Essential Tremor (ET)

Essential Tremor (ET)

Global Prevalence of Essential Tremor by Age and Sex
Global Prevalence of Essential Tremor by Age and Sex

4% 4%
4 Number of Cases Among Men
Number of Cases Among Women
Number of cases among men
Prevalence Among Men
Number of cases among women 3%
3% Prevalence Among Women
3
million
million

Prevalence (%)
per per
of cases

2% 2%
of cases

2
Number
Number

1% 1%
1

0 0
0
<20 20-29 30-39 40-49 50-59 60-69 70-79 ≥80
<years
20 20-29
years 30-39
years 40-49
years 50-59
years 60-69
years 70-79
years 80
≥years
years years years years years years years years

Source: Song P, Zhang Y, ZHa M, et al; Global Health Epidemiology Reference Group (GHERG). The global prevalence of essential tremor. J Glob Health 2021; 11:04029.
Source: Song P, Zhang Y, ZHa M, et al; Global Health Epidemiology Reference Group (GHERG). The global prevalence of essential tremor. J Glob Health. 2021;11:04029.

ET Brain
Key Brain Pathways Pathways
Involved in ET Pathophysiology
Motor cortex

Corticopontine tract
Pre-lemniscal radiation
Corticopontine tract
VIM thalamus
Guillain-Mollaret
Prelemniscal triangle
radiation
Spino-cerebellar tract
Guillain-Mollaret triangle
Red nucleus Other connectingtract
Spino-cerebellar white matter tract
Pons Other connecting white matter tract
Dentate nucleus

Cerebellar cortex

Spinal cord
Source: Welton,T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers. 2021; Nov 11;7(1):83.
Source: Welton,T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers. 2021;7:83.

ET Effect on Quality of Life

ET Effect on Quality of Life

Ability
Ability to to
Using
Using computer,
computer, write Concerns about Feelingofof
Feeling
write
hand-held
hand-held devices
devices financial isolation
isolation
problems

Physical
Physical Reading/ Psychosocial
Reading/ Embarrassment
Effects Holding
Holding objects
objects and negative
Eating/
Eating/ Anxiety self-image
Drinking
Drinking and worry
Interference
Interference
Dressing/
Dressing/ with
with
Personal
Personal relationships
relationships
grooming
grooming

Source: Welton,T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers. 2021; Nov 11;7(1):83.
Source: Welton,T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers. 2021;7:83.

ET: Autosomal Dominant Inheritance Risk Factors and Etiology of ET

ET: Autosomal Dominant Inheritance Risk Factors and Etiology of ET

ENVIRONMENTAL GENETIC EPIGENETIC

Affected Unaffected ENVIRONMENTAL GENETIC EPIGENETIC
Affected
father Unaffected
mother
father mother • Exposure to • ETMI-5 Possible
• Exposure
pesticidestoor •• ETM1-5
FUS Possible
pesticides or •• FUS involvement
heavy metals TENM involvement
of epigenetic
• heavy metals
Dietary •• TENM
LINGO1 of epigenetic
factors
• Dietary
factors •• LINGO1
SLC1A2 factors
Normal Two
Two
• factors
Smoking •• SLC1A2
CTNNA3
Normal
gene normal • Smoking • CTNNA3
gene
Mutated gene normal
genes
Mutated gene genes
BIOLOGICAL INTERACTIONS
BIOLOGICAL INTERACTIONS
• Gene-gene interactions
•• Gene-gene interactions
Genetic modifications
•• Genetic modifications
Gene-lifestyle interactions
Affected •• Gene-lifestyle interactions
Protective genetic factors
Affected Unaffected •• Protective
daughter Unaffected
daughter Protectivegenetic
lifestylefactors
factors
daughter • Protective lifestyle factors
daughter

Unaffected Affected
Affected
son AT-RISK INDIVIDUALS
Unaffected
son AT-RISK INDIVIDUALS
son son
Time and ageing
Time and ageing
CLINICAL ET
CLINICAL ET

Source: Welton,T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers. 2021; Nov 11;7(1):83. Source: Welton, T., Cardoso, F., Carr, J.A. et al. Essential tremor. Nat Rev Dis Primers 7, 83 (2021).
Source: Welton,T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers. 2021;7:83. Source: Welton,T, Cardoso F, Carr JA, et al. Essential tremor. Nat Rev Dis Primers. 2021;7:83.