For patients who suffer from Parkinson's disease and essential tremor, writing a grocery list or taking a drink from a cup can be a daily struggle due to disabling arm tremor. Now, technology developed in London provides a personalized therapy that is giving new hope for these patients.
The technology, under the tradename TremorTek, uses a combination of wearable movement sensors and computer software to determine exactly which muscles and what biomechanics are at play for each individual patient's tremor symptoms. Using the information from that technology, clinicians can precisely place injections to reduce tremor at the exact source.
Developed by a research team led by Dr. Mandar Jog, Professor in the Department of Clinical Neurological Sciences at Western's Schulich School of Medicine & Dentistry, and a scientist at Lawson Health Research Institute, the technology is showing exceptional promise in clinical trials for both essential tremor and Parkinson's disease tremor.
"We have now implemented the technology in a large population and showed quite significant efficacy," Dr. Jog said. During the most recent trials, TremorTek technology was used to precisely guide injections of a drug called botulinum toxin type A, which blocks nerve signals in the muscles, causing temporary reduction in activity in muscles affected by tremor. The technology was tested on 24 patients with essential tremor and 28 patients with Parkinson's disease from the Movement Disorder Clinic at London Health Sciences Centre's University Hospital.
A video of Dr. Jog explaining the technology can be viewed below:Over the course of 38 weeks, the severity of the tremor was significantly reduced and eating, drinking and working performance was improved. The results of the studies were recently published in the journals PLoS One and in Tremor and Other Hyperkinetic Movements Journal.
"Very few clinicians inject for tremor because before now, it just didn't work. The injections would only cause weakness," said Dr. Jog. "We realize now that was because they didn't know where to inject. The uniqueness of our development is the simplicity of it. It records from multiple joints in a straightforward way."
Articles:
Effective Management of Upper Limb Parkinsonian Tremor by IncobotulinumtoxinA Injections Using Sensor-based Biomechanical Patterns, Fariborz Rahimi, Olivia Samotus, Jack Lee, Mandar Jog, Tremor and Other Hyperkinetic Movements Journal, doi: 10.7916/D8BP0270, published 30 October 2015.