Cerebellar transcranial alternating current stimulation in essential tremor patients with thalamic stimulation: a proof-of-concept study - Sorbonne Université Access content directly
Journal Articles Neurotherapeutics Year : 2023

Cerebellar transcranial alternating current stimulation in essential tremor patients with thalamic stimulation: a proof-of-concept study

Abstract

Essential tremor (ET) is a disabling condition resulting from a dysfunction of cerebello-thalamo-cortical circuitry. Deep brain stimulation (DBS) or lesion of the ventral-intermediate thalamic nucleus (VIM) is an effective treatment for severe ET. Transcranial cerebellar brain stimulation has recently emerged as a non-invasive potential therapeutic option. Here, we aim to investigate the effects of high-frequency non-invasive cerebellar transcranial alternating current stimulation (tACS) in severe ET patients already operated for VIM-DBS. Eleven ET patients with VIM-DBS, and 10 ET patients without VIM-DBS and matched for tremor severity, were included in this double-blind proof-of-concept controlled study. All patients received unilateral cerebellar sham-tACS and active-tACS for 10 minutes. Tremor severity was blindly assessed at baseline, without VIM-DBS, during sham-tACS, during and at 0, 20, 40 minutes after active-tACS, using kinetic recordings during holding posture and action (‘nose-to-target’) task and videorecorded Fahn-Tolosa-Marin (FTM) clinical scales. In the VIM-DBS group, active-tACS significantly improved both postural and action tremor amplitude and clinical (FTM scales) severity, relative to baseline, whereas sham-tACS did not, with a predominant effect for the ipsilateral arm. Tremor amplitude and clinical severity were also not significantly different between ON VIM-DBS and active-tACS conditions. In the non-VIM-DBS group, we also observed significant improvements in ipsilateral action tremor amplitude, and clinical severity after cerebellar active-tACS, with a trend for improved postural tremor amplitude. In non-VIM-DBS group, sham- active-tACS also decreased clinical scores. These data support the safety and potential efficacy of high-frequency cerebellar-tACS to reduce ET amplitude and severity.
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Dates and versions

hal-04100044 , version 1 (17-05-2023)

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Claire Olivier, Jean-Charles C Lamy, Zuzana Kosutzka, Angèle Van Hamme, Saoussen Cherif, et al.. Cerebellar transcranial alternating current stimulation in essential tremor patients with thalamic stimulation: a proof-of-concept study. Neurotherapeutics, In press, ⟨10.1007/s13311-023-01372-6⟩. ⟨hal-04100044⟩
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