2019/11 Mechanical vibration does not systematically reduce the tremor in essential tremor patients.


“Essential tremor (ET) is a major cause of disability and is not efectively managed in half of the patients. We investigated whether mechanical vibration could reduce tremor in ET by selectively recruiting aferent pathways. We used piezoelectric actuators to deliver vibratory stimuli to the hand and forearm during long trials (4min), while we monitored the tremor using inertial sensors. We analyzed the efect of four stimulation strategies, including diferent constant and variable vibration frequencies, in 18 ET patients. Although there was not a clear homogeneous response to vibration across patients and strategies, in most cases (50–72%) mechanical vibration was associated with an increase in the amplitude of their tremor. In contrast, the tremor was reduced in 5–22% of the patients, depending on the strategy. However, these results are hard to interpret given the intrinsic variability of the tremor: during equally long trials without vibration, the tremor changed signifcantly in 67% of the patients (increased in 45%; decreased in 22%). We conclude that mechanical vibration of the limb does not have a systematic efect on tremor in ET. Moreover, the observed intrinsic variability of the tremor should be taken into account when designing future experiments to assess tremor in ET and how it responds to any intervention.”