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 inv...

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Autores principales:	Carolina Reis, Beatriz S. Arruda, Alek Pogosyan, Peter Brown, Hayriye Cagnan
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dcadfca39a9b480a886624ff0e1680b9
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spelling	oai:doaj.org-article:dcadfca39a9b480a886624ff0e1680b92021-12-02T18:03:06ZEssential tremor amplitude modulation by median nerve stimulation10.1038/s41598-021-96660-62045-2322https://doaj.org/article/dcadfca39a9b480a886624ff0e1680b92021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96660-6https://doaj.org/toc/2045-2322Abstract 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.Carolina ReisBeatriz S. ArrudaAlek PogosyanPeter BrownHayriye CagnanNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Carolina Reis Beatriz S. Arruda Alek Pogosyan Peter Brown Hayriye Cagnan Essential tremor amplitude modulation by median nerve stimulation
description	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.
format	article
author	Carolina Reis Beatriz S. Arruda Alek Pogosyan Peter Brown Hayriye Cagnan
author_facet	Carolina Reis Beatriz S. Arruda Alek Pogosyan Peter Brown Hayriye Cagnan
author_sort	Carolina Reis
title	Essential tremor amplitude modulation by median nerve stimulation
title_short	Essential tremor amplitude modulation by median nerve stimulation
title_full	Essential tremor amplitude modulation by median nerve stimulation
title_fullStr	Essential tremor amplitude modulation by median nerve stimulation
title_full_unstemmed	Essential tremor amplitude modulation by median nerve stimulation
title_sort	essential tremor amplitude modulation by median nerve stimulation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/dcadfca39a9b480a886624ff0e1680b9
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Essential tremor amplitude modulation by median nerve stimulation

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