Tremor in progressive supranuclear palsy

Shinsuke Fujioka, Avi A. Algom, Melissa E Murray, Monica Y. Sanchez-Contreras, Pawel Tacik, Yoshio Tsuboi, Jay A Van Gerpen, Ryan J. Uitti, Rosa V Rademakers, Owen A Ross, Zbigniew K Wszolek, Dennis W Dickson

Research output: Contribution to journalArticle

6 Scopus citations


Introduction: Tremor is thought to be a rare feature of progressive supranuclear palsy (PSP). Methods: We retrospectively reviewed the database of the CurePSP brain bank at Mayo Clinic Florida to retrieve all available clinical information for PSP patients. All patients underwent a standard neuropathological assessment and an immunohistochemical evaluation for tau and α-synuclein. DNA was genotyped for the MAPT H1/H2 haplotype. Results: Of the 375 PSP patients identified, 344 had a documented presence or absence of tremor, which included 146 (42%) with tremor, including 29 (20%) with postural/action tremors, 16 (11%) with resting tremor, 7 (5%) with intention tremor, 20 (14%) with a combination of different types of tremor, and 74 (51%) patients who had tremor at some point during their illness, but details were unavailable. The tremor severity of 96% of the patients (54/55) who had this data was minimal to mild. The probability of observing a tremor during a neurological examination during the patient's illness was estimated to be ∼22%. PSP patients with postural/action tremors and PSP patients with resting tremor responded to carbidopa-levodopa therapy more frequently than PSP patients without tremor, although the therapy response was always transient. There were no significant differences in pathological findings between the tremor groups. Conclusions: Tremor is an inconspicuous feature of PSP; however, 42% (146/344) of the PSP patients in our study presented some form of tremor. Because there is no curative therapy for PSP, carbidopa/levodopa therapy should be tried for patients with postural, action, and resting tremor.

Original languageEnglish (US)
JournalParkinsonism and Related Disorders
StateAccepted/In press - Jan 20 2016


  • Carbidopa/levodopa therapy
  • MAPT H1/H2 haplotype
  • Neuropathology
  • Progressive supranuclear palsy
  • Tremor

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

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