Effects of alprazolam on cortical activity and tremors in patients with essential tremor

Essential tremor (ET) is characterised by postural and action tremors with a frequency of 4-12 Hz. Previous studies suggest that the tremor activity originates in the cerebello-thalamocortical pathways. Alprazolam is a short-acting benzodiazepine that attenuates tremors in ET. The mechanisms that me...

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Published in:PloS one 2014-03, Vol.9 (3), p.e93159-e93159
Main Authors: Ibáñez, Jaime, González de la Aleja, Jesús, Gallego, Juan A, Romero, Juan P, Saíz-Díaz, Rosana A, Benito-León, Julián, Rocon, Eduardo
Format: Article
Language:English
Subjects:
Alcohol
Alprazolam
Alprazolam - pharmacology
Alprazolam - therapeutic use
Analysis
Attenuation
Benzodiazepines
Bioengineering
Biology and Life Sciences
Brain - drug effects
Brain - physiopathology
Care and treatment
Cerebral cortex
Coherence
Electrodes
Electroencephalography
Electromyography
Engineering and Technology
Essential Tremor - complications
Essential Tremor - drug therapy
Essential Tremor - physiopathology
Female
Health aspects
Humans
Male
Medicine
Medicine and Health Sciences
Middle Aged
Muscles - drug effects
Muscles - physiopathology
Neurology
Patients
Posture
Quantitative analysis
Reduction
Rhythm
Thalamus
Tomography
Tremor
Tremor - complications
Tremor - drug therapy
Tremors
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cited_by cdi_FETCH-LOGICAL-c692t-e21eeb0c6d9d1c011813d5ffeebf1682d4115d72b96924c7b288cc79ab16371f3
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creator Ibáñez, Jaime
González de la Aleja, Jesús
Gallego, Juan A
Romero, Juan P
Saíz-Díaz, Rosana A
Benito-León, Julián
Rocon, Eduardo
description Essential tremor (ET) is characterised by postural and action tremors with a frequency of 4-12 Hz. Previous studies suggest that the tremor activity originates in the cerebello-thalamocortical pathways. Alprazolam is a short-acting benzodiazepine that attenuates tremors in ET. The mechanisms that mediate the therapeutic action of alprazolam are unknown; however, in healthy subjects, benzodiazepines increase cortical beta activity. In this study, we investigated the effect of alprazolam both on beta and tremor-related cortical activity and on alterations in tremor presentation in ET patients. Therefore, we characterised the dynamics of tremor and cortical activity in ET patients after alprazolam intake. We recorded hand tremors and contralateral cortical activity in four recordings before and after a single dose of alprazolam. We then computed the changes in tremors, cortico-muscular coherence, and cortical activity at the tremor frequency and in the beta band. Alprazolam significantly attenuated tremors (EMG: 76.2 ± 22.68%), decreased cortical activity in the tremor frequency range and increased cortical beta activity in all patients (P
doi_str_mv 10.1371/journal.pone.0093159
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Alprazolam significantly attenuated tremors (EMG: 76.2 ± 22.68%), decreased cortical activity in the tremor frequency range and increased cortical beta activity in all patients (P&lt;0.05). At the same time, the cortico-muscular coherence at the tremor frequency became non-significant (P&lt;0.05). We also found a significant correlation (r = 0.757, P&lt;0.001) between the reduction in tremor severity and the increased ratio of cortical activity in the beta band to the activity observed in the tremor frequency range. This study provides the first quantitative analysis of tremor reduction following alprazolam intake. We observed that the tremor severity decreased in association with an increased ratio of beta to tremor-related cortical activity. 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Previous studies suggest that the tremor activity originates in the cerebello-thalamocortical pathways. Alprazolam is a short-acting benzodiazepine that attenuates tremors in ET. The mechanisms that mediate the therapeutic action of alprazolam are unknown; however, in healthy subjects, benzodiazepines increase cortical beta activity. In this study, we investigated the effect of alprazolam both on beta and tremor-related cortical activity and on alterations in tremor presentation in ET patients. Therefore, we characterised the dynamics of tremor and cortical activity in ET patients after alprazolam intake. We recorded hand tremors and contralateral cortical activity in four recordings before and after a single dose of alprazolam. We then computed the changes in tremors, cortico-muscular coherence, and cortical activity at the tremor frequency and in the beta band. Alprazolam significantly attenuated tremors (EMG: 76.2 ± 22.68%), decreased cortical activity in the tremor frequency range and increased cortical beta activity in all patients (P&lt;0.05). At the same time, the cortico-muscular coherence at the tremor frequency became non-significant (P&lt;0.05). We also found a significant correlation (r = 0.757, P&lt;0.001) between the reduction in tremor severity and the increased ratio of cortical activity in the beta band to the activity observed in the tremor frequency range. This study provides the first quantitative analysis of tremor reduction following alprazolam intake. We observed that the tremor severity decreased in association with an increased ratio of beta to tremor-related cortical activity. 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subjects Alcohol
Alprazolam
Alprazolam - pharmacology
Alprazolam - therapeutic use
Analysis
Attenuation
Benzodiazepines
Bioengineering
Biology and Life Sciences
Brain - drug effects
Brain - physiopathology
Care and treatment
Cerebral cortex
Coherence
Electrodes
Electroencephalography
Electromyography
Engineering and Technology
Essential Tremor - complications
Essential Tremor - drug therapy
Essential Tremor - physiopathology
Female
Health aspects
Humans
Male
Medicine
Medicine and Health Sciences
Middle Aged
Muscles - drug effects
Muscles - physiopathology
Neurology
Patients
Posture
Quantitative analysis
Reduction
Rhythm
Thalamus
Tomography
Tremor
Tremor - complications
Tremor - drug therapy
Tremors
title Effects of alprazolam on cortical activity and tremors in patients with essential tremor
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