Transcutaneous Afferent Patterned Stimulation Therapy Reduces Hand Tremor for One Hour in Essential Tremor Patients

Yu, Jinxin; Rajagopal, Apoorva; Syrkin-Nikolau, Judy; Shin, Seungjae; Rosenbluth, Kathryn H.; Khosla, Dhira; Ross, Erika; Delp, Scott L.

doi:10.3389/fnins.2020.530300

Cited by 16 publications

(23 citation statements)

References 42 publications

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“…These devices also measure tremor characteristics using a gyroscope, accelerometer, and electromyogram. Peripheral nerve stimulation has been reported to be useful in reducing tremors—especially in patients with ET ( Kim et al, 2020 ; Yu et al, 2020 ; Reis et al, 2021 )—and is thought to evoke central activity via VIM, a thalamic target widely accepted to improve tremor with DBS ( Morigaki et al, 2011a , b ; Morigaki and Goto, 2015 ). Lin et al (2018) reported the effect of median and radial nerve stimulation using a wrist band in patients with PD.…”

Section: Resultsmentioning

confidence: 99%

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Fujikawa

Morigaki

Yamamoto

et al. 2022

Front. Aging Neurosci.

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BackgroundPharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease.MethodsWe first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices.ResultsOur review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark.ConclusionInvasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.

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Section: Resultsmentioning

confidence: 99%

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Fujikawa

Morigaki

Yamamoto

et al. 2022

Front. Aging Neurosci.

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“…However, this procedure could not represent daily living activities (117), and therefore, the experimental validation could not be useful to evaluate the effect on assisting the patient in daily life. In this sense, only the Cala Health neuromodulation device reported its effect over the performance of activities of the daily life (82)(83)(84)(85).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the clinician-rated TETRAS score was improved in 62% of patients, and the patient-rated BF-ADL was also improved in 68% of patients. Finally, the authors analyzed the duration of the effect of this stimulation in (85). They followed the same stimulation treatment as in previous studies with 15 ET patients and found that for 80% of them, the suppressive effect of the treatment lasted for 60 min at least.…”

Section: Stimulation Of Afferent Pathways For Tremor Managementmentioning

confidence: 93%

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A Review on Wearable Technologies for Tremor Suppression

et al. 2021

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Tremor is defined as a rhythmic, involuntary oscillatory movement of a body part. Although everyone exhibits a certain degree of tremor, some pathologies lead to very disabling tremors. These pathological tremors constitute the most prevalent movement disorder, and they imply severe difficulties in performing activities of daily living. Although tremors are currently managed through pharmacotherapy or surgery, these treatments present significant associated drawbacks: drugs often induce side effects and show decreased effectiveness over years of use, while surgery is a hazardous procedure for a very low percentage of eligible patients. In this context, recent research demonstrated the feasibility of managing upper limb tremors through wearable technologies that suppress tremors by modifying limb biomechanics or applying counteracting forces. Furthermore, recent experiments with transcutaneous afferent stimulation showed significant tremor attenuation. In this regard, this article reviews the devices developed following these tremor management paradigms, such as robotic exoskeletons, soft robotic exoskeletons, and transcutaneous neurostimulators. These works are presented, and their effectiveness is discussed. The article also evaluates the different metrics used for the validation of these devices and the lack of a standard validation procedure that allows the comparison among them.

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“…TAPS doses consist of forty minutes of noninvasive stimulation that alternates between the median and radial nerves at the wrist at a patient's tremor frequency; motion sensors on a wrist-worn TAPS delivery device measure this tremor frequency during an initial calibration [54]. Randomized sham-controlled single-session clinical trials and subsequent longitudinal at-home clinical trials in ET have shown that TAPS therapy provides at least 50% lasting tremor reduction for the majority of patients, with over 90% of patients receiving at least some tremor reduction [53][54][55][56][57]; that tremor reduction with TAPS persists for over an hour after a TAPS dose for many patients [54,56]; and that repeated daily use of TAPS therapy over three months indicated no habituation or dose tolerance-induced loss of tremor reduction [54]. Efficacy of TAPS for tremor reduction was similar between patients on and off tremor medication [54].…”

Section: Clinically Available Tremor Management Pes Therapiesmentioning

confidence: 99%

Non-invasive electrical stimulation of peripheral nerves for the management of tremor

Pascual-Valdunciel

Rajagopal²,

Pons

et al. 2022

Journal of the Neurological Sciences

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Transcutaneous Afferent Patterned Stimulation Therapy Reduces Hand Tremor for One Hour in Essential Tremor Patients

Cited by 16 publications

References 42 publications

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

A Review on Wearable Technologies for Tremor Suppression

Non-invasive electrical stimulation of peripheral nerves for the management of tremor

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