{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:47:54Z","timestamp":1792118874290,"version":"4.4.0"},"reference-count":57,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,8]],"date-time":"2022-01-08T00:00:00Z","timestamp":1641600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>(1) Background: Non-invasive neuromodulation is a promising alternative to medication or deep-brain stimulation treatment for Parkinson\u2019s Disease or essential tremor. In previous work, we developed and tested a wearable system that modulates tremor via the non-invasive, electrical stimulation of peripheral nerves. In this article, we examine the proper range and the effects of various stimulation parameters for phase-locked stimulation. (2) Methods: We recruited nine participants with essential tremor. The subjects performed a bean-transfer task that mimics an eating activity to elicit kinetic tremor while using the wearable stimulation system. We examined the effects of stimulation with a fixed duty cycle, at different stimulation amplitudes and frequencies. The epochs of stimulation were locked to one of four phase positions of ongoing tremor, as measured with an accelerometer. We analyzed stimulation-evoked changes of the frequency and amplitude of tremor. (3) Results: We found that the higher tremor amplitude group experienced a higher rate of tremor power reduction (up to 65%) with a higher amplitude of stimulation when the stimulation was applied at the \u00b1peak of tremor phase. (4) Conclusions: The stimulation parameter can be adjusted to optimize tremor reduction, and this study lays the foundation for future large-scale parameter optimization experiments for personalized peripheral nerve stimulation.<\/jats:p>","DOI":"10.3390\/jpm12010076","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T23:06:15Z","timestamp":1641769575000},"page":"76","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Analyzing the Effects of Parameters for Tremor Modulation via Phase-Locked Electrical Stimulation on a Peripheral Nerve"],"prefix":"10.3390","volume":"12","author":[{"given":"Jeonghee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Engineering Technology and Industrial Distribution, Texas A&M University, College Station, TX 77843, USA"},{"name":"Department of Multidisciplinary Engineering, Texas A&M University, College Station, TX 77843, USA"},{"name":"Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX 77843, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2751-9545","authenticated-orcid":false,"given":"Thomas","family":"Wichmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Emory University, Atlanta, GA 30322, USA"},{"name":"Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center at Emory University, Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-1794","authenticated-orcid":false,"given":"Omer T.","family":"Inan","sequence":"additional","affiliation":[{"name":"School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P.","family":"DeWeerth","sequence":"additional","affiliation":[{"name":"School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA"},{"name":"Department of Biomedical Engineering, Lehigh University, Bethlehem, PA 18015, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/mds.27121","article-title":"Tremor Task Force of the International Parkinson and Movement Disorder Society. Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society","volume":"33","author":"Bhatia","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"l4485","DOI":"10.1136\/bmj.l4485","article-title":"Essential tremor: Diagnosis and management","volume":"366","author":"Shanker","year":"2019","journal-title":"BMJ"},{"key":"ref_3","first-page":"1","article-title":"Tremor: Clinical phenomenology and assessment techniques","volume":"2","author":"Hess","year":"2012","journal-title":"Tremor Other Hyperkinetic Mov."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S369","DOI":"10.1016\/S1353-8020(08)70032-4","article-title":"Tremor","volume":"13","author":"Bain","year":"2007","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.parkreldis.2012.06.011","article-title":"Quality of life and its determinants in essential tremor","volume":"19","author":"Chandran","year":"2013","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.1600-0404.2007.00863.x","article-title":"Quality of life in a random sample of community dwelling older patients with essential tremor","volume":"116","author":"Nguyen","year":"2007","journal-title":"Acta Neurol. Scand."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.parkreldis.2015.04.019","article-title":"Tremor-related quality of life: A comparison of essential tremor vs. Parkinson's disease patients","volume":"21","author":"Louis","year":"2015","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_8","first-page":"250","article-title":"Essential tremor: Epidemiology, diagnosis, and treatment","volume":"10","author":"Sullivan","year":"2004","journal-title":"Neurology"},{"key":"ref_9","unstructured":"(2021, September 22). 12-Month Annual Report, Hope through Research, Awareness and Support. Available online: http:\/\/www.essentialtremor.org\/wp-content\/uploads\/2013\/07\/2006-IETF-An-Rep-for-WEB.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S162","DOI":"10.1016\/j.parkreldis.2015.09.032","article-title":"The relationship between essential tremor and Parkinson's disease","volume":"22","author":"Thenganatt","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S90","DOI":"10.1016\/S1353-8020(11)70029-3","article-title":"Epidemiology, diagnosis and differential diagnosis in Parkinson's disease tremor","volume":"18","author":"Baumann","year":"2012","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1136\/pgmj.2005.032979","article-title":"Differential diagnosis of common tremor syndromes","volume":"81","author":"Bhidayasiri","year":"2005","journal-title":"Postgrad. Med. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S1474-4422(06)70471-9","article-title":"Epidemiology of Parkinson\u2019s disease","volume":"5","author":"Breteler","year":"2006","journal-title":"Lancet Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1002\/mds.22838","article-title":"How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor","volume":"25","author":"Louis","year":"2010","journal-title":"Mov. Disord."},{"key":"ref_15","unstructured":"Mayo Clinic (2021, September 22). Essential Tremor: Treatment. Available online: http:\/\/www.mayoclinic.org\/diseases-conditions\/essential-tremor\/basics\/treatment\/con-20034509."},{"key":"ref_16","unstructured":"(2021, September 22). Drug Treatments for Essential Tremor. Available online: https:\/\/www.webmd.com\/epilepsy\/guide\/essential-tremor-drug."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1002\/mds.27700","article-title":"evidence-based review of treatments for essential tremor","volume":"34","author":"Ferreira","year":"2019","journal-title":"Mov. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1111\/j.1468-1331.2009.02926.x","article-title":"How are we doing with the treatment of essential tremor (ET)? Persistence of patients with ET on medication: Data from 528 patients in three settings","volume":"17","author":"Louis","year":"2010","journal-title":"Eur. J. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1159\/000492831","article-title":"The roles of age and aging in essential tremor: An epidemiological perspective","volume":"52","author":"Louis","year":"2019","journal-title":"Neuroepidemiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1212\/WNL.41.8.1185","article-title":"Botulinum toxin treatment of tremors","volume":"41","author":"Jankovic","year":"1991","journal-title":"Neurology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1212\/WNL.45.4.822","article-title":"Botulinum toxin treatment of essential head tremor","volume":"45","author":"Pahwa","year":"1995","journal-title":"Neurology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1097\/00005537-200008000-00028","article-title":"Botulinum toxin for essential tremor of the voice with multiple anatomical sites of tremor: A crossover design study of unilateral versus bilateral injection","volume":"110","author":"Warrick","year":"2000","journal-title":"Laryngoscope"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1212\/WNL.51.3.850","article-title":"Double-blind evaluation of subthalamic nucleus deep brain stimulation in advanced Parkinson's disease","volume":"51","author":"Kumar","year":"1998","journal-title":"Neurology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1212\/WNL.46.4.1150","article-title":"Deep brain stimulation for essential tremor","volume":"46","author":"Hubble","year":"1996","journal-title":"Neurology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.nurt.2008.01.004","article-title":"Deep brain stimulation and tremor","volume":"5","author":"Lyons","year":"2008","journal-title":"Neurotherapeutics"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/WCO.0000000000000465","article-title":"New neurosurgical approaches for tremor and Parkinson\u2019s disease","volume":"30","author":"Fasano","year":"2017","journal-title":"Curr. Opin. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1136\/jnnp-2018-318240","article-title":"Outcomes from stereotactic surgery for essential tremor","volume":"90","author":"Dallapiazza","year":"2019","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3086","DOI":"10.1093\/brain\/awz236","article-title":"Connectivity profile of thalamic deep brain stimulation to effectively treat essential tremor","volume":"142","author":"Ewert","year":"2019","journal-title":"Brain"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1212\/WNL.0000000000004295","article-title":"Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia","volume":"89","author":"Cury","year":"2017","journal-title":"Neurology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/BF02368521","article-title":"Attenuation of pathological tremors by functional electrical stimulation I: Method","volume":"20","author":"Prochazka","year":"1992","journal-title":"Ann. Biomed. Eng."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/BF02368522","article-title":"Attenuation of pathological tremors by functional electrical stimulation II: Clinical evaluation","volume":"20","author":"Javidan","year":"1992","journal-title":"Ann. Biomed. Eng."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1109\/86.788474","article-title":"Tremor suppression using functional electrical stimulation: A comparison between digital and analog controllers","volume":"7","author":"Gillard","year":"1999","journal-title":"IEEE Trans. Rehabil. Eng."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1111\/aor.12261","article-title":"On the use of fxedintensity functional electrical stimulation for attenuating essential tremor","volume":"38","author":"Geny","year":"2014","journal-title":"Artif Organs."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/1743-0003-10-36","article-title":"A neuroprosthesis for tremor management through the control of muscle co-contraction","volume":"10","author":"Gallego","year":"2013","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_35","first-page":"123","article-title":"Functional electrical stimulation efect on upper limb tremor","volume":"13","author":"Grimaldi","year":"2011","journal-title":"Int. J. Bioelectromagn."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jns.2015.08.1527","article-title":"Exploring the effect of electrical muscle stimulation as a novel treatment of intractable tremor in Parkinson's disease","volume":"358","author":"Jitkritsadakul","year":"2015","journal-title":"J. Neurol. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Hao, M., He, X., Xiao, Q., Alstermark, B., and Lan, N. (2013). Corticomuscular transmission of tremor signals by propriospinal neurons in Parkinson's disease. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0079829"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S803","DOI":"10.3233\/BME-151372","article-title":"Sensory electrical stimulation for suppression of postural tremor in patients with essential tremor","volume":"26","author":"Heo","year":"2015","journal-title":"Bio-Med. Mater. Eng."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1840006","DOI":"10.1142\/S0219519418400067","article-title":"Continuous sensory electrical stimulation for the suppression of parkinsonian rest tremor","volume":"18","author":"Heo","year":"2018","journal-title":"J. Mech. Med. Biol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1940033","DOI":"10.1142\/S0219519419400335","article-title":"Effect of Sensory Electrical Stimulation on Resting Tremors in Patients with Parkinson\u2019s Disease and SWEDDS","volume":"19","author":"Heo","year":"2019","journal-title":"J. Mech. Med. Biol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1111\/ner.12930","article-title":"An acute randomized controlled trial of noninvasive peripheral nerve stimulation in essential tremor","volume":"22","author":"Pahwa","year":"2019","journal-title":"Neuromodulation Technol. Neural Interface"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"178","DOI":"10.3389\/fnins.2017.00178","article-title":"Electrical stimulation of afferent pathways for the suppression of pathological tremor","volume":"11","author":"Dideriksen","year":"2017","journal-title":"Front. Neurosci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5334\/tohm.59","article-title":"Prospective home-use study on non-invasive neuromodulation therapy for essential tremor","volume":"10","author":"Isaacson","year":"2020","journal-title":"Tremor Other Hyperkinetic Mov."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1002\/mds.27350","article-title":"Noninvasive neuromodulation in essential tremor demonstrates relief in a sham-controlled pilot trial","volume":"33","author":"Lin","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_45","first-page":"1768","article-title":"Intramuscular stimulation of muscle afferents attains prolonged tremor reduction in essential tremor patients","volume":"68","author":"Muceli","year":"2020","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"17720","DOI":"10.1038\/s41598-021-96660-6","article-title":"Essential tremor amplitude modulation by median nerve stimulation","volume":"11","author":"Reis","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_47","first-page":"1","article-title":"A wearable system for attenuating essential tremor based on peripheral nerve stimulation","volume":"8","author":"Kim","year":"2020","journal-title":"IEEE J. Transl. Eng. Health Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"80066","DOI":"10.1109\/ACCESS.2021.3084819","article-title":"Wearable Peripheral Electrical Stimulation Devices for the Reduction of Essential Tremor: A Review","volume":"9","author":"Karamesinis","year":"2021","journal-title":"IEEE Access"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s12984-021-00811-9","article-title":"Peripheral electrical stimulation to reduce pathological tremor: A review","volume":"18","author":"Hoo","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"700600","DOI":"10.3389\/fneur.2021.700600","article-title":"A Review on Wearable Technologies for Tremor Suppression","volume":"12","author":"Rocon","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_51","unstructured":"(2021, September 22). CalaTM Health Care Professional FAQs. Available online: https:\/\/calatrio.com\/healthcare-professionals\/frequently-asked-questions\/."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.1093\/brain\/awl190","article-title":"Tremor amplitude is logarithmically related to 4-and 5-point tremor rating scales","volume":"129","author":"Elble","year":"2006","journal-title":"Brain"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"34","DOI":"10.29245\/2572.942X\/2016\/4.1038","article-title":"The essential tremor rating assessment scale","volume":"1","author":"Elble","year":"2016","journal-title":"J. Neurol. Neuromedicine"},{"key":"ref_54","unstructured":"Kim, J., Wichmann, T., Inan, O.T., and Deweerth, S.P. (2021). Fitts Law-Based Performance Metrics to Quantify Tremor in Individuals with Essential Tremor. IEEE J. Biomed. Health Inform., 1\u201311."},{"key":"ref_55","unstructured":"Kim, J. (2018). Assessment and modulation of essential tremor using peripheral-nerve stimulation. [Ph.D. Thesis, Georgia Institute of Technology]."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Kim, J., Parnell, C., Wichmann, T., and Deweerth, S.P. (2016, January 16\u201320). Longitudinal wearable tremor measurement system with activity recognition algorithms for upper limb tremor. Proceedings of the 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Orlando, FL, USA.","DOI":"10.1109\/EMBC.2016.7592136"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kim, J., Parnell, C., Wichmann, T., and Deweerth, S.P. (2016, January 16\u201320). Quantitative assessment of arm tremor in people with neurological disorders. Proceedings of the 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Orlando, FL, USA.","DOI":"10.1109\/EMBC.2016.7591189"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/1\/76\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:01:44Z","timestamp":1760364104000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/1\/76"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,8]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["jpm12010076"],"URL":"https:\/\/doi.org\/10.3390\/jpm12010076","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,8]]}}}