Abstract Details

TAPS is a non-invasive wrist-worn neuromodulation therapy for ET and PD patients that has been shown to improve action tremor.

To present 3 Veterans Administration (VA) patients with essential tremor (ET) or Parkinson's Disease (PD) who experienced subjective improvement in activities of daily living (ADLs), as well as objective and kinematic reduction in action hand tremor power from pre- to post-stimulation with transcutaneous afferent patterned stimulation (TAPS). Kinematics were obtained from device data summaries.

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Case 1

A 77-year-old man with a 10-year history of ET and 8-year history of PD experienced significant difficulty eating due to tremor. Primidone and topiramate were poorly tolerated and propranolol dose was limited by bradycardia and erectile dysfunction. He utilizes TAPS two to three times per day and has tremor power improvement of 79%. With TAPS, he is able to eat without any difficulty and reports tremor reduction lasts for at least one hour.

Case 2

A 64-year-old man who has had ET for 50 years experienced difficulty eating, typing, and using the computer mouse at work. Primidone led to partial relief of tremor but interfered with sleep at higher doses. TAPS three times per day results in tremor power improvement of 96%, with improved ability to eat, work, and use the computer.

Case 3

A 76-year-old man with ET for 14 years had impaired handwriting and eating and requested non-pharmacologic treatment. Once daily use of TAPS results in tremor power improvement of 37.5%, and patient-reported all-day relief in handwriting and feeding, as well as overall quality of life.

Action tremor of the hands in ET and PD patients can lead to severe impairments in eating, drinking, writing, and everyday activities. TAPS therapy can improve kinematic measurements of tremor, essential ADLs and other meaningful activities for veterans, and enhance their quality of life.