Peroneal Electrical Transcutaneous Neuromodulation (Peroneal eTNM) in the Treatment of Essential Tremor

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2025-10-21 DOI:10.1155/ane/5231029

Petra Bártová, Eva Augste, Filip Strouhal, Jan Krhut, Martin Slovák, Lukáš Peter, Martin Schmidt, David Školoudík

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Abstract

Objectives

Given the limitations of the currently available treatment options for essential tremor (ET), the development of a safe and effective method to manage ET is warranted. The aim of this study is to investigate the safety and feasibility of peroneal electrical transcutaneous neuromodulation (peroneal eTNM) in patients with ET.

Methods

Patients enrolled in the study were treated with peroneal eTNM daily for 30 min over 6 weeks, followed by a 6-week follow-up period without stimulation. Peroneal eTNM was administered alongside their chronic medication.

Results

A total of 12 patients (eight men, mean age 60.2 ± 17.7 years, mean disease duration 9.2 ± 7.8 years) were enrolled. All patients were able to use the stimulation at home without assistance. During the study, only two transient treatment-related adverse events were reported. Seven patients (58.3%) reported subjective improvement using the Patient Global Impression of Improvement questionnaire at the end of treatment (EoT), and five patients (41.7%) reported improvement at the end of study (EoS). We observed a significant reduction in the total Essential Tremor Rating Assessment Scale (TETRAS) score, with median (IQR) values decreasing from 38.3 (30.5–49.0) at baseline to 36.5 (20.8–41.5) at EoT and 34.5 (13.0–36.8) at EoS. Similarly, tremor severity, as measured visually and with an accelerometer, showed significant improvement. However, no significant changes were observed in tools assessing quality of life and general disability.

Conclusion

This pilot study demonstrates that peroneal eTNM is safe and feasible for patients with ET. Despite the limited sample size, ET patients treated with peroneal eTNM showed significant improvement in tremor severity as measured by both subjective and objective tools. Future studies with a larger sample size and sham-controlled design are needed to confirm these findings and further validate the potential of peroneal eTNM in the treatment of patients with ET.

Trial Registration

ClinicalTrials.gov identifier: NTC06036368

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经皮腓电神经调节（Peroneal eTNM）治疗原发性震颤

鉴于目前特发性震颤（ET）治疗方案的局限性，开发一种安全有效的治疗ET的方法是必要的。本研究的目的是探讨经皮腓电神经调节（peroneal eTNM）治疗ET患者的安全性和可行性。方法入组的患者在6周内每天接受30分钟的腓电eTNM治疗，然后进行6周的无刺激随访。腓骨eTNM与慢性药物同时使用。结果共纳入12例患者，其中男性8例，平均年龄60.2±17.7岁，平均病程9.2±7.8年。所有患者都能在家中无需辅助的情况下使用刺激。在研究期间，仅报告了两起与治疗相关的短暂不良事件。7名患者（58.3%）在治疗结束时使用患者总体改善印象问卷报告主观改善，5名患者（41.7%）在研究结束时报告改善（EoS）。我们观察到总特发性震颤等级评估量表（TETRAS）评分显著降低，中位数（IQR）值从基线时的38.3（30.5-49.0）降至EoT时的36.5（20.8-41.5）和EoS时的34.5（13.0-36.8）。同样，用视觉和加速度计测量的震颤严重程度也有显著改善。然而，在评估生活质量和一般残疾的工具中没有观察到明显的变化。结论本初步研究表明，腓骨eTNM治疗ET患者是安全可行的。尽管样本量有限，但经腓骨eTNM治疗的ET患者在主观和客观指标上均表现出震颤严重程度的显著改善。未来的研究需要更大的样本量和假对照设计来证实这些发现，并进一步验证腓侧eTNM治疗ET患者的潜力。试验注册临床试验

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.