QOL07
Tremor in Multiple Sclerosis: An Area of Unmet Need and Opportunity
Tremor in multiple sclerosis (MS) is common and contributes to disability. In one large study, nearly half (45%) of MS patients reported tremor which negatively impacted their employment status. Also, nearly half of MS patients report upper limb mobility issues that impact their daily activities. Despite the prevalence of tremor and its impact on MS patients, little is known about its pathophysiology, imaging correlates, characteristics, and treatment.
Objectives:
We hypothesized that the current research of tremor in MS has several gaps relating to characterization, pathophysiology, and treatment. We aimed to provide a comprehensive and systematized review of tremors in MS. We identified knowledge gaps and reviewed what is currently known.
Methods:
Four databases (PubMed, Cochrane, Scopus, OVID) were searched, and citations were generated from the keywords “multiple sclerosis” and “tremor.” The search was filtered to include research articles in English about the adult population. Studies of co-existing neurologic disease were excluded. A manual filtering process from two authors (CI, and AZO) yielded a total of 58 relevant studies included in the review. We investigated the characterization, pathophysiology, treatment, and disability.
Results:
We found that there is an incomplete understanding of the pathophysiology of tremor in MS and no effective treatments for MS associated tremor. Also, the current literature lacks classification and stratification of tremor in MS. For example, there is no reported association of tremor with disability level, age, or gender which may reflect the limited incorporation of tremors in measures of MS disability. Furthermore, there is no MS-specific patient reported tool (PRO) for tremor. We developed a PRO measure that is MS-tremor specific and will be presented at the meeting.
Conclusions:
We identified opportunities for future studies that will focus on the detailed characterization of MS tremor, association with disease characteristics, and imaging findings. Furthermore, we developed the first PRO for MS-specific tremor.
Study funded by the Foundation of the Consortium of MS Centers (Medical Student Research Grant)