Wrist stimulation to be trialled for Parkinson’s tremor

Developed at Nottingham University, the neupulse wrist worn device delivers electrical pulses to the median nerve (MNS) to synchronise rhythmic neural oscillations.

Results from a clinical trial revealed that people who received active stimulation experienced a significant reduction in the severity and frequency of their tics.

The electrical wrist stimulation is now being trialled in people with Parkinson’s Disease (PD) in a two-year study funded by Parkinson’s UK. In the trial the team will investigate in a sham-controlled study if two weeks of twice-daily sessions of home-administered MNS is effective in reducing PD tremor.

“The success of the Tourette’s clinical trial, and subsequent ongoing development of the wrist device, has gained a huge amount of interest and we were contacted by many people with Parkinson’s Disease asking whether the same approach could be used to help control tremor,” Professor Stephen Jackson from the Nottingham University’s Centre for Neuromodulation, Neurotechnology and Neurotherapeutics said in a statement.

Tremor is one of the main motor symptoms of PD and occurs in approximately 75 per cent of individuals. Tremor in PD has a unique pathophysiology compared to other motor symptoms such as bradykinesia and rigidity and has a variable response to medication. For this reason, neuromodulation using MNS could offer a feasible, non-drug, treatment for the improvement of PD tremor.

Brain imaging studies have demonstrated that Parkinson’s tremor is linked to activity in two, partially overlapping brain networks that converge within the cortical sensorimotor area (CSM). The tremor is associated with activity in a cerebellar-thalamo-cortical (CTC) brain circuit that is correlated with tremor power, and Parkinson’s Disease is also associated with altered synchronisation of brain oscillations within a cortical-striatal-thalamo-cortical (CSTC) network.

Professor Jackson said: “Previously it has been demonstrated that PD tremor can be reduced by delivering peripheral electrical stimulation. The aim of this project is to determine, in a sham controlled study, whether trains of MNS that target the cortical sensorimotor area can be used to effectively suppress PD tremor, and if so, whether this approach could be incorporated in a wearable therapeutic device that can be used in a community setting.”

The research is being presented and discussed at a two-day workshop taking place on 10-11 March on the advances in non-invasive brain stimulation at Nottingham University.