Trans-Spinal Direct Current Stimulation for Managing Primary Orthostatic Tremor

Area of Science:

• Neurology
• Neuroscience
• Biomedical Engineering

Background:

• Primary orthostatic tremor (POT) is a rare, often treatment-refractory condition causing leg tremors when standing.
• Current treatments like epidural spinal cord stimulation are invasive, limiting their use.

Purpose of the Study:

• To investigate the efficacy of trans-spinal direct current stimulation (tsDCS) as a non-invasive treatment for POT.
• To assess the effects of tsDCS on tremor, standing ability, and corticospinal excitability in POT patients.

Main Methods:

• A double-blind, sham-controlled study involving 16 POT patients.
• Patients received either sham or active tsDCS (cathodal or anodal) in separate sessions.
• Outcomes included time in standing, tremor quantification, corticospinal excitability, and clinical improvement scores.

Main Results:

• Cathodal tsDCS significantly reduced tremor amplitude, frequency, and corticospinal excitability.
• Anodal tsDCS primarily reduced tremor frequency.
• Clinical improvement scores correlated positively with increased standing time after both active tsDCS conditions.

Conclusions:

• A single tsDCS session can improve postural instability in POT patients.
• This non-invasive neuromodulation technique presents a novel therapeutic avenue for POT.
• Further research into multiple tsDCS sessions is warranted for POT management.