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Abstract Details

Transcutaneous Afferent Patterned Stimulation Provides Upper Limb Motor Symptom Relief in Patients with Parkinson’s Disease
Movement Disorders
P7 - Poster Session 7 (8:00 AM-9:00 AM)
5-006

This study evaluated efficacy and safety of transcutaneous afferent patterned stimulation (TAPS) to reduce postural and kinetic tremors in Parkinson’s disease (PD) patients.

TAPS of median and radial nerves at the wrist has been shown to relieve essential tremor symptoms [Isaacson 2020], possibly by modulating activity within the central tremor network at the ventral intermediate nucleus (VIM) [Hallett 2014]. Many PD patients have similar postural and kinetic tremors that respond to deep brain stimulation at the VIM, and may respond to TAPS therapy [Chen 2017].
40 PD patients with postural tremor were enrolled in a remote, prospective, single-arm, open-label study with 4 weeks of TAPS therapy between 2 telemedicine appointments. Improvements were calculated in (1) postural tremor power (2) clinician-rated postural and kinetic tremor from Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS) Part III, 8 patient-rated tasks from the Bain and Findley Activities of Daily Living (BF-ADL) scale, and (3) clinical and patient global impressions of improvement (CGI-I, PGI-I).
TAPS reduced postural tremor power by 66% (median, p<0.01, N=35). MDS-UPDRS and BF-ADL scores improved acutely by 0.5±0.5 and 0.3±0.4, respectively (mean ± standard deviation, p<0.01). Between 38 and 70% of patients with bradykinesia, postural, kinetic, or rest tremor (rated at least ‘mild’ before stimulation) improved by at least 1 point in that task. At study exit, clinicians reported improvement in 83% of patients (CGI-I), and 81% of patients reported improvement (PGI-I). Adverse events (AEs) were similar in frequency and type (e.g., skin irritation, discomfort) to previous TAPS studies in ET [Isaacson 2020], with no serious device-related AEs.

Objective, clinician-rated, and patient-rated outcomes demonstrated that TAPS improved upper limb motor symptoms in PD patients. Further studies are needed to develop understanding of the efficacy of TAPS in PD.
Authors/Disclosures
Salima Brillman, MD
PRESENTER 		The institution of Dr. Brillman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cala Health. The institution of Dr. Brillman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acorda. The institution of Dr. Brillman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. The institution of Dr. Brillman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia. The institution of Dr. Brillman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for USWorldMeds. Dr. Brillman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Brillman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda. Dr. Brillman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Amneal. Dr. Brillman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Acadia. Dr. Brillman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Adamas. Dr. Brillman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for USWorld Meds. Dr. Brillman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva.
Pravin Khemani, MD, FAAN (Swedish Neuroscience Institute) Dr. Khemani has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cala Trio. Dr. Khemani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Khemani has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurocrine.
Stuart H. Isaacson, MD, FAAN (Parkinson's Dis & Mov Dis Ctr of Boca Raton) The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acadia. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sunovion. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for acorda. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Supernus. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocrine. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Kyowa. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for adamas. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neuroderm. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. The institution of Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for amneal. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurocrine. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for adamas. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Supernus. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acadia. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amneal. Dr. Isaacson has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie.
Rajesh Pahwa, MD, FAAN (University of Kansas Medical Center) Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for ACADIA. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amneal. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Supernus. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Insightec. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jaaz. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Fasikl. Dr. Pahwa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genetech. Dr. Pahwa has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Mitsubishi Tanabe. Dr. Pahwa has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Photopharmics. The institution of Dr. Pahwa has received research support from Abbott. The institution of Dr. Pahwa has received research support from Abbvie. The institution of Dr. Pahwa has received research support from Biogen. The institution of Dr. Pahwa has received research support from Parkinson Foundation. The institution of Dr. Pahwa has received research support from Roche. The institution of Dr. Pahwa has received research support from Sage. The institution of Dr. Pahwa has received research support from Sun Pharma. The institution of Dr. Pahwa has received research support from Theravance. The institution of Dr. Pahwa has received research support from Neuroderm. The institution of Dr. Pahwa has received research support from Ask Bio. The institution of Dr. Pahwa has received research support from Blue Rock. The institution of Dr. Pahwa has received research support from Cerevance. The institution of Dr. Pahwa has received research support from Fasikl. The institution of Dr. Pahwa has received research support from Scion. The institution of Dr. Pahwa has received research support from UCB. The institution of Dr. Pahwa has received research support from Ono. The institution of Dr. Pahwa has received research support from Intra-cellular Therapies. The institution of Dr. Pahwa has received research support from Ask Bio. The institution of Dr. Pahwa has received research support from Michael J Fox Foundation . The institution of Dr. Pahwa has received research support from Neuron 23. The institution of Dr. Pahwa has received research support from Roche.
Ruta Deshpande (Cala Health, Inc.) Ruta Deshpande has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Dhira Khosla, DO Dr. Khosla has received personal compensation for serving as an employee of Cala Health. Dr. Khosla has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Cala Health.