Stimulation of the motor cortex for disabling essential tremor

Area of Science:

• Neuroscience
• Neurosurgery
• Neurology

Background:

• Essential tremor (ET) is a common neurological disorder characterized by involuntary rhythmic shaking.
• Current treatments for ET have limitations, necessitating the exploration of novel therapeutic approaches.

Observation:

• This study investigated the safety and efficacy of direct cortical stimulation of the primary hand motor cortex in two patients with essential tremor.
• An investigational implantable pulse generator (IPG) was used to deliver stimulation, with patients assessed using the Fahn Tolosa Marin tremor rating scale (TRS) and neuropsychological evaluations.

Findings:

• Neither patient experienced significant reduction in tremor severity as measured by the TRS scores after one month of stimulation.
• No adverse effects were reported during the study period, indicating a potentially safe profile for cortical stimulation.
• The specific stimulation parameters (frequency, amplitude, pulse width) used in this trial did not yield therapeutic benefits for essential tremor.

Implications:

• Direct cortical stimulation of the motor cortex, using the parameters tested, is not an effective treatment for essential tremor.
• Future research should investigate alternative stimulation parameters, targets, or techniques to determine the potential role of cortical stimulation in managing ET.
• This study highlights the need for continued investigation into neurostimulation strategies for movement disorders like essential tremor.