Groundbreaking research that has led to the development of a wrist device to help control tics in people with Tourette syndrome is now being used to investigate whether it can help reduce tremor in people with Parkinson's Disease.
Scientists from the University of Nottingham have previously shown that delivering repetitive trains of electrical stimulation to the median nerve (MNS) at the wrist in order to entrain rhythmic electrical brain activity - known as brain oscillations – reduces the amount and severity of tics in people with Tourette syndrome.
This electrical wrist stimulation is now being trialled in people with Parkinson's Disease (PD) in a 2-year study funded by Parkinson's UK. In the trial the team will investigate in a sham-controlled study if two weeks of twice-daily sessions of home-administered MNS is effective in reducing PD tremor.
The success of the Tourette's clinical trial, and subsequent ongoing development of the wrist device, has gained a huge amount of interest and we were contacted by many people with Parkinson's Disease asking whether the same approach could be used to help control tremor.
Tremor is one of the main motor symptoms of PD and occurs in approximately 75% of individuals. Tremor in PD has a unique pathophysiology compared to other motor symptoms (e.g. bradykinesia and rigidity) and has a variable response to medication. For this reason, neuromodulation using MNS may offer an attractive, non-drug, treatment for the improvement of PD tremor.
Brain imaging studies have demonstrated that Parkinson's tremor is linked to activity in two, partially overlapping brain networks that converge within the cortical sensorimotor area (CSM). The tremor is associated with activity in a cerebellar-thalamo-cortical (CTC) brain circuit that is correlated with tremor power, and Parkinson's Disease is also associated with altered synchronization of brain oscillations within a cortical-striatal-thalamo-cortical (CSTC) network.
Professor Jackson continues: "Previously it has been demonstrated that PD tremor can be reduced by delivering peripheral electrical stimulation. The aim of this project is to determine, in a sham controlled study, whether trains of MNS that target the cortical sensorimotor area can be used to effectively suppress PD tremor, and if so, whether this approach could be incorporated in a wearable therapeutic device that can be used in a community setting."
We are delighted to be funding this project because it has the potential to find that symptoms of Parkinson's could be managed, without someone having to take more medication or undergo invasive surgery. Tremor is one of the more well-known symptoms of Parkinson's and for people who struggle with this symptom, it can interfere with day to day activities and make them feel self-conscious. This research study will give an insight into whether this wristband can help control tremor. If so, this would add another option in the treatment of Parkinson's to allow people to live better with the condition.
The research is being presented and discussed at a two day workshop taking place on 10-11 March on the advances in non-invasive brain stimulation at the Univerity of Nottingham where scientists and people with Parkinson's Disease will be able to find out more.
