Transcutaneous Peripheral Nerve Stimulation for Essential Tremor: A Randomized Clinical Trial

Area of Science:

• Neurology
• Biomedical Engineering
• Artificial Intelligence

Background:

• Essential tremor (ET) is the most prevalent form of arm tremor.
• Transcutaneous peripheral nerve stimulation (TPNS) offers a method to modulate the central tremor-generating network.

Purpose of the Study:

• To evaluate the efficacy of an artificial intelligence (AI)-driven TPNS device compared to a sham device in alleviating ET.
• To assess the impact of AI-driven TPNS on daily activities in individuals with ET.

Main Methods:

• A randomized clinical trial involving 125 adults with ET across 12 clinics in the US and China.
• Participants used either an active AI-driven TPNS device or a sham device for 90 days.
• The primary outcome measured was the change in the modified Activities of Daily Living (mADL) subscale of the TETRAS.

Main Results:

• The AI-driven TPNS group showed a significantly greater reduction in mADL scores (6.9 points) compared to the sham group (2.7 points) at 90 days (P < .001).
• Skin irritation was the most common adverse event, occurring in 33.7% of the TPNS group versus 4.8% of the sham group.
• Other adverse events were infrequent and primarily reported in the TPNS group.

Conclusions:

• AI-driven TPNS demonstrated superior efficacy in improving upper limb function and daily activities for ET patients over 90 days.
• The device represents a potentially effective, noninvasive therapeutic option for managing essential tremor.