Short-term efficacy of peripheral nerve stimulation for essential tremor in a randomized double-blind controlled trial

TL;DR

A study tested if a single session of peripheral nerve stimulation could reduce tremors in people with essential tremor, finding some short-term benefits.

Contribution

This is the first randomized, double-blind, sham-controlled trial to assess the short-term efficacy of peripheral nerve stimulation for essential tremor.

Findings

PNS significantly reduced tremor amplitude compared to sham stimulation.

No significant improvement was observed in clinical ratings or daily activity scales.

Effects lasted up to 90 minutes after stimulation.

Abstract

Peripheral nerve stimulation (PNS) demonstrates promise for some neurological conditions. However, its effectiveness for essential tremor (ET) requires further research. In this randomized, double-blind, sham-controlled trial, we investigated the safety and efficacy of a single, 40-minute PNS session in ET. Eighty-eight participants (age: 63.5 [52.5, 70.3], male: 57.95%) were assigned to active PNS stimulation (n = 45) or sham procedure (n = 43). Efficacy was assessed using accelerometer-measured tremor amplitude (m/s²), clinician-rated tremor severity using the Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS), patients’ own experience with daily activities using the Bain and Findley Activities of Daily Living scale (BF-ADL), and their perceived improvement based on the Clinical Global Impression-Improvement scale (CGI-I). Assessments were conducted at baseline, immediately post-stimulation, and at multiple intervals up to 90 min (extending to 24 h for subjective outcomes). Temporal changes in outcomes over time were evaluated using the Generalized Estimating Equation (GEE). The effects of group, time, and their interaction (group*time) on the outcomes were subsequently assessed using GEE. GEE analyses revealed significant group*time interaction for tremor amplitude (B = − 51.61, 95%CI [− 94.60, − 8.62], p = 0.019). However, no significant group*time interactions were observed for TETRAS, BF-ADL, and CGI-I. This study indicated the effect of PNS on reducing ET amplitude. ID: IRCT20161212031362N2.

The online version contains supplementary material available at 10.1038/s41598-025-13487-1.

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