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Clinical observations and population survey studies have reported that up to 58% of patients with LD may have symptom improvement following alcohol intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the objective characteristics of alcohol responsiveness in LD using a standardized alcohol challenge test and genetic testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 109 patients with isolated focal LD participated in the study. Patients were administered two non\u2010diluted drinks of 40\u2010proof vodka 30\u2009min apart, followed by assessments of voice symptoms, breath alcohol content, and side effects. Patients were considered alcohol\u2010responsive (EtOH+) if their symptoms changed by \u226510% from baseline. Whole\u2010exome sequencing was performed to identify genetic variants associated with the alcohol responsiveness of LD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients tolerated the standardized alcohol challenge test without major adverse events. Fifty\u2010two patients (47.7%) had an average of 44.4\u2009\u00b1\u200925.0% improvement of LD symptoms about 45\u2009min after alcohol intake. Five genetic variants in GABAergic pathway\u2010related genes were enriched in EtOH+ patients, and two of these, rs11644926 (<jats:italic>ADCY7<\/jats:italic>) and rs2230741 (<jats:italic>ADCY9<\/jats:italic>), were associated with the improvement of dystonic voice symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Alcohol responsiveness of LD symptoms is a robust feature related to the genes regulating the GABAergic synapses. This finding provides support for the evaluation of novel oral medications with mechanisms of action similar to alcohol for the treatment of patients with alcohol\u2010responsive dystonia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.70097","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T09:13:56Z","timestamp":1745399636000},"page":"1283-1292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Vodka Trial: Clinical and Genetic Characteristics of Alcohol Responsiveness in Laryngeal Dystonia"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6368-0793","authenticated-orcid":false,"given":"Lena C.","family":"O'Flynn","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear and Harvard Medical School  Boston Massachusetts USA"},{"name":"Program in Speech Hearing Bioscience and 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