Essential tremor (ET) is among the most common neurological diseases, with a prevalence (age >40 years) estimated to be 4.0% and prevalence in advanced age (>90 years) exceeding 20.0%. The underlying pathogenesis remains poorly understood and, as a consequence, current medications are empiric and of limited efficacy. There are only two front-line medications, a situation that has not changed in more than 30 years, and one in two patients simply stops these medications due to poor efficacy. The foremost obstacle to the study of pathogenesis is the absence of an animal (genetic) model for this disease. ET (often referred to as """"""""familial tremor""""""""), is generally regarded as a highly-genetic disorder, with physicians commonly seeing families with affecteds over multiple generations, and twin studies showing high concordance among monozygotes. Despite this, as of 2010, genetic studies have not advanced to the point where susceptibility genes have been identified. Previously published studies of linkage in families suggest that susceptibility loci contribute to the etiology of ET. In the current application we will build on previous studies and propose to use a linkage and resequencing approach to identify susceptibility genes for familial early-onset (<40 years) ET. To overcome the problems associated with previously published genetic studies of ET, which did not use strict phenotype definition in assigning affectedness status, we will use strict diagnostic criteria of 'definite'or 'probable'ET for inclusion of probands and affected individuals in families and further restrict our inclusion to individuals with pure ET (i.e. no dystonia) to reduce heterogeneity and to increase our power to detect a linkage signal. We will also focus on multiplex and multigenerational early onset ET families. To date we have already identified 96 families with an affected proband and >2 living first-degree relatives with ET and in 74 (77%) of families, the proband's age at onset was <40 years.

Public Health Relevance

ET, a highly genetic disorder, is the most common cause of tremor in humans, affecting large numbers of individuals worldwide. Current treatments, which are largely unsuccessful, are empiric. Therapies based on an understanding of disease pathogenesis are needed, yet the absence of any identified genes and the resultant lack of an animal model, is the foremost obstacle standing in the way of these studies.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Research Project (R01)
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Neurological, Aging and Musculoskeletal Epidemiology (NAME)
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Gwinn, Katrina
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Columbia University (N.Y.)
Schools of Medicine
New York
United States
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Liu, Xinmin; Hernandez, Nora; Kisselev, Sergey et al. (2016) Identification of candidate genes for familial early-onset essential tremor. Eur J Hum Genet 24:1009-15
Robakis, Daphne; Louis, Elan D (2016) Head tremor in essential tremor: ""Yes-yes"", ""no-no"", or ""round and round""? Parkinsonism Relat Disord 22:98-101
Louis, Elan D (2016) Essential Tremor: A Common Disorder of Purkinje Neurons? Neuroscientist 22:108-18
Louis, Elan D; Clark, Lorraine; Ottman, Ruth (2016) Familial Aggregation and Co-Aggregation of Essential Tremor and Parkinson's Disease. Neuroepidemiology 46:31-6
Louis, Elan D (2016) Non-motor symptoms in essential tremor: A review of the current data and state of the field. Parkinsonism Relat Disord 22 Suppl 1:S115-8
Louis, Elan D; Factor-Litvak, Pam (2016) Screening for and Estimating the Prevalence of Essential Tremor: A Random-Digit Dialing-Based Study in the New York Metropolitan Area. Neuroepidemiology 46:51-6
Morgan, Sarah; Louis, Elan D (2016) Re-Emergent Tremor of Parkinson's Disease Masquerading as Essential Tremor. Tremor Other Hyperkinet Mov (N Y) 6:370
Shin, Hyeeun; Lee, Dong-Kyun; Lee, Jong-Min et al. (2016) Atrophy of the Cerebellar Vermis in Essential Tremor: Segmental Volumetric MRI Analysis. Cerebellum 15:174-81
Eken, Hatice N; Louis, Elan D (2016) Agnosia for head tremor in essential tremor: prevalence and clinical correlates. J Clin Mov Disord 3:4
Louis, Elan D; Collins, Kathleen; Rohl, Brittany et al. (2016) Self-reported physical activity in essential tremor: Relationship with tremor, balance, and cognitive function. J Neurol Sci 366:240-5

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