Calzetti S, Findley L J, Perucca E, Richens A
Neuro-Otology Unit, National Hospital, Queen Square, London, UK.
J Neurol Neurosurg Psychiatry. 1983 May;46(5):393-8. doi: 10.1136/jnnp.46.5.393.
The factors influencing the response of essential tremor to prolonged administration of propranolol (120 mg daily for two weeks followed by 240 mg daily for a further two weeks) were investigated in a double-blind, cross-over, placebo-controlled study in 16 patients. Hand tremor was assessed by means of accelerometers with off-line computer analysis. Propranolol was found to be superior to placebo only at the higher dosage regimen (240 mg daily). At this dosage, the median reduction in tremor amplitude (as compared to the control value) was by 45%. The response to the drug (expressed as percentage change in tremor amplitude) was correlated positively with the control amplitude (rs = 0.71, p < 0.01) and negatively (but more weakly) with the control peak frequency of tremor (rs = -0.53, p < 0.05). In the patients with hand tremor greater than 6 x 10(-3) cm hand displacement the tremor amplitude was reduced by 65%, as compared to only 17% in patients whose tremor amplitude was below this limit. No statistically significant relationship could be found between percentage change in tremor amplitude and duration of the disorder, age of the patients, degree of cardiac beta-blockade or serum propranolol levels. The results suggest that patients with small tremor amplitude should not be treated with propranolol unless their tremor becomes severely aggravated under conditions of excessive adrenergic discharge.
在一项针对16例患者的双盲、交叉、安慰剂对照研究中，调查了长期服用普萘洛尔（最初两周每日120毫克，随后两周每日240毫克）时影响特发性震颤反应的因素。通过加速度计进行离线计算机分析来评估手部震颤。结果发现，仅在较高剂量方案（每日240毫克）下，普萘洛尔才优于安慰剂。在此剂量下，震颤幅度的中位数降低（与对照值相比）为45%。药物反应（以震颤幅度的百分比变化表示）与对照幅度呈正相关（rs = 0.71，p < 0.01），与震颤的对照峰值频率呈负相关（但较弱，rs = -0.53，p < 0.05）。手部震颤大于6×10⁻³厘米手部位移的患者，其震颤幅度降低了65%，而震颤幅度低于此限值的患者仅降低了17%。在震颤幅度的百分比变化与疾病持续时间、患者年龄、心脏β受体阻滞程度或血清普萘洛尔水平之间，未发现有统计学意义的关系。结果表明，除非在肾上腺素能过度释放的情况下震颤严重加重，否则震颤幅度较小的患者不应使用普萘洛尔治疗。
