Abstract：
BACKGROUND: Essential tremor (ET) is a common debilitating condition, yet current treatments often fail to provide satisfactory relief. Transcutaneous spinal cord electrical stimulation (tSCS) has emerged as a potential noninvasive neuromodulation technique capable of disrupting the oscillatory activity underlying tremors.
OBJECTIVE: This study aimed to investigate the potential of tSCS to disrupt tremor in a frequency-dependent manner in a cohort of patients with ET.
METHODS: Eighteen patients with ET completed the study. The experiment consisted of 60-s postural tremor recording, during tSCS at tremor frequency, at 1 Hz, at 21 Hz, no stimulation, and trapezius stimulation. Tremor frequency and amplitude were analyzed and compared across the conditions.
RESULTS: We found tremor amplitude reduction at tremor frequency stimulation significant only during the second half of the stimulation. The same stimulation resulted in the highest number of responders. tSCS at 1 Hz showed a trend toward decreased tremor amplitude in the latter half of stimulation. tSCS at 21 Hz did not produce any significant alterations in tremor, whereas trapezius stimulation exacerbated it. Notably, during tremor frequency stimulation, a subgroup of responders exhibited consistent synchronization between tremor phase and delivered stimulation, indicating tremor entrainment.
CONCLUSIONS: Cervical tSCS holds promise for alleviating postural tremor in patients with ET when delivered at the subject\'s tremor frequency. The observed changes in tremor amplitude likely result from the modulation of spinal cord circuits by tSCS, which disrupts the oscillatory drive to muscles by affecting afferent pathways or spinal reflexes. However, the possibility of an interplay between spinal and supraspinal centers cannot be discounted. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
OBJECTIVE: This study aimed to investigate the potential of tSCS to disrupt tremor in a frequency-dependent manner in a cohort of patients with ET.
METHODS: Eighteen patients with ET completed the study. The experiment consisted of 60-s postural tremor recording, during tSCS at tremor frequency, at 1 Hz, at 21 Hz, no stimulation, and trapezius stimulation. Tremor frequency and amplitude were analyzed and compared across the conditions.
RESULTS: We found tremor amplitude reduction at tremor frequency stimulation significant only during the second half of the stimulation. The same stimulation resulted in the highest number of responders. tSCS at 1 Hz showed a trend toward decreased tremor amplitude in the latter half of stimulation. tSCS at 21 Hz did not produce any significant alterations in tremor, whereas trapezius stimulation exacerbated it. Notably, during tremor frequency stimulation, a subgroup of responders exhibited consistent synchronization between tremor phase and delivered stimulation, indicating tremor entrainment.
CONCLUSIONS: Cervical tSCS holds promise for alleviating postural tremor in patients with ET when delivered at the subject\'s tremor frequency. The observed changes in tremor amplitude likely result from the modulation of spinal cord circuits by tSCS, which disrupts the oscillatory drive to muscles by affecting afferent pathways or spinal reflexes. However, the possibility of an interplay between spinal and supraspinal centers cannot be discounted. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
摘要：
背景：特发性震颤（ET）是一种常见的衰弱状态，然而，目前的治疗往往不能提供令人满意的缓解。经皮脊髓电刺激（tSCS）已成为一种潜在的非侵入性神经调节技术，能够破坏震颤的振荡活动。
目的：本研究旨在研究在ET患者队列中，tSCS以频率依赖性方式破坏震颤的潜力。
方法：18名ET患者完成了研究。实验包括60秒的姿势震颤记录，在震颤频率的tSCS期间，在1Hz时，在21Hz时，没有刺激,和斜方肌刺激。分析并比较了不同条件下的震颤频率和振幅。
结果：我们发现震颤频率刺激下的震颤幅度降低仅在刺激的后半期才显著。相同的刺激导致最高数量的反应者。1Hz的tSCS在刺激的后半期显示出震颤幅度降低的趋势。21Hz的tSCS没有产生任何明显的震颤改变，而斜方肌刺激加剧了它。值得注意的是,在震颤频率刺激期间，一组反应者在震颤阶段和传递的刺激之间表现出一致的同步，指示震颤夹带。
结论：当在受试者的震颤频率下递送时，宫颈tSCS有望减轻ET患者的姿势性震颤。所观察到的震颤幅度的变化可能是由tSCS对脊髓回路的调制引起的，通过影响传入途径或脊柱反射来破坏对肌肉的振荡驱动。然而,不能忽视脊柱中心和脊柱上中心之间相互作用的可能性.©2024作者（S）。由WileyPeriodicalsLLC代表国际帕金森症和运动障碍协会出版的运动障碍。
目的：本研究旨在研究在ET患者队列中，tSCS以频率依赖性方式破坏震颤的潜力。
方法：18名ET患者完成了研究。实验包括60秒的姿势震颤记录，在震颤频率的tSCS期间，在1Hz时，在21Hz时，没有刺激,和斜方肌刺激。分析并比较了不同条件下的震颤频率和振幅。
结果：我们发现震颤频率刺激下的震颤幅度降低仅在刺激的后半期才显著。相同的刺激导致最高数量的反应者。1Hz的tSCS在刺激的后半期显示出震颤幅度降低的趋势。21Hz的tSCS没有产生任何明显的震颤改变，而斜方肌刺激加剧了它。值得注意的是,在震颤频率刺激期间，一组反应者在震颤阶段和传递的刺激之间表现出一致的同步，指示震颤夹带。
结论：当在受试者的震颤频率下递送时，宫颈tSCS有望减轻ET患者的姿势性震颤。所观察到的震颤幅度的变化可能是由tSCS对脊髓回路的调制引起的，通过影响传入途径或脊柱反射来破坏对肌肉的振荡驱动。然而,不能忽视脊柱中心和脊柱上中心之间相互作用的可能性.©2024作者（S）。由WileyPeriodicalsLLC代表国际帕金森症和运动障碍协会出版的运动障碍。
