Huang H, Yang X, Zhao Q, et al. - Given that The International Parkinson and Movement Disorder Society introduced the category of essential tremor (ET; most prevalent movement disorders affecting about 1%-5% of the population above the age of 60 years worldwide)-plus in its new ET classification scheme, researchers conducted this first large sample study that concentrated on the motor and non-motor symptoms in ET syndrome patients with different subtypes. They expect to better understand the impact and invoked questions of the new classification on clinical practice by comparing the clinical characteristics of ET and ET-plus patients. They analyzed the records of 280 ET syndrome individuals in an ongoing cross-sectional study in a Chinese population and reclassified them based on the new criteria. Using logistic regression, risk factors of diagnosis of ET-plus were explored. In total, 121 patients were reclassified as having ET and 117 as having ET-plus. At the onset of tremor, the ET-plus group was significantly older, less educated, and more likely to have cranial tremor, symptoms of depression, symptoms of anxiety, and likely REM sleep behavior disorder. In addition, ET-plus group exhibited more severe upper limb tremor and cognition impairment. The new classification system underscored the heterogeneity of ET syndrome. ET-plus can not be regarded as an ET syndrome subtype or diagnosis but rather as a placeholder reflecting an area of current scientific uncertainty.