - Journal of the peripheral nervous system
JF - Journal of the peripheral nervous system
ER -