Non-invasive Brain Stimulation for Essential Tremor

<p><strong>Background:</strong>&nbsp;There is increasing interest in the use of non-invasive brain stimulation to characterize and potentially treat essential tremor (ET). Studies have used a variety of stimulation coils, paradigms, and target locations to make these observatio...

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Main Authors: Ludy C. Shih, Alvaro Pascual-Leone
Format: Article
Language:English
Published: Ubiquity Press 2017-03-01
Series:Tremor and Other Hyperkinetic Movements
Online Access:https://tremorjournal.org/index.php/tremor/article/view/458
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author Ludy C. Shih
Alvaro Pascual-Leone
author_facet Ludy C. Shih
Alvaro Pascual-Leone
author_sort Ludy C. Shih
collection DOAJ
description <p><strong>Background:</strong>&nbsp;There is increasing interest in the use of non-invasive brain stimulation to characterize and potentially treat essential tremor (ET). Studies have used a variety of stimulation coils, paradigms, and target locations to make these observations. We reviewed the literature to compare prior studies and to evaluate the rationale and the methods used in these studies.</p><p><strong>Methods:</strong>&nbsp;We performed a systematic literature search of the PubMed database using the terms &ldquo;transcranial,&rdquo; &ldquo;noninvasive,&rdquo; &ldquo;brain stimulation,&rdquo; &ldquo;transcranial magnetic stimulation (TMS),&rdquo; &ldquo;transcranial direct current stimulation (tDCS),&rdquo; &ldquo;transcranial alternating current stimulation (tACS),&rdquo; and &ldquo;essential tremor.&rdquo;</p><p><strong>Results:</strong>&nbsp;Single pulses of TMS to the primary motor cortex have long been known to reset tremor. Although there are relatively few studies showing alterations in motor cortical physiology, such as motor threshold, short and long intracortical inhibition, and cortical silent period, there may be some evidence of altered intracortical facilitation and cerebello-brain inhibition in ET. Repetitive TMS, theta burst stimulation, tDCS, and tACS have been applied to human subjects with tremor with some preliminary signs of tremor reduction, particularly in those studies that employed consecutive daily sessions.</p><p><strong>Discussion:</strong>&nbsp;A variety of stimulation paradigms and targets have been explored, with the increasing rationale an interest in targeting the cerebellum. Rigorous assessment of coil geometry, stimulation paradigm, rationale for selection of the specific anatomic target, and careful phenotypic and physiologic characterization of the subjects with ET undergoing these interventions may be critical in extending these preliminary findings into effective stimulation therapies.</p>
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spelling doaj.art-c8d2da6e4f3a419aa7080f607411f8eb2022-12-21T22:50:06ZengUbiquity PressTremor and Other Hyperkinetic Movements2160-82882017-03-01710.7916/D8G44W01313Non-invasive Brain Stimulation for Essential TremorLudy C. Shih0Alvaro Pascual-Leone1Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical CenterBerenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School<p><strong>Background:</strong>&nbsp;There is increasing interest in the use of non-invasive brain stimulation to characterize and potentially treat essential tremor (ET). Studies have used a variety of stimulation coils, paradigms, and target locations to make these observations. We reviewed the literature to compare prior studies and to evaluate the rationale and the methods used in these studies.</p><p><strong>Methods:</strong>&nbsp;We performed a systematic literature search of the PubMed database using the terms &ldquo;transcranial,&rdquo; &ldquo;noninvasive,&rdquo; &ldquo;brain stimulation,&rdquo; &ldquo;transcranial magnetic stimulation (TMS),&rdquo; &ldquo;transcranial direct current stimulation (tDCS),&rdquo; &ldquo;transcranial alternating current stimulation (tACS),&rdquo; and &ldquo;essential tremor.&rdquo;</p><p><strong>Results:</strong>&nbsp;Single pulses of TMS to the primary motor cortex have long been known to reset tremor. Although there are relatively few studies showing alterations in motor cortical physiology, such as motor threshold, short and long intracortical inhibition, and cortical silent period, there may be some evidence of altered intracortical facilitation and cerebello-brain inhibition in ET. Repetitive TMS, theta burst stimulation, tDCS, and tACS have been applied to human subjects with tremor with some preliminary signs of tremor reduction, particularly in those studies that employed consecutive daily sessions.</p><p><strong>Discussion:</strong>&nbsp;A variety of stimulation paradigms and targets have been explored, with the increasing rationale an interest in targeting the cerebellum. Rigorous assessment of coil geometry, stimulation paradigm, rationale for selection of the specific anatomic target, and careful phenotypic and physiologic characterization of the subjects with ET undergoing these interventions may be critical in extending these preliminary findings into effective stimulation therapies.</p>https://tremorjournal.org/index.php/tremor/article/view/458
spellingShingle Ludy C. Shih
Alvaro Pascual-Leone
Non-invasive Brain Stimulation for Essential Tremor
Tremor and Other Hyperkinetic Movements
title Non-invasive Brain Stimulation for Essential Tremor
title_full Non-invasive Brain Stimulation for Essential Tremor
title_fullStr Non-invasive Brain Stimulation for Essential Tremor
title_full_unstemmed Non-invasive Brain Stimulation for Essential Tremor
title_short Non-invasive Brain Stimulation for Essential Tremor
title_sort non invasive brain stimulation for essential tremor
url https://tremorjournal.org/index.php/tremor/article/view/458
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