Active clinical trials for "Tremor"

The goals of this project are 1) to determine the incidence of neurological voice disorders in patients with dystonia and essential tremor undergoing deep brain stimulation (DBS), 2) investigate the neuroimaging and intracranial neurophysiology correlates of voice dysfunction in these subjects, and subsequently 3) determine the effects of DBS on voice function.

Mindfulness meditation is an approach that has shown interest in treatment of anxiety in Parkinson's disease. This pilot study aims to assess a more specific effect on tremor using Essential Tremor Embarrassment Assessment and inertial sensors allowing monitoring during sessions and in daily life. This study will focus on 20 patients (10 with and without Mindfulness based intervention and will aim to develop the interface and demonstrate proof of concept before setting up a controlled study

This is a feasibility study based on physician-initiated Investigational Device Exemption (IDE) including intraoperative experiments and chronic testing of implanted dual thalamic DBS lead systems. This study will inform protocols for optimal use of implanted next-gen DBS systems for primarily tremor control in refractory essential tremor.If the approach appears to be successful, the pilot data generated will be used to base a future pivotal trial for FDA approval for enhanced tremor control and adaptive DBS (aDBS) functionality of DBS systems.

The purpose of this study is to understand the neurophysiological mechanisms of peripheral electrical stimulation (PES) in modulating supraspinal tremorogenic input to motoneurons. For this purpose, the investigators will use transcutaneous PES, high-density electromyography (HD-EMG), transcranial magnetic stimulation (TMS), electroencephalography (EEG), magnetic resonance imaging (MRI), and neuromusculoskeletal modelling. This study will be carried out in both healthy participants and patients with essential tremor (ET) and Parkinson's disease (PD).

Essential tremor is a chronic and progressive neurological disease characterized by upper limb tremor. This is one of the most frequent movement disorders. Most of the time the disease worsens over the time, affecting patients' work abilities and in the most severe cases activities of daily living such as eating or dressing. For the most disabled patients, Deep brain stimulation (DBS) of the thalamic ventral intermediate median nucleus (Vim), a procedure consisting in an electrode implantation in a structure of the brain involved in tremor genesis, is the gold standard treatment. While this therapy is most of the time highly effective in alleviating the tremor, some subjects may exhibit gait impairment or upper limb coordination troubles years after the surgery, which are thought to be due to the involuntary stimulation of efferent cerebellar fiber tract. Unfortunately, this DBS induced side effect cannot be systematically avoided and may limit the possibilities of settings adaptation required to control the tremor. Surprisingly, while it could be a valuable therapeutic option for these patients suffering from DBS induced balance troubles, little is known about the effect of varying the rate of stimulation on the gait disorders associated with essential tremor and Vim DBS. The aim of or study is consequently to assess the effect of different frequency of stimulation on tremor, gait and balance disorders as well as on eye movements in patients uni or bilaterally stimulated in the Vim for a severe and medically intractable essential tremor. Patients followed at the National Hospital for Neurology and Neurosurgery (University College London Hospital) will be included. To better characterize the different symptoms, the investigators will use ataxia and tremor rating scale together with 3D gait motion analysis, oculography and computerized spiral test analysis. Our findings might lead to a better understanding of Vim-DBS associated gait disorders in essential tremor.

To determine the efficacy of frameless Virtual Cone Radiosurgical Thalamotomy for medically refractory tremor resulting from either Essential Tremor or Tremor-Dominant Parkinson's Disease with the Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS) in patients who are not candidates for deep brain stimulation (DBS).

The proposed study is to evaluate the effectiveness of ExAblate Transcranial MRgFUS as a tool for creating a unilateral lesion in the Vim thalamus or the globus pallidus (GPi) in patients with treatment-refractory symptoms of movement disorders.

Focused ultrasound for Essential Tremor is an FDA approved treatment performed by neurosurgeons at the Ohio State Center for Neuromodulation that utilizes ultrasound technology to create a lesion in the thalamus of Essential Tremor patients. In order to improve long term effectiveness and reduce potential for side effects, brain imaging may be used to examine the functional connectivity of certain brain networks during the procedure. In order to investigate functional connectivity changes with these long term goals in mind, in this study neuroimaging will be taken immediately before, immediately after, and 24 hours after the focused ultrasound procedure for 10 Essential Tremor patients. One series of neuroimaging will also be conducted for 20 healthy control subjects to serve as a comparison. This study will not introduce any risks above standard of care, and may lead to improved long term outcomes of patients undergoing the Focused Ultrasound procedure.

The purpose of this study is to see if the MR-guided focused ultrasound (MRgFUS) thalamotomy procedure can be performed on both sides of the brain safely and effectively to reduce bilateral tremor.

The study objective is to evaluate hand tremor relief in the treated hand following stimulation with the Cala Trio Device in adults with essential tremor, and healthcare resource utilization and total healthcare costs over a 12-month period.