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Essential tremor is associated with reduced serum ceruloplasmin levels

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Abstract

Background

Essential tremor (ET), a prevalent movement disorder, has an elusive pathogenesis. A reduction in ceruloplasmin (Cp) levels can be found in some patients with ET. In addition, some studies have suggested an association between ET and neurodegeneration. As a ferroxidase, Cp is critical for iron metabolism, protecting against oxidative stress and neurodegeneration. Iron metabolism dysregulation, linked to ferroptosis, has implications in neurodegenerative diseases. Yet, research on Cp and ET remains limited.

Objectives

This study aims to elucidate the relationship between ET and serum Cp levels.

Methods

We collected demographic and clinical data from 62 patients with ET satisfying the diagnostic criteria and compared these to data from 100 healthy controls.

Results

The median Cp levels in ET patients were 21.5 (18.8, 23.9) mg/dL, significantly lower than those in controls (23.1 [(20.7, 25.7) mg/dL; P = 0.006]). A reduction in Cp levels emerged as a risk factor for ET incidence (odds ratio (OR) = 0.873, 95% confidence interval (CI), 0.795, 0.959; P = 0.005). The area under the receiver operating characteristic (ROC) curve for serum Cp levels to predict the onset of ET was 0.629 (95% CI, 0.537–0.720; P = 0.006), and the optimal cut-off value for Cp levels was 19.5 mg/dL with a sensitivity of 91% and a specificity of 33.9%.

Conclusion

Our analysis suggests that reduced Cp levels are associated with ET. We speculate that reduced Cp levels may be involved in the pathogenesis of ET, which requires further studies.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We extend our heartfelt gratitude to everyone who contributed to this study, particularly the patients and control subjects. We express our appreciation to the reviewers for their insightful and constructive feedback on the manuscript. Additionally, we are thankful to the Translational Medicine Center of the First Affiliated Hospital of Zhengzhou University for their unwavering support.

Funding

This study was funded by the Natural Science Foundation of Henan Province (162300410278).

Author information

Author notes

  1. **aotong Hou and Liting Wei contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    **aotong Hou, **shun Liu, Shibo Li & Jiwei Zhang

  2. Department of Neurology, Luoyang Central Hospital: Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China

    Liting Wei

  3. Translational Medicine Center, The First Affiliated Hospital of Zhengzhou University, 1 Longhu Central Ring Road, Zhengzhou, 450003, China

    Jiwei Zhang

Authors
  1. **aotong Hou
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by **aotong Hou and Liting Wei. Analysis was performed by **aotong Hou, Liting Wei, **shun Liu, and Shibo Li. The first draft of the manuscript was written by **aotong Hou and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jiwei Zhang.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University (No. 2023-KY-0257- 002). All patients were exempted from signing the informed consent.

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The authors declare no competing interests.

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Hou, X., Wei, L., Liu, J. et al. Essential tremor is associated with reduced serum ceruloplasmin levels. Neurol Sci (2024). https://doi.org/10.1007/s10072-024-07441-8

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