Closed-Loop Sensory Peripheral Nerve Stimulation Provides Tremor Suppression by Decreasing Tremorgenic Drive to the Wrist Extensors and Flexors in Essential Tremor
摘要
Essential tremor patients are limited in daily activities due to involuntary tremors in various parts of their body. Sensory peripheral electrical stimulation (sPES) is a new, promising intervention to provide tremor suppression. While various stimulation strategies (Closed-loop: CLS; Open-loop: OLS) have been employed to deliver tremor suppression, the underlying mechanisms of the effect are still elusive, limiting the optimization of the therapeutic effect. In this work, we aimed to evaluate the impact of the CLS, OLS, and control (CON: no stimulation) on wrist joint neuromechanics through intermuscular coherence and phase difference between wrist flexors and extensors. CLS provides significant decrease in intermuscular coherence and reduces the phase between the wrist flexors and extensors in the tremor band, but no significant changes were observed for OLS and CON conditions. These results suggests that CLS alters the neuromechanics of the wrist resulting in tremor suppression.