Health. What neurological disease does Clara Luciani suffer from?

"I'm shaking all the time." In an interview with the Konbini website , on David Castello-Lopes' Small Talk show, Clara Luciani returned on Wednesday, May 14, to the neurological condition she suffers from, essential tremor. "My mother has the same thing, I don't think it's going to get better with age," continued the French singer-songwriter.

What is essential tremor disease?

According to the Brain Institute, 50 to 70% of cases of essential tremor are genetic in origin and 300,000 people are affected in France. And according to the Association of People Affected by Essential Tremor (APTES) , 1 in 200 people are affected. It is the most common pathology of abnormal movements. And yet, "this disease remains poorly understood by the general public but also by the medical community outside of neurologists. Diagnosis is unfortunately too often delayed," says Dr. David Grabli, neurologist at Pitié-Salpêtrière.

It can thus lead to social stigma, as Clara Luciani testifies. "It's very embarrassing because there are many situations in my life where I've been told: 'you've been drinking, you've taken drugs, you're being bullied...'. I was none of those things." Severe in a certain number of patients, essential tremor disease can then have disabling repercussions on the daily lives of nearly 25% of them.

The disease can appear in childhood, but its frequency increases with age. 5% of people over 65 suffer from it, and some 16,000 people under 40 are affected, according to figures from Vidal.fr. The disease is described as "rare" in this segment of the population.

What are the symptoms?

Unlike Parkinson's disease , where the tremors are said to be "resting" tremors, the tremor in this case is attitude and action-related; that is, it occurs when the person holds a posture (stretching their hands out in front of them, holding a microphone) or performs an action (writing, drinking). It mainly affects the upper limbs, bilaterally, particularly the hands, and can progress to include the head and voice. Sometimes, there is also instability when walking. The nature of the tremor also changes: "The amplitude of the tremor increases and it disrupts voluntary movements much more, making fine gestures, meals, DIY, writing, etc., very difficult," notes the Brain Institute. This progression increases the disability and harms the quality of life, both professional and personal.

Essential tremor disease is often familial, with an autosomal dominant hereditary pathology (1 in 2 risk of transmitting the disease to one's child); several genes have been identified. "Although the disorders of people with essential tremor are very similar, the current hypothesis is that the origin of essential tremor does not have a single cause, with heterogeneity in the causes and in the evolution from one person to another," suggests the Brain Institute. For other cases, known as sporadic, it is believed to be a combination of environmental factors and a genetic predisposition.

How to treat the disease?

Clinical diagnosis can rule out several other causes of tremors (Parkinson's disease, side effects of certain medications, thyroid diseases, etc.). It will be confirmed by a neurological examination. There is no specific treatment, but certain medications can reduce tremors, such as beta-blockers, antiepileptics, or anxiolytics. "I was taking beta-blockers," says Clara Luciani, "which slow the heart rate... It works for me, but I decided to live with these tremors." She explains that she has now identified when the tremors occur—especially in stressful situations—which helps her manage them. According to APTES, relaxation techniques can be valuable for patients.

Another way to treat the most severely affected patients, deep brain stimulation is also used in patients suffering from a severe form of the disease. The technique is said to reduce the intensity of tremors by 80%.