Evaluation of blood heavy metal concentrations in patients with essential tremor

Essential Tremor (ET); is one of the most common movement disorders and is a chronic neurological disease characterized by the involvement of the upper extremity and/or other body parts, with prominent postural and kinetic tremors. Its incidence increases bimodally in young adults and over 60 years of age. Genetic and environmental factors play a very important role in the etiology of the disease. Heavy metals, organic solvents, pesticides, β-carboline alkaloids were investigated in terms of environmental predisposing factors. As a result of the accumulation of heavy metal exposure in the basal ganglia, all kinds of movement disorders may occur. There are studies evaluating blood Pb levels in ET patients. However, there is no clear data in the literature about the effects of heavy metals (Al, Cr, Mn, Ni, Cu, Zn, Cd, Sn, Sb, Pb) that we are frequently exposed to on ET. In this study, we aimed to reveal the relationship between tremor characteristics, neuropsychiatric evaluation and sleep scales and heavy metal levels in the blood of ET patients, and the possible place of these heavy metals in the etiology of the disease. Our study is a cross-sectional case-control study. 110 ET patients followed in our movement disorders outpatient clinic and 104 healthy controls were included in our study. Sociodemographic characteristics, personal and family history information of the patient and control groups were recorded. The patients underwent a detailed neurological examination, the drugs they used and the history of the disease were taken. In the patient group, Basic Tremor Evaluation Evaluation Scale, Fahn-Tolosa-Marin Tremor Evaluation Scales; Beck Depression and Anxiety Scales, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were applied to all participants. Heavy metal levels of peripheral blood samples taken from all participants were examined. Al, Cd, Cr and Sb blood levels were found to be statistically significantly higher in ET patients compared to the control group. A positive correlation was found between disease duration and Al blood level. A positive correlation was found between Al blood level and BAI score; between Sb, Zn blood levels and BDI scores of the patient group. When these results are evaluated, we think that ET and Al, Cd, Cr and Sb blood levels could be etiologically related. Keywords: Essential tremor, heavy metal, etiology, toxicity, spectrometry