Biblioteca Hospital 12 de Octubre
González de la Aleja Tejera, Jesús Romero Muñoz, Juan Pablo Saiz Díaz, Rosa Ana Benito León, Julián

Effects of alprazolam on cortical activity and tremors in patients with essential tremor. [articulo] - PloS one, 2014 - 9(3):e93159.

Formato Vancouver:
Ibáñez J, González de la Aleja J, Gallego JA, Romero JP, Saíz-Díaz RA, Benito-León J et al. Effects of alprazolam on cortical activity and tremors in patients with essential tremor. PLoS One. 2014 Mar 25;9(3):e93159.

PMID: 24667763
PMC3965529

Contiene 54 referencias

Background: 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.
Methods: 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.
Results: 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<0.05). At the same time, the cortico-muscular coherence at the tremor frequency became non-significant (P<0.05). We also found a significant correlation (r = 0.757, P<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.
Conclusions: 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. We hypothesise that the increase in cortical beta activity may act as a blocking mechanism and may dampen the pathological oscillatory activity, which in turn attenuates the observed tremor.

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