To help Parkinson’s patients who suffer from uncontrollable tremors, London scientists have developed a device that can let doctors know precisely where to inject drugs to calm the shaking. The team said the device makes drug injections more effective, as the treatment is individualized for each patient.
Neurological diseases, such as Parkinson’s and essential tremor, are characterized by involuntary and rhythmic shaking. Most notably, the disease affects muscle movements in the hands, causing trembling and tremors as patients perform ordinary tasks like picking up a cup or writing.
There are no cures for these diseases yet; however, one type of therapy that can help curb the shaking involves injecting the nerves with botulinum toxin type A (BoNT-A), which is similar to Botox. This focal therapy is designed to relax or deaden the nerves that cause the shaking, thereby relieving some symptoms of the disease. But as is, this therapy provides only modest benefits to some patients.
“Very few clinicians inject for tremor because before now, it just didn’t work. The injections would only cause weakness,” said Mandar Jog, a scientist at Lawson Health Research Institute, and senior study author. “We realize now that was because they didn’t know where to inject.”
To solve this problem, Jog and his team devised a technology that they call TremorTek. Using a combination of movement sensors and computer software, the device pinpoints the exact muscles causing a patient’s tremors. That knowledge then informs the doctors where they should inject the Botox-like drugs.
“The uniqueness of our development is the simplicity of it. It records from multiple joints in a straightforward way,” said Jog. In a small clinical trial of 24 patients with essential tremor and 28 patients with Parkinson’s disease, the team demonstrated “quite significant efficacy” in combining TremorTek with the drug injections. Over the course of 38 weeks, the patients reported reduced tremors and improved quality of life, as measured by eating, drinking, and working performance.
For 39-year old Michael Dietrich who was diagnosed with Parkinson’s disease 7 years ago, the trial, like the disease, is “life-altering.” “Being involved in the trial [I] can do most functions that I used to do. I have seen a marked difference,” he said.
The team credits the marked patient response to the TremorTek’s ability to individualize the injection treatments. Whereas doctors before had to guess where to inject, the technology enables precise location of the affected nerves and muscles. This increases the efficacy of the drug and reduces unwanted side-effects like muscle weakness.
In the next phase, Jog hopes to expand the clinical trial so that personalized therapy can be a widespread option for Parkinson’s and essential tremor patients.
Additional source: Western University