LOS ANGELES – User-defined, non-invasive nerve stimulation appears to reduce hand shaking in essential tremor patients, data from two other studies presented here next week.
The wrist-worn neuromodulation device stimulated median and radial nerves in the wrist and provided a stimulation pattern designed to interrupt a patient's trembling signal. Two early versions of this research from the annual meeting of the American Academy of Neurology, which begins on April 21
The company that developed the device is a pioneering achievement in a new class of electrical medicine, potentially named, that can counteract chronic diseases such as essential tremor by externally stimulating peripheral nerves with body-worn electronics.
"Our research suggests that this non-invasive therapy can provide significant relief from the symptoms of hand tremor in people with essential tremor," said author Rajesh Pahwa, MD, of Kansas Medical Center, Kansas City, said in a statement that the treatment was safe and produced significant improvements in both physician-assessed and patient-assessed measures of tremor severity.
This represents a new approach to the treatment of essential tremor, noted Vicki Shanker, MD, of the Icahn School of Medicine at Mount Sinai in New York City, which was not involved in the study.
"There is a limited amount of medication available for patients with essential tremor, and use is often limited by side effects," she said MedPage Today .  "While surgical options are available, many patients are looking for options that are less invasive." This study by Pahwa and colleagues provides a non-invasive alternative to drugs with neuromodulation therapy, in which treated patients had improved tremor and their activities in the area In addition, the side effect profile was minimal. "
It is believed that the essential tremor is caused by tremors in a central tremor network. The evidence has supported invasive neuromodulation of deep brain structures in the network. Invasive Neuromodulation of Peripheral Peripheral Nerve Inputs
Pahwa and colleagues performed two randomized controlled trials of essential tremor patients: an acute (clinical) study and a chronic (home) randomized study involving 77 patients receiving either a treatment or a sham stimulation of the wrist of the tremor-dominant hand, they evaluated the tremor before and after a single stimulation session. In the chronic study, the team randomly enrolled 61 participants for treatment, sham or standard care of two sessions per day for up to 1 month
In the acute study, physician evaluations showed that patients wearing the device had a 65% Tremore enhancements showed truth in their entire arm, compared with a 32% improvement in the dummy group. In patient evaluations, patients who received treatment stimulation showed an improvement of 27% after certain activities of daily life in the clinic, compared with an improvement of 16% in patients receiving sham stimulation. Overall, 88% of the patients wearing the device reported improvement in tremor.
In the chronic study, the researchers measured the tremor before and after each therapy using sensors on the device. The sensors showed that the patients wearing the device had a reduction in their tremor severity after 89.5% of the stimulation sessions at home.
The patients had no serious side effects. In the acute study, 3% of participants had mild side effects, such as redness and irritation, which spontaneously resolved.
"These randomized, controlled studies suggest that non-invasive peripheral neuromodulation in [essential tremor] can provide significant symptomatic relief of hand tremor, a favorable adverse event profile compared to other available therapies, and that home surveillance provides important insights could provide in the assessment and treatment of tremor, "wrote Pahwa and co-authors.
A limitation of the studies is that the treatment was tested in small groups groups of individuals for a short time; Future studies will include more people and longer periods of time.
While it is unclear whether patients will benefit from this therapy on a sustained basis, "the first finding is certainly associated with larger studies and is likely to be received with great enthusiasm by the essential tremor community." Shanker notes.
Pahwa will present these findings at 5:30 pm PT on Wednesday, April 25, at the West Exhibition Hall A at the Los Angeles Convention Center
The experiments were supported by Cala Health, developer of pacing therapy.
F. Perry Wilson, MD, MSCE Assistant Professor, Department of Nephrology, Yale School of Medicine and Dorothy Caputo, MA, BSN, RN, Nurse Planner
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