Objective: The goal of this paper is to explore a possible effect of TPS on the PD rest tremor circuit, stimulating the motor cortex (M1) of the contralateral most affected side.

Background: Transcranical Pulse stimulation (TPS) is a recent, safe and painless non-invasive brain stimulation technique that has been proved to ameliorate cognitive performance in neurodegenerative diseases. There is not yet a study investigating the effectiveness of this stimulation on PD patients, especially in terms of rest tremor.

Method: The study included only patients suffering from Parkinson Disease accordingly to MDS criteria, attending the Movement Disorders Outpatient Clinics of the University Hospital of Trieste. All patients displayed a rest tremor, referred as frustrating, and accepted to undergo a single session of TPS. All subjects were tested with UPDRS III and accelerometer recording the upper limbs tremor at T0 (before TPS), T1 (right after TPS) and T2 (24-hours after TPS). At the end of the study, patients were asked to fill a questionnaire about a potential improvement of the PD symptoms (tremor, rigidity, bradykinesia).

Results: 14 PD tremor dominant patients were recruited and underwent all items. In our cohort of patients, the efficacy on the UPDRS was displayed in 13 individuals. The reduction up to 19 points was evaluated after 24h. The mean UPDRS decrease reached 7 points in the next day. On the accelerometer graphic, a cut of the width of the tremor was evaluated in 12 patients at T2. We appreciated a mean width reduction of the tremor reached the 57% compared to baseline. 13 patients were satisfied with the TPS session and reported a subjective improvement of the tremor. No adverse effect were reported.

Conclusion: TPS is a harmless, non-invasive brain stimulation method that is well tolerated by the patients. This technique can be safely practiced on M1 to help in reducing the PD rest tremor in the next 24 hours after stimulation. This is supported by a clear improvement of the tremor symptoms highlighted by both the clinician (decrease in UPDRS III and reduction in the width of the tremor) and subjectively by the patient. More studies or a larger group of are needed to better understand an eventual long-lasting function of this technique on PD rest tremor.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/transcranical-pulse-stimulation-in-parkinsons-rest-tremor-a-pilot-study/