SynthesisMovement disorders : official journal of the Movement Disorder Society2026
Update on Medical Treatments for Essential Tremor: An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review.
Synthesis in Movement disorders : official journal of the Movement Disorder Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Peripheral nerve stimulation for essential tremor: a GRADE-assessed systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Efficacy and safety of botulinum toxin type a for upper-limb essential tremor: a systematic review and meta-analysis of randomized placebo-controlled trials.Frontiers in neurology · 2026Pooled it
- Signal-based differentiation of essential and dystonic tremor.Frontiers in neurology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe first International Parkinson and Movement Disorder Society Evidence-Based Medicine (MDS-EBM) review for essential tremor (ET) was published in 2019; since then, the modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was adopted by MDS, and new evidence exists.
objectiveThe objective of this study was to update EBM conclusions for medical treatments of ET with a focus on longer follow-up periods.
methodsA systematic literature search was conducted for randomized controlled trials (RCTs) investigating medical interventions for ET with a minimum 1-month follow-up, with subsequent appraisal of data using an MDS-EBM framework.
resultsThirty-one RCTs were included evaluating 16 interventions against placebo. Nine interventions were evaluated by more than one RCT: alprazolam, botulinum toxin type A (BtA), levetiracetam, phenobarbitone, pregabalin, primidone, propranolol, topiramate, and trazodone. The remainder were studied in a single RCT (acetazolamide, flunarizine, gabapentin, mirtazapine, perampanel, progabide, and zonisamide). Trial sample size ranged from 5 to 117 participants, and study duration ranged from 4 to 28 weeks. More than one RCT documented improvement in tremor severity for propranolol, primidone, topiramate, and BtA. Using the modified GRADE framework, we found significant methodological shortcomings in the studies, resulting in insufficient evidence for all interventions. Concerns about risk of bias and imprecision commonly limited the ability to make stronger recommendations for these interventions.
conclusionsCurrent evidence from RCTs with at least 1 month of follow-up is insufficient to confidently support the efficacy of available medical treatments for ET. There is a need for longer, higher-quality clinical trials to improve treatment recommendations and guide decision-making for clinicians and patients with ET. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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