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Elan D. Louis, MD, MS; Karen Marder, MD, MPH; Eva C. Jurewicz, BA; Dryden Watner, MA; Gilberto Levy, MD; Helen Mejia-Santana, MA

Arch Neurol. 2002;59:1273-1277.

Background  The pathogenesis of essential tremor (ET) is unknown, but it could be neurodegenerative. Weight loss has been observed in patients with neurodegenerative diseases.

Objectives  To compare body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) in ET cases and controls and to determine whether BMI is correlated with tremor severity and duration.

Methods  Patients with ET were ascertained from the Neurological Institute of New York, New York, NY. Control subjects were recruited from 2 studies at the same institution. Height and weight were measured and BMI was calculated. Dietary data were collected using a Willett Semi-Quantitative Food-Frequency Questionnaire. Tremor severity was assessed using a clinical scale and the Klove Matthews Motor Steadiness Battery.

Results  The 78 cases and 242 controls were of similar age. Mean (SD) BMI in cases vs controls was 26.5 (5.0) vs 28.2 (4.8) (P = .008). This difference remained significant in an unconditional linear regression analysis that adjusted for age, sex, ethnicity, and years of education (P = .02). Mean daily caloric intake was similar in cases and controls. In cases, BMI was negatively correlated with both measures of tremor severity (r = -0.22; P = .05 and r = -0.24; P = .03) and with tremor duration (r = -0.22; P = .05).

Conclusions  The BMI was lower in ET cases than in controls, and lower BMI was associated with disease of greater severity and longer duration. Caloric intake did not differ between groups, suggesting that lower BMI is not due to a reduction in calories. Lower BMI may be due to increased energy expenditure in ET.

From the Gertrude H. Sergievsky Center (Drs Louis, Marder, and Levy, and Mss Jurewicz, Watner, and Mejia-Santana) and the Department of Neurology (Drs Louis and Marder), College of Physicians and Surgeons, Columbia University, New York, NY.

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