Burden of tremor in Parkinson's disease: A survey study

Background Tremor is reported by people with Parkinson's disease (PwP) as being one of the most troublesome symptoms. Objective To characterize the PwP experience of tremor. Methods An internet-based survey of PwP living with tremor was conducted in the US, from September 2023 to March 2024. Results Survey responses from 634 respondents (PwP = 599; care partner = 35) were analyzed. Most (93%) PwP had tremor in their upper extremities and of these, 59% reported >= 2 tremor subtypes (rest/postural/kinetic). Overall, 24% reported little or no effect of medication and a further 25% reported that medication only somewhat improved their tremor. At least mild functional impairment due to tremor was reported by 65% of PwP and most indicated that >= 1 daily activity (83%), sensory experience (77%), or psychosocial function (92%) was impacted. Multinomial logistic regression analyses revealed that the odds [95%CI] of reporting severe functional impairment due to tremor (vs. slight) were increased by worse tremor in the dominant hand (4.9 [1.36, 17.72]); presence of OFF-time (4.7 [1.22, 18.30]), number of body parts affected (2.0 [1.45, 2.88]) and lack of medication effect (1.6 [0.30, 8.22]). The presence of all three tremor subtypes was associated with increased odds of being "very dissatisfied" with quality of life (21.5 [2.51, 183.44]). Conclusions Results from this survey demonstrate that tremor in PD is often more than a rest tremor and frequently impacts function and activities of daily living. Medication response is inadequate in about half of cases, highlighting that effective treatment of tremor is an important unmet need.