Objective: To assess the use of a wearable vibration-based device for the treatment of Parkinson’s disease (PD) tremor.

Background: PD is a neurodegenerative movement disorder with debilitating symptoms, including tremor, which affects quality of life throughout the disease. Limited treatments for PD tremor are available: levodopa is frequently only partially beneficial, while deep brain stimulation has risks and is limited by eligibility criteria. The use of vibration has been suggested as a treatment for tremor and other PD symptoms. We sought to assess a non-invasive wristband that delivers mechanical vibratory stimuli for potential on-demand hand tremor relief.

Method: We enrolled 22 patients with tremor-predominant PD. Patients were screened to ensure adequate tremor severity (designated sum of Unified Parkinson’s Disease Rating Scale [MDS-UPDRS] sections 3.15-3.17 score ≥4) and assessed in-person in a practically-defined off state. We used a standardized paradigm assessing rest, postural and kinetic tremor both clinically, using the MDS-UPDRS and quantitatively, using accelerometers at the wrist and fingers. Tremor severity was assessed with varying stimulation settings, both open (frequency 6 Hz) and closed-loop (variable frequency, and 0/90-degree phase rotation). Data from different stimulation settings was statically compared using fixed and random effects ANOVA and post-hoc tests.

Results: Mean patient age was 66.9±11 years, male:female 13:9; 17/22 were on dopamine-replacement therapy. A substantial decrease in rest tremor in response to the vibratory stimuli was observed in two study participants. A noticeable entrainment-like effect (i.e., an increase in rest tremor amplitude) was observed in one study participant. The same two participants who displayed a prominent rest tremor response also displayed a prominent postural tremor response. Small amplitude kinetic tremor was observed in the considered sample and no response to vibratory stimuli was observed.

Conclusion: These data suggests that the use of a wrist-worn vibration-based device resulted in prominent clinical benefits in a relatively small percentage of PD patients tested. Given the lack of efficacious non-surgical treatment options for PD tremor, further research is needed to identify factors that may predict responders to vibration-based therapy and longer-term assessment, including in the home setting.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/use-of-a-wearable-vibration-based-device-for-the-treatment-of-parkinsons-disease-tremor/