Parkinson's Disease and Movement Disorders Center of Silicon Valley, Palo Alto, CA, USA.
Department of Neurology, Edward Hines Jr. VA Hospital, Hines, IL, USA.
Tremor Other Hyperkinet Mov (N Y). 2022 Sep 1;12:27. doi: 10.5334/tohm.715. eCollection 2022.
Transcutaneous afferent patterned stimulation (TAPS) is a prescription, wrist-worn device-delivered, non-invasive neuromodulation therapy for treatment of hand tremor in patients with essential tremor (ET). This retrospective post-market surveillance study evaluated real-world effectiveness of TAPS from patients using therapy on-demand for at least 90 days between August 2019 through June 2021.
Demographics were summarized from TAPS prescriptions received from the patient's healthcare provider. Therapy usage and effectiveness were analyzed from device logs, which included tremor measurements from onboard motion sensors. Tremor history and patient-reported outcomes were assessed from a voluntary survey.
A total of 321 patients (average age 71 years, 32% female) met the criteria for this analysis, 216 of whom had tremor measurements available for analysis and 69 of whom completed the survey. Total usage period ranged from 90 to 663 days, with 28% of patients using the device for over one year. Patients used therapy 5.4 ± 4.5 (mean ± 1 standard deviation) times per week. TAPS reduced tremor power by 71% (geometric mean) across all sessions, with 59% of patients experiencing >50% tremor reduction after their sessions. Eighty-four percent (84%) of patients who returned the voluntary survey reported improvement in at least one of eating, drinking, or writing, and 65% of patients reported improvement in quality of life. Self-reported device-related safety complaints were consistent with adverse events in prior clinical trials.
Real-world evidence is consistent with prior clinical trials and confirms TAPS provides safe and effective tremor control for many patients with ET. Future work assessing multi-year safety and effectiveness would be valuable to extend these data.
经皮传入模式刺激(TAPS)是一种处方、腕戴式设备提供的非侵入性神经调节疗法,用于治疗特发性震颤(ET)患者的手部震颤。这项回顾性上市后监测研究评估了 2019 年 8 月至 2021 年 6 月期间至少 90 天按需使用 TAPS 的患者的真实世界疗效。
从患者的医疗保健提供者处收到的 TAPS 处方中总结了人口统计学数据。从设备日志中分析了治疗效果,其中包括来自板载运动传感器的震颤测量值。从自愿调查中评估了震颤病史和患者报告的结果。
共有 321 名患者(平均年龄 71 岁,32%为女性)符合本分析标准,其中 216 名患者有可用于分析的震颤测量值,69 名患者完成了调查。总使用期从 90 天到 663 天不等,28%的患者使用该设备超过一年。患者每周使用治疗 5.4 ± 4.5 次(平均 ± 1 个标准差)。在所有疗程中,TAPS 降低了 71%的震颤功率(几何平均值),59%的患者在疗程后震颤减少超过 50%。返回自愿调查的 84%的患者报告至少在进食、饮水或书写方面有改善,65%的患者报告生活质量改善。与先前临床试验中的不良事件一致,报告的与设备相关的安全性投诉占 84%。
真实世界的证据与先前的临床试验一致,证实 TAPS 为许多 ET 患者提供了安全有效的震颤控制。未来评估多年安全性和有效性的工作将有助于扩展这些数据。