Non-Invasive Transcutaneous Afferent Patterned Stimulation Therapy Offers Action Tremor Relief in Parkinson's Disease.

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Publication Date


Publication Title

Tremor Other Hyperkinet Mov (N Y)


Humans; Activities of Daily Living; Essential Tremor; Parkinson Disease; Prospective Studies; Tremor; Action Tremor; Neuromodulation; Non-invasive; Parkinson’s Disease; Transcutaneous Afferent Patterned Stimulation; washington; swedish; swedish neuro


BACKGROUND: Many patients with Parkinson's disease (PD) experience action tremor (including postural and kinetic tremors) that impair activities of daily living. Transcutaneous afferent patterned stimulation (TAPS) is a non-invasive neuromodulation therapy that modulates tremorgenic activity at the ventral intermediate nucleus (VIM). Most TAPS evidence evaluated relief of action tremor associated with essential tremor (ET). This study evaluated whether TAPS results in similar relief of action tremor associated with PD.

METHODS: Forty PD patients with action tremors were enrolled in a prospective, single-arm, open-label study with four weeks of unsupervised at-home TAPS sessions in the dominant hand twice daily in between supervised TAPS sessions at two telemedicine appointments. The primary endpoint was change in tremor power as measured by the on-board accelerometer before and immediately after a stimulation session. Additional study endpoints included change in Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS), change in Bain and Findley Activities of Daily Living (BF-ADL) scale, and clinician and patient global impressions of improvement (CGI-I and PGI-I).

RESULTS: TAPS reduced tremor power by 64% (54%-79%) (median (interquartile range),

CONCLUSION: Objective, clinician-rated, and patient-rated assessments demonstrated that TAPS provided clinically meaningful relief of action tremor in patients with PD.

Clinical Institute

Neurosciences (Brain & Spine)