Arruda, Beatriz S;
Reis, Carolina;
Sermon, James J;
Pogosyan, Alek;
Brown, Peter;
Cagnan, Hayriye;
(2021)
Identifying and modulating distinct tremor states through peripheral nerve stimulation in Parkinsonian rest tremor.
Journal of NeuroEngineering and Rehabilitation
, 18
(1)
, Article 179. 10.1186/s12984-021-00973-6.
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Abstract
Background: Resting tremor is one of the most common symptoms of Parkinson’s disease. Despite its high prevalence, resting tremor may not be as effectively treated with dopaminergic medication as other symptoms, and surgical treatments such as deep brain stimulation, which are effective in reducing tremor, have limited availability. Therefore, there is a clinical need for non-invasive interventions in order to provide tremor relief to a larger number of people with Parkinson’s disease. Here, we explore whether peripheral nerve stimulation can modulate resting tremor, and under what circumstances this might lead to tremor suppression. Methods: We studied 10 people with Parkinson’s disease and rest tremor, to whom we delivered brief electrical pulses non-invasively to the median nerve of the most tremulous hand. Stimulation was phase-locked to limb acceleration in the axis with the biggest tremor-related excursion. Results: We demonstrated that rest tremor in the hand could change from one pattern of oscillation to another in space. Median nerve stimulation was able to significantly reduce (− 36%) and amplify (117%) tremor when delivered at a certain phase. When the peripheral manifestation of tremor spontaneously changed, stimulation timing-dependent change in tremor severity could also alter during phase-locked peripheral nerve stimulation. Conclusions: These results highlight that phase-locked peripheral nerve stimulation has the potential to reduce tremor. However, there can be multiple independent tremor oscillation patterns even within the same limb. Parameters of peripheral stimulation such as stimulation phase may need to be adjusted continuously in order to sustain systematic suppression of tremor amplitude.
| Type: | Article |
|---|---|
| Title: | Identifying and modulating distinct tremor states through peripheral nerve stimulation in Parkinsonian rest tremor |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12984-021-00973-6 |
| Publisher version: | https://doi.org/10.1186/s12984-021-00973-6 |
| Language: | English |
| Additional information: | © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Keywords: | Science & Technology, Technology, Life Sciences & Biomedicine, Engineering, Biomedical, Neurosciences, Rehabilitation, Engineering, Neurosciences & Neurology, Parkinson's disease, Peripheral stimulation, Non-invasive, Phase-locked stimulation, Tremor oscillation patterns, FUNCTIONAL ELECTRICAL-STIMULATION, SUBTHALAMIC NUCLEUS, PATHOLOGICAL TREMORS, GLOBUS-PALLIDUS, HUMAN THALAMUS, OSCILLATIONS, SUPPRESSION, DISEASE, ATTENUATION, POTENTIALS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Imaging Neuroscience UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10216239 |
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