December 19, 2025

@michaelokun

Could wearable AI nerve stimulation calm essential tremor and help folks in their daily tasks? A new randomized study in JAMA Neurology says YES. Transcutaneous is a treatment delivered through the skin w/o needles or surgery. In peripheral nerve stimulation a device emits gentle electrical signals that are applied to nerves outside the brain and spinal cord. Ondo and colleagues just dropped a randomized clinical trial testing a novel AI driven transcutaneous peripheral nerve stimulation for essential tremor through a wrist worn device (that was compared to a sham device). Key points: - Daily function improved more than sham. - Following 3 months, the active device reduced the modified 'Activities of Daily Living score' more than the sham device. - The separation between groups became more clear after the first couple of weeks, supporting the idea that ongoing use and adaptive adjustments may matter. - Safety was generally acceptable, however skin irritation was common. My take: It is really fantastic to see some less invasive devices emerging for mild to moderate essential tremor. I suspect this will help some folks, but more severe cases will still require DBS or focused ultrasound. Here are 5 points that resonated w/ me: 1- This is a noninvasive option. It is a wrist worn device that aims to reduce tremor related disability w/o brain surgery. 2- It targets function, not just amount of tremor. 3- AI personalization was a differentiator. The device adjusted stimulation in real time. 4- Expect tradeoffs at the skin as local irritation was frequent. 5- The next questions for this device will be durability and who benefits most. https://jamanetwork.com/journals/jamaneurology/fullarticle/2840156 #parkinson #michaelokun #tremor #essentialtremor #fixelinstitute