The heterogeneity of drug response as the basis of identification of essential tremor subtypes

Abstract

Introduction. Essential tremor (ET) is one of the most common movement disorders. It is mainly characterized by postural and kinetic tremor, affecting arms and other body parts. Progression of ET violates social activity, lowers self-esteem, and occasionally leads to the patient’s disability. Selection of an effective drug therapy for ET is mostly carried out empirically and takes long time, which causes additional negative psycho-emotional effects, distrust of the doctor and abandonment of the treatment. Present study is aimed at the implementing a novel approach to the segregation of ET subtypes based on the heterogeneity of the pharmacological response. Results. Neuroanatomical, electrophysiological and biochemical data published to date are outlined in the current paper, to designate parameters for identification of ET subtypes with deterministic pharmacological response. Before prescribing pharmacotherapy for patients with ET, it is necessary to perform asurface electromyography to identify the patterntype of antagonist muscles contractions. In addition, the concentration of glutamate and gamma-aminobutyric acid in peripheral blood should be determined. Conclusion. The heterogeneity of pharmacological response among patients with ET necessitates a more subtle classification within the syndrome by neuroanatomical, electrophysiological and biochemical indicators. The approach proposed in the review will increase the effectiveness of therapy and improve the lifequality of patients with ET. (For citation: Muruzheva ZM, Karpenko MN, Klimenko VM. The heterogeneity of drug response as the basis of identificationof essential tremor subtypes. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(1):54-59. doi: 10.17816/RCF16154-59).