White matter lesions predict cognitive dysfunction in patients with essential tremor

ObjectivePrevious researches are not sufficient to explain why cognitive deficits occur in patients with essential tremor (ET). The aim of this study is to evaluate the relationships among vascular risk factors, MRI measures of white matter lesions (WMLs), and the rate of decline in the global cognitive functioning of elderly patients with ET.MethodWe used the Mini-Mental State Examination (MMSE) to assess cognitive decline in patients with ET. The MMSE results of 106 patients were compared with those of 67 age- and sex-matched controls. All participants underwent cranial MRI examinations to exclude other possible causes of cerebellar or extrapyramidal disorders. WMLs were identified via T2-weighted MR scans and then evaluated. We examined correlations of MMSE scores with vascular risk factors, cranial MRI findings, and factors of age, educational level, and sex.ResultsLower MMSE scores were related to WMLs and age in the patient group (p < 0.05), and WMLs independently predicted mental status in this group (Beta value = −0.233, p = 0.016). We found no correlation between MMSE scores and commonly seen vascular risk factors.ConclusionCognitive assessments should be part of clinical dialogs with elderly patients with ET, and prospective neuro-imaging studies and detailed neuropsychological tests should be performed when cognitive impairment related to ET is suspected.