Closed-Loop Modulation of a Notch-Filter Stimulation Strategy for Tremor Management with a Neuroprosthesis

Tremor is the most common movement disorder, and one of the major causes of functional disability. In spite of the existence of various treatments, tremor is not managed effectively in a large number of patients, which make it a major cause of loss of quality of life. Here we present a novel strategy for tremor suppression through neurostimulation that replicates an adaptive notch-filter at the frequency of the tremor. The controller, which adapts the neurostimulation to the ongoing amplitude, frequency and phase of the tremor, is implemented in a wearable neuroprosthesis for tremor management. Experimental results in one patient with severe essential tremor illustrate the interest of the approach.

[1]  R. Elble Tremor: clinical features, pathophysiology, and treatment. , 2009, Neurologic clinics.

[2]  L. Cote,et al.  Correlates of functional disability in essential tremor , 2001, Movement disorders : official journal of the Movement Disorder Society.

[3]  Thierry Keller,et al.  Electrical stimulation for the suppression of pathological tremor , 2011, Medical & Biological Engineering & Computing.

[4]  José Luis Pons Rovira,et al.  Design and validation of a neuroprosthesis for the treatment of upper limb tremor , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[5]  E. Rocon,et al.  Design and Validation of a Rehabilitation Robotic Exoskeleton for Tremor Assessment and Suppression , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[6]  Günther Deuschl,et al.  Projected numbers of people with movement disorders in the years 2030 and 2050 , 2011, Movement disorders : official journal of the Movement Disorder Society.

[7]  A. Nordez,et al.  Influence of stimulus intensity on electromechanical delay and its mechanisms. , 2013, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[8]  J. Pons,et al.  A neuroprosthesis for tremor management through the control of muscle co-contraction , 2013, Journal of NeuroEngineering and Rehabilitation.

[9]  I. Hunter,et al.  A comparison of voluntary and involuntary measures of electromechanical delay. , 2006, The International journal of neuroscience.

[10]  L Forsgren,et al.  Activities of daily living and quality of life in persons with newly diagnosed Parkinson’s disease according to subtype of disease, and in comparison to healthy controls , 2011, Acta neurologica Scandinavica.

[11]  W. J. Studden,et al.  Theory Of Optimal Experiments , 1972 .

[12]  M. Brin,et al.  Consensus Statement of the Movement Disorder Society on Tremor , 2008, Movement disorders : official journal of the Movement Disorder Society.

[13]  A. Prochazka,et al.  Attenuation of pathological tremors by functional electrical stimulation II: Clinical evaluation , 2006, Annals of Biomedical Engineering.

[14]  A. Prochazka,et al.  Attenuation of pathological tremors by functional electrical stimulation I: Method , 2006, Annals of Biomedical Engineering.