Wearable Peripheral Electrical Stimulation Devices for the Reduction of Essential Tremor: A Review.

Alexandra Karamesinis,Roy V Sillitoe,Abbas Z Kouzani

doi:10.1109/access.2021.3084819

Abstract

Essential tremor is the most common pathological tremor, with a prevalence of 6.3% in people over 65 years of age. This disorder interferes with a patient’s ability to carry out activities of daily living independently, and treatment with medical and surgical interventions is often insufficient or contraindicated. Mechanical orthoses have not been widely adopted by patients due to discomfort and lack of discretion. Over the past 30 years, peripheral electrical stimulation has been investigated as a possible treatment for patients who have not found other treatment options to be satisfactory, with wearable devices revolutionizing this emerging approach in recent years. In this paper, an overview of essential tremor and its current medical and surgical treatment options are presented. Following this, tremor detection, measurement and characterization methods are explored with a focus on the measurement options that can be incorporated into wearable devices. Then, novel interventions for essential tremor are described, with a detailed review of open and closed-loop peripheral electrical stimulation methods. Finally, discussion of the need for wearable closed-loop peripheral electrical stimulation devices for essential tremor, approaches in their implementation, and gaps in the literature for further research are presented.

Highlights

Tremor is an involuntary, rhythmic and oscillatory movement of any body part, which may be pathological or physiological [1]
A common pathological tremor is essential tremor, a neurological disorder which has an estimated prevalence of 0.4%, which increases to 6.3% in those aged older than 65 years [2]
This paper provides an overview of essential tremor, current approaches to measuring the key symptoms of essential tremor, and an analysis of wearable peripheral electrical stimulation devices used to regulate this condition

Summary

INTRODUCTION

Rhythmic and oscillatory movement of any body part, which may be pathological or physiological [1]. The psychosocial impacts of the disorder must be considered; many patients with essential tremor experience embarrassment, difficulties at work and symptoms of anxiety and depression [5]. These negative impacts of essential tremor are significant given the prevalence of essential tremor that is refractory to medical treatment and common issues with decreased treatment effect over time and progression of the severity of tremor with advancing age [6]. Nine studies investigating the use of peripheral electrical stimulation for essential tremor suppression were analyzed; studies which did not include human trials of the intervention on essential tremor patients were excluded From these studies, two wearable devices were identified and compared

PATHOPHYSIOLOGY OF ESSENTIAL TREMOR

Findings

DISCUSSION

CONCLUSION