Frequency of tremor in people with multiple sclerosis: A systematic review and meta-analysis

Abstract

BACKGROUND: Multiple sclerosis (MS) is a chronic neurodegenerative disorder causing various symptoms, including tremors, which significantly affect the quality of life and disability in people with MS (PwMS). Previous studies report a wide range of tremor frequency in PwMS, necessitating a comprehensive review for reliable estimates. OBJECTIVES: This review aimed to elucidate the frequency rate of tremor among PwMS. METHOD: A systematic search was conducted in PubMed/MEDLINE, Embase, Scopus, and Web of Science up to April 27, 2024, to identify studies evaluating various types of tremors in PwMS. The Meta-proportion method implemented in R software version 4.0.0, utilizing a random-effects model, was employed to estimate the pooled frequency rates of tremor, with its 95 confidence interval (CI), among PwMS. RESULTS: From 3780 studies, 14 studies encompassing 17,458 PwMS (71.5 female) were included. The mean age was 46.4 years, with a disease duration of 9.3 years and an Expanded Disability Status Scale (EDSS) score of 3.4. The pooled frequency of tremor was 33.32 (95 CI: 23.47 to 44.88 ; I(2) = 98 ; p-heterogeneity < 0.01). Subgroup analysis by sample size revealed that the pooled frequency of tremor in PwMS was significantly lower (p-value < 0.01) in studies with over 200 participants (22.46, 95 CI: 15.69 to 31.08 , I(2) = 99 ; p-heterogeneity < 0.01) compared to those with fewer than 200 participants (47.65, 95 CI: 31.97 to 63.81 , I(2) = 91 ; p-heterogeneity < 0.01). CONCLUSION: Tremor is a prevalent complaint in PwMS. These findings highlight the necessity for targeted supportive, therapeutic, and rehabilitative interventions to effectively address this prevalent issue in PwMS.