The first-line treatments for essential tremor are beta-blockers, drugs commonly used in cardiac disorders. They allow a 50% reduction in the amplitude of tremors, but are contraindicated in asthma or diabetes.
Medications
Antiepileptics or anxiolytics can also reduce the magnitude of tremors.
However, no essential tremor-specific medication is yet available.
Some patients experience a significant decrease in symptoms after ingesting a small amount of alcohol. However, the risk of addiction must be taken into account, and the patient must be warned of the “rebound” effect of shaking the day after drinking.
Deep Brain Stimulation
In the most severe cases of essential tremor, the treatment involves implanting a stimulation electrode into the thalamus that delivers electrical impulses that control the tremor.
Deep brain stimulation is a surgical procedure that reduces tremors by 70 to 80%.
At Paris Brain Institute
At Paris Brain Institute, a Phase 2 clinical trial led by Prof. Carine Karachi, in collaboration with Prof. Stéphane Lehéricy, Dr. Elodie Hainque, is underway. The ULTRABRAIN project involves coupling two technologies: focused ultrasound and MRI. When applied at low intensity, ultrasound is used to neuromodulate the activity of a targeted area of the thalamus, i.e. to modify briefly the activity of this area. The effectiveness of this neuromodulation is verified in real time in a patient awake during the procedure by the immediate disappearance of his tremors.
This project is an important step forward for patients as it provides access to minimally invasive treatment that is personalized and targeted to the brain region to be treated, while limiting side effects. This innovative therapy now greatly reduces upper limb tremor and thus improves patients’ quality of life.