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Journal of Neurology
Published in: Journal of Neurology 11/2018

01-11-2018 | Original Communication

Differential effects of propranolol on head and upper limb tremor in patients with essential tremor and dystonia

Authors: Giulia Paparella, Gina Ferrazzano, Antonio Cannavacciuolo, Francesco Cogliati Dezza, Giovanni Fabbrini, Matteo Bologna, Alfredo Berardelli

Published in: Journal of Neurology | Issue 11/2018

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Abstract

Propranolol is used as the first-line treatment in essential tremor and it has also been proposed as a treatment for tremor in dystonia. However, several issues remain uncertain. For example, it is still not clear whether propranolol exerts a beneficial effect on head tremor. Moreover, no studies have investigated whether the effect of propranolol on head and upper limb tremor in essential tremor differs from that in dystonia. We aimed to assess the effects of propranolol on tremor in different body parts in essential tremor and in patients with tremor and dystonia. Twenty-nine patients with head and upper limb tremor were enrolled in the study, 14 with essential tremor, and 15 with dystonia. Participants underwent a clinical and kinematic analysis of tremor in two sessions, i.e., without (baseline) and ‘on therapy’ with propranolol. We found that head tremor was more severe in patients with dystonia, while upper limb tremor was more evident in patients with essential tremor (P < 0.05). Propranolol had no effect on head tremor in either group (all Ps > 0.05), but it did reduce upper limb tremor in patients with essential tremor. The present study demonstrates differential effects of propranolol on head and upper limb tremor in patients with essential tremor. The lack of effect on head and upper limb tremor in patients with dystonia suggests that the pathophysiological mechanisms underlying tremor in these two conditions and in different body parts may be distinct.
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Metadata
Title
Differential effects of propranolol on head and upper limb tremor in patients with essential tremor and dystonia
Authors
Giulia Paparella
Gina Ferrazzano
Antonio Cannavacciuolo
Francesco Cogliati Dezza
Giovanni Fabbrini
Matteo Bologna
Alfredo Berardelli
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 11/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-018-9052-z

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