The impact of pregabalin and gabapentin on essential tremor: a systematic review and meta-analysis.

IF 1.8 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders Pub Date : 2025-07-30 eCollection Date: 2025-01-01 DOI:10.1016/j.prdoa.2025.100381

Hooman Pourbala, Zhale Nahavandi, Arash Maghsoudlou, Melina Gazerani Farahani, Avin Khallaghi, Sepehr Izadi, Mehrdad Faizi, Mehran Ghaffari, Hadi Esmaily

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Abstract

Introduction: Essential tremor (ET) is a common neurological disorder characterized by involuntary rhythmic oscillations. Emerging evidence suggests that gabapentinoids, including gabapentin and pregabalin, may be effective in managing ET. This study aimed to assess the efficacy of gabapentinoids in treating ET by analyzing data from randomized controlled trials (RCTs).

Methods: A systematic search was conducted across various databases to identify relevant RCTs utilizing gabapentin or pregabalin. Tremor severity was evaluated using the total tremor score (TTS) and accelerometry.

Results: In a between-group meta-analysis of seven RCTs (N = 235), gabapentinoids did not significantly outperform placebo in reducing TTS or its subscales. Accelerometry data suggested a non-significant trend favoring gabapentinoids.However, within-group analyses demonstrated a significant reduction in TTS from baseline with gabapentinoids overall (P = 0.016), an effect driven by gabapentin (P = 0.021) but not pregabalin. No significant within-group improvements were observed for TTS subscales or accelerometry measures post-treatment.

Conclusion: This meta-analysis found no significant advantage of gabapentinoids over placebo in ET. However, within-group analyses demonstrated that gabapentin-but not pregabalin-significantly reduced tremor severity from baseline, suggesting a potential therapeutic signal that warrants further investigation. Larger, standardized trials are needed to identify which patient subgroups, if any, may benefit from gabapentin therapy.

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普瑞巴林和加巴喷丁对特发性震颤的影响：系统回顾和荟萃分析。

特发性震颤（ET）是一种常见的神经系统疾病，其特征是不自主的节律性振荡。新出现的证据表明，加巴喷丁类药物，包括加巴喷丁和普瑞巴林，可能对ET治疗有效。本研究旨在通过分析随机对照试验（RCTs）的数据来评估加巴喷丁类药物治疗ET的疗效。方法：在不同数据库中进行系统检索，以确定使用加巴喷丁或普瑞巴林的相关随机对照试验。使用总震颤评分（TTS）和加速度计评估震颤严重程度。结果：在7项随机对照试验（N = 235）的组间荟萃分析中，加巴喷丁类在降低TTS或其亚量表方面没有显著优于安慰剂。加速度计数据显示，加巴喷丁类药物没有明显的优势。然而，组内分析显示，加巴喷丁类药物总体上较基线显著降低TTS (P = 0.016)，加巴喷丁（P = 0.021）而普瑞巴林不起作用。治疗后TTS亚量表或加速测量没有观察到组内显著改善。结论：本荟萃分析未发现加巴喷丁类药物在ET治疗中较安慰剂有显著优势。然而，组内分析表明，加巴喷丁（而非普瑞巴林）可显著降低基线震颤严重程度，这表明其潜在的治疗信号值得进一步研究。需要更大规模的标准化试验来确定哪些患者亚组（如果有的话）可以从加巴喷丁治疗中获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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