Clinical trial: Defining Phenotypes of Movement Disorders :Parkinson's Plus Disorders (PD), Essential Tremor (ET), Cortical Basal Degeneration (CBD), Multiple Systems Atrophy (MSA), Magnetoencephalography. (NCT02132052)

Eligibility criteria:
Inclusion Criteria:

          -  All subjects will be age 40 or older,

          -  Be on stable medications for at least 30 days

          -  Montreal Cognitive Assessment (MOCA) of 26 or higher

          -  Scores within 1.5 standard deviations of age-matched norms for all neuropsychological
             tests

          -  Parkinson's Plus Disorders (PD) will be defined using United Kingdom (UK) Brain Bank
             Criteria.

          -  PD dementia (PDD) will be defined using the Movement Disorder Task Force 2007 criteria
             and supported by scores less than 1.5 standard deviations of age-matched norms in at
             least two domains.

          -  Probable Alzheimer's Disease (AD) will be defined using the National Institute on
             Aging-Alzheimer Association 2011 guidelines.

          -  Parkinson's Plus Disorders (PD) with mild cognitive impairment (MCI) will be defined
             by history, MOCA of 21 or higher, at least one score less than 1.5 standard deviations
             of age-matched norms, and cannot meet diagnostic criteria for PDD.

          -  Essential tremor and Parkinson plus syndromes (multiple systems atrophy, corticobasal
             degeneration, progressive supranuclear palsy) will be defined using previously
             published research criteria.19-22

        Exclusion Criteria

          -  Features suggestive of other causes of parkinsonism/Parkinson-plus syndromes;

          -  Features suggestive of other causes of dementia, including moderate to severe
             cerebrovascular disease by history, or imaging or history of major head trauma;

          -  History of deep brain stimulation, ablation surgery, or other brain surgery;

          -  Evidence for depression based on the Hospital Anxiety Depression Scale (score > 11).
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 40 Years old.


Patient description (medical language): A 60-year-old man comes to the clinic complaining of hand tremor that started few months ago.  It is most bothering when he wants to drink from a glass or pour from a bottle. He does not smoke, but drinks occasionally. He recently started consuming more alcohol as his tremor subsides somewhat when he drinks small amounts of alcohol.  Family history is significant for similar problems in his mother.  Vital signs are normal and the patient has no other medical conditions.  Neurologic examination shows bilateral tremor in the upper extremities. The diagnosis of essential tremor is confirmed.

Patient description (patient's own words): I'm only a 60 years old man but I already suffer from shaky hands. It started a few months ago, and it really bothers me when I want to pour myself a glass or even while drinking. I don't smoke, but I drink alcohol from time to time. To be honest, I've been drinking a little more lately since it helps me with the shaking. My mom had the same issue when she was my age. The doctor took my vitals, and they were normal. I don't have any other medical issues. I underwent neurological exams and it showed that I’m shaky from both sides. The doctor diagnosed me with essential tremor.

Does the patient match the trial criteria? Entailment