Analyzing the Effects of Parameters for Tremor Modulation via Phase-Locked Electrical Stimulation on a Peripheral Nerve

• Type of Material: Article
• Authors: Jeonghee Kim, Texas A&M Univ; Thomas Wichmann, Emory University; Omer T Inan, Georgia Institute of Technology; Stephen DeWeerth, Emory University
• Language: English
• Date: 2022-01-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/jpm12010076
• Title of Journal or Parent Work: JOURNAL OF PERSONALIZED MEDICINE
• Volume: 12
• Issue: 1
• Grant/Funding Information: This research was funded, in part, by NIH, Office of Research Infrastructure Programs, P51 OD011132 (T.W.) and NIH/NINDS grant P50 NS123103 (T.W.).
• Keywords: REDUCTION; DIAGNOSIS; Medicine, General & Internal; neuromodulation; wearable non-invasive stimulation; PATHOLOGICAL TREMORS; EPIDEMIOLOGY; parameter optimization; peripheral nerve stimulation; ATTENUATION; Life Sciences & Biomedicine; General & Internal Medicine; Science & Technology; DISEASE; PARKINSON; essential tremor; Health Care Sciences & Services; DEEP BRAIN-STIMULATION; QUALITY-OF-LIFE; tremor quantification; BOTULINUM TOXIN TREATMENT
• Research Categories: Engineering, Biomedical; Engineering, Electronics and Electrical

Abstract

(1) Background: Non-invasive neuromodulation is a promising alternative to medication or deep-brain stimulation treatment for Parkinson’s Disease or essential tremor. In previous work, we developed and tested a wearable system that modulates tremor via the non-invasive, electrical stimulation of peripheral nerves. In this article, we examine the proper range and the effects of various stimulation parameters for phase-locked stimulation. (2) Methods: We recruited nine participants with essential tremor. The subjects performed a bean-transfer task that mimics an eating activity to elicit kinetic tremor while using the wearable stimulation system. We examined the effects of stimulation with a fixed duty cycle, at different stimulation amplitudes and frequencies. The epochs of stimulation were locked to one of four phase positions of ongoing tremor, as measured with an accelerometer. We analyzed stimulation-evoked changes of the frequency and amplitude of tremor. (3) Results: We found that the higher tremor amplitude group experienced a higher rate of tremor power reduction (up to 65%) with a higher amplitude of stimulation when the stimulation was applied at the ±peak of tremor phase. (4) Conclusions: The stimulation parameter can be adjusted to optimize tremor reduction, and this study lays the foundation for future large-scale parameter optimization experiments for personalized peripheral nerve stimulation.