Dietary Epidemiology of Essential Tremor: Meat Consumption and Meat Cooking Practices

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Abstract

Background/Aim: Harmane [1-methyl-9H-pyrido(3,4-b)indole] is a tremor-producing neurotoxin. Blood harmane concentrations are elevated in essential tremor (ET) patients for unclear reasons. Potential mechanisms include increased dietary harmane intake (especially through well-cooked meat) or genetic-metabolic factors. We tested the hypothesis that meat consumption and level of meat doneness are higher in ET cases than in controls. Methods: Detailed data were collected using the Lawrence Livermore National Laboratory Meat Questionnaire. Results: Total current meat consumption was greater in men with than without ET (135.3 ± 71.1 vs. 110.6 ± 80.4 g/day, p = 0.03) but not in women with versus without ET (80.6 ± 50.0 vs. 79.3 ± 51.0 g/day, p = 0.76). In an adjusted logistic regression analysis in males, higher total current meat consumption was associated with ET (OR = 1.006, p = 0.04, i.e., with 10 additional g/day of meat, odds of ET increased by 6%). Male cases had higher odds of being in the highest than lowest quartile of total current meat consumption (adjusted OR = 21.36, p = 0.001). Meat doneness level was similar in cases and controls. Conclusion: This study provides evidence of a dietary difference between male ET cases and male controls. The etiological ramifications of these results warrant additional investigation.

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Most cited references 19

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Prevalence of essential tremor in three elderly populations of central Spain.

Julián Benito-León, Felix Bermejo-Pareja, Jose-Manuel Morales … (2003)

Although essential tremor (ET) is considered the most prevalent adult movement disorder, the available information on its prevalence and distribution worldwide is not completely understood. We investigated the prevalence and distribution of ET in three elderly Spanish populations using a door-to-door, two-phase approach. A brief screening instrument was administered on May 1, 1994 to subjects over 64 years old taken from the census of one urban municipality of Greater Madrid (quarter of Margaritas, Getafe), one urban district of Madrid (Lista), and one rural site (Arévalo county, Avila) (N = 5278). Study subjects were limited to those who screened positively (N = 472). To increase reliability, each patient was examined by 3 experienced neurologists, and was classified as having ET only when all 3 neurologists agreed (183 of 472). The present study was part of a large-scale epidemiological survey of neurological diseases, and served as a baseline investigation in a 3-year incidence study. Accordingly, 41 ET patients were identified when evaluating subjects who had screened positively for dementia, stroke, or parkinsonism, despite the fact that they had screened negatively for tremor; furthermore, 32 additional ET prevalent cases were detected when evaluating subjects who had screened positively for tremor in the second cross-sectional study (May 1, 1997), although they had screened negatively for tremor in the first cross-sectional study. We identified 256 persons (152 women, 104 men) with ET; of these, 87 patients (34.0%) reported having an affected relative. Two hundred and four (79.7%) of the subjects with ET were detected through this screening and had not been diagnosed previously. The prevalence of ET was 4.8% (95% CI = 4.2-5.4) for the total population; 4.6% (95% CI = 3.7-5.4) in men and 5.0% (95% CI = 4.2-5.8) in women. Age-specific prevalence increased with advancing age for both men and women. Despite the variability in worldwide data, ET is a frequently encountered disorder in elderly people. Furthermore, as ET may be seen as a relatively benign condition, a large proportion of patients may never seek neurological attention. Copyright 2002 Movement Disorder Society

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Incidence of essential tremor in three elderly populations of central Spain.

E Louis, Julián Benito-León, … (2005)

To estimate the incidence of essential tremor (ET) in three populations in central Spain using data from the Neurologic Disorders in Central Spain (NEDICES), a population-based survey of elderly subjects (65 years and older). Individuals were evaluated at baseline (1994 to 1995) and at follow-up (a median of 3.3 years later in 1997 to 1998). The evaluation included a screening question for ET and a neurologic examination, when possible. Of 5,278 subjects evaluated at baseline, there were 256 prevalent ET cases. Eighty-three incident ET cases were identified among 3,942 individuals assessed at follow-up. The adjusted annual incidence rate (per 100,000 person-years) in the population aged 65 years and older was 616 (95% CI: 447 to 784). Sixty-four (77.1%) of 83 incident cases had not been diagnosed before our assessment. The incidence of ET may be higher than previously recognized because a large proportion of patients with ET may never seek medical attention.

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Degeneration of Purkinje cells in parasagittal zones of the cerebellar vermis after treatment with ibogaine or harmaline.

E O'Hearn, M.E. Molliver (1993)

The indole alkaloids ibogaine and harmaline are beta-carboline derivatives that cause both hallucinations and tremor. Reports that ibogaine may have potent anti-addictive properties have led to initiatives that it be tested for the treatment of opiate and cocaine addiction. In this study, ibogaine-treated rats were analysed for evidence of neurotoxic effects because human clinical trials of ibogaine have been proposed. We recently found that ibogaine induces a marked glial reaction in the cerebellum with activated astrocytes and microglia aligned in parasagittal stripes within the vermis. Based on those findings, the present study was conducted to investigate whether ibogaine may cause neuronal injury or degeneration. The results demonstrate that, after treatment with ibogaine or harmaline, a subset of Purkinje cells in the vermis degenerates. We observed a loss of the neuronal proteins microtubule-associated protein 2 and calbindin co-extensive with loss of Nissl-stained Purkinje cell bodies. Argyrophilic staining of Purkinje cell bodies, dendrites and axons was obtained with the Gallyas reduced silver method for degenerating neurons. Degenerating neurons were confined to narrow parasagittal stripes within the vermis. We conclude that both ibogaine and harmaline have selective neurotoxic effects which lead to degeneration of Purkinje cells in the cerebellar vermis. The longitudinal stripes of neuronal damage may be related to the parasagittal organization of the olivocerebellar climbing fiber projection. Since these drugs produce sustained activation of inferior olivary neurons, we hypothesize that release of an excitatory amino acid from climbing fiber synaptic terminals may lead to excitotoxic degeneration of Purkinje cells.

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Author and article information

Journal

Journal ID (publisher-id): NED

Journal ID (nlm-ta): Neuroepidemiology

Journal ID (doi): 10.1159/issn.0251-5350

Title: Neuroepidemiology

Publisher: S. Karger AG

ISSN (Print): 0251-5350

ISSN (Electronic): 1423-0208

Publication date Subscription-year: 2008

Publication date (Print): May 2008

Publication date (Electronic): 02 April 2008

Volume: 30

Issue: 3

Pages: 161-166

Affiliations

^aG.H. Sergievsky Center, ^bDepartment of Neurology, and ^cTaub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, and ^dDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, N.Y., ^eEnergy and Environmental Directorate, Lawrence Livermore National Security, LLC, Livermore, Calif., USA

Article

Publisher ID: 122333 Pmcid ID: PMC2821442 Other ID: Neuroepidemiology 2008;30:161–166

DOI: 10.1159/000122333

PMC ID: PMC2821442

PubMed ID: 18382115

SO-VID: f5eff71e-3c29-4127-9a2e-8db030cc1ac9

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 26 September 2007

Date accepted : 23 January 2008

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Figures: 1, Tables: 3, References: 26, Pages: 6

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Dietary Epidemiology of Essential Tremor: Meat Consumption and Meat Cooking Practices

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Karger: Neurology and Neuroscience

Most cited references 19

Prevalence of essential tremor in three elderly populations of central Spain.

Incidence of essential tremor in three elderly populations of central Spain.

Degeneration of Purkinje cells in parasagittal zones of the cerebellar vermis after treatment with ibogaine or harmaline.

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