Objective response to ethanol in essential tremor: results from a standardized ethanol challenge study
Abstract Background and Objectives Ethanol has been reported to improve tremor severity in approximately two thirds of patients with essential tremor (ET), but the accuracy of that proportion is not certain and the mechanism of action is unknown. The goal of this study was to investigate alcohol res...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51943 |
| _version_ | 1797353823970263040 |
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| author | Patrick McGurrin Gina Norato Johanna Thompson‐Westra Gayle McCrossin Emily Lines Codrin Lungu Sanjay Pandey Sule Tinaz Bernhard Voller Vijay Ramchandani Mark Hallett Dietrich Haubenberger |
| author_facet | Patrick McGurrin Gina Norato Johanna Thompson‐Westra Gayle McCrossin Emily Lines Codrin Lungu Sanjay Pandey Sule Tinaz Bernhard Voller Vijay Ramchandani Mark Hallett Dietrich Haubenberger |
| author_sort | Patrick McGurrin |
| collection | DOAJ |
| description | Abstract Background and Objectives Ethanol has been reported to improve tremor severity in approximately two thirds of patients with essential tremor (ET), but the accuracy of that proportion is not certain and the mechanism of action is unknown. The goal of this study was to investigate alcohol response on tremor by applying an a priori objective response definition and subsequently to describe the responder rate to a standardized ethanol dose in a cohort of 85 ET patients. A secondary analysis evaluated other tremor and nontremor features, including demographics, tremor intensity, breath alcohol concentration, nontremor effects of alcohol, self‐reported responder status to ethanol, and prior ethanol exposure. Methods This was a prospective, open‐label, single‐dose challenge of oral ethanol during which motor and nonmotor measurements were obtained starting immediately prior to ethanol administration and subsequently every 20 min for 120 min. We defined tremor reduction as a 35% decline in power in the patient's tremor frequency recorded during spiral drawing 60 min after ethanol administration. Results In total, 80% of patients were considered alcohol responsive using our objective definition. Responder status and change in the objective tremor metrics were significantly correlated with the change in breath alcohol concentration levels after ethanol administration, but no other relationships to nontremor metrics were found. Discussion A high percentage of patients actually respond to acute ethanol. However, their self‐reported response does not correlate well with their objective response. Objective response correlates with breath alcohol level but not with sedation, indicating a specific effect of ethanol on tremor. |
| first_indexed | 2024-03-08T13:35:36Z |
| format | Article |
| id | doaj.art-a927110d951f4b21b291b7dfa95e6bf4 |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-03-08T13:35:36Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-a927110d951f4b21b291b7dfa95e6bf42024-01-16T18:36:37ZengWileyAnnals of Clinical and Translational Neurology2328-95032024-01-0111115616810.1002/acn3.51943Objective response to ethanol in essential tremor: results from a standardized ethanol challenge studyPatrick McGurrin0Gina Norato1Johanna Thompson‐Westra2Gayle McCrossin3Emily Lines4Codrin Lungu5Sanjay Pandey6Sule Tinaz7Bernhard Voller8Vijay Ramchandani9Mark Hallett10Dietrich Haubenberger11Office of the Senior Vice President and Provost University of Maryland College Park Maryland USAOffice of the Clinical Director National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USAHuman Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USAHuman Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USADepartment of Family Medicine University of Colorado Anschutz Aurora Colorado USADivision of Clinical Research National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USADepartment of Neurology and Stroke Medicine Amrita Hospital Faridabad IndiaDepartment of Neurology Yale School of Medicine New Haven Connecticut USANeurozentrum Bern Bern SwitzerlandHuman Psychopharmacology Laboratory National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health Bethesda Maryland USAHuman Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USAHuman Motor Control Section National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda Maryland USAAbstract Background and Objectives Ethanol has been reported to improve tremor severity in approximately two thirds of patients with essential tremor (ET), but the accuracy of that proportion is not certain and the mechanism of action is unknown. The goal of this study was to investigate alcohol response on tremor by applying an a priori objective response definition and subsequently to describe the responder rate to a standardized ethanol dose in a cohort of 85 ET patients. A secondary analysis evaluated other tremor and nontremor features, including demographics, tremor intensity, breath alcohol concentration, nontremor effects of alcohol, self‐reported responder status to ethanol, and prior ethanol exposure. Methods This was a prospective, open‐label, single‐dose challenge of oral ethanol during which motor and nonmotor measurements were obtained starting immediately prior to ethanol administration and subsequently every 20 min for 120 min. We defined tremor reduction as a 35% decline in power in the patient's tremor frequency recorded during spiral drawing 60 min after ethanol administration. Results In total, 80% of patients were considered alcohol responsive using our objective definition. Responder status and change in the objective tremor metrics were significantly correlated with the change in breath alcohol concentration levels after ethanol administration, but no other relationships to nontremor metrics were found. Discussion A high percentage of patients actually respond to acute ethanol. However, their self‐reported response does not correlate well with their objective response. Objective response correlates with breath alcohol level but not with sedation, indicating a specific effect of ethanol on tremor.https://doi.org/10.1002/acn3.51943 |
| spellingShingle | Patrick McGurrin Gina Norato Johanna Thompson‐Westra Gayle McCrossin Emily Lines Codrin Lungu Sanjay Pandey Sule Tinaz Bernhard Voller Vijay Ramchandani Mark Hallett Dietrich Haubenberger Objective response to ethanol in essential tremor: results from a standardized ethanol challenge study Annals of Clinical and Translational Neurology |
| title | Objective response to ethanol in essential tremor: results from a standardized ethanol challenge study |
| title_full | Objective response to ethanol in essential tremor: results from a standardized ethanol challenge study |
| title_fullStr | Objective response to ethanol in essential tremor: results from a standardized ethanol challenge study |
| title_full_unstemmed | Objective response to ethanol in essential tremor: results from a standardized ethanol challenge study |
| title_short | Objective response to ethanol in essential tremor: results from a standardized ethanol challenge study |
| title_sort | objective response to ethanol in essential tremor results from a standardized ethanol challenge study |
| url | https://doi.org/10.1002/acn3.51943 |
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