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Essential tremor amplitude modulation by median nerve stimulation

Abstract:
Essential tremor is a common neurological disorder, characterised by involuntary shaking of a limb. Patients are usually treated using medications which have limited effects on tremor and may cause side-effects. Surgical therapies are effective in reducing essential tremor, however, the invasive nature of these therapies together with the high cost, greatly limit the number of patients benefiting from them. Non-invasive therapies have gained increasing traction to meet this clinical need. Here, we test a non-invasive and closed-loop electrical stimulation paradigm which tracks peripheral tremor and targets thalamic afferents to modulate the central oscillators underlying tremor. To this end, 9 patients had electrical stimulation delivered to the median nerve locked to different phases of tremor. Peripheral stimulation induced a subtle but significant modulation in five out of nine patients—this modulation consisted mainly of amplification rather than suppression of tremor amplitude. Modulatory effects of stimulation were more pronounced when patient’s tremor was spontaneously weaker at stimulation onset, when significant modulation became more frequent amongst subjects. This data suggests that for selected individuals, a more sophisticated control policy entailing an online estimate of both tremor phase and amplitude, should be considered in further explorations of the treatment potential of tremor phase-locked peripheral stimulation.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1038/s41598-021-96660-6

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Role:
Author


Publisher:
Springer Nature
Journal:
Scientific Reports More from this journal
Volume:
11
Issue:
1
Article number:
17720
Publication date:
2021-09-06
Acceptance date:
2021-08-05
DOI:
EISSN:
2045-2322


Language:
English
Keywords:
Pubs id:
1194019
Local pid:
pubs:1194019
Deposit date:
2021-09-10

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