Karamesinis Alexandra, Sillitoe Roy V, Kouzani Abbas Z
School of Engineering, Deakin University, Geelong, VIC 3216, Australia.
Department of Pathology and Immunology, Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA.
IEEE Access. 2021;9:80066-80076. doi: 10.1109/access.2021.3084819. Epub 2021 May 28.
Essential tremor is the most common pathological tremor, with a prevalence of 6.3% in people over 65 years of age. This disorder interferes with a patient's ability to carry out activities of daily living independently, and treatment with medical and surgical interventions is often insufficient or contraindicated. Mechanical orthoses have not been widely adopted by patients due to discomfort and lack of discretion. Over the past 30 years, peripheral electrical stimulation has been investigated as a possible treatment for patients who have not found other treatment options to be satisfactory, with wearable devices revolutionizing this emerging approach in recent years. In this paper, an overview of essential tremor and its current medical and surgical treatment options are presented. Following this, tremor detection, measurement and characterization methods are explored with a focus on the measurement options that can be incorporated into wearable devices. Then, novel interventions for essential tremor are described, with a detailed review of open and closed-loop peripheral electrical stimulation methods. Finally, discussion of the need for wearable closed-loop peripheral electrical stimulation devices for essential tremor, approaches in their implementation, and gaps in the literature for further research are presented.
特发性震颤是最常见的病理性震颤，在65岁以上人群中的患病率为6.3%。这种疾病会干扰患者独立进行日常生活活动的能力，而药物和手术干预治疗往往不足或存在禁忌。由于佩戴不适和缺乏隐蔽性，机械矫形器尚未被患者广泛采用。在过去30年里，对于那些未找到其他满意治疗方案的患者，外周电刺激作为一种可能的治疗方法进行了研究，近年来可穿戴设备使这种新兴方法发生了变革。本文介绍了特发性震颤及其当前的药物和手术治疗方案。在此之后，探讨了震颤检测、测量和表征方法，重点关注可纳入可穿戴设备的测量选项。然后，描述了特发性震颤的新型干预措施，并详细综述了开环和闭环外周电刺激方法。最后，讨论了用于特发性震颤的可穿戴闭环外周电刺激设备的需求、其实施方法以及文献中有待进一步研究的空白。
