# Wearable-Sensor Driven Responsive Deep Brain Stimulation for the Improved Treatment of Essential Tremor

> **NIH NIH F31** · UNIVERSITY OF FLORIDA · 2021 · $10,012

## Abstract

Project Summary/Abstract
Clinically associated with chronic, disabling tremors within the 4-12 Hz range, essential tremor (ET) is the most
prevalent adult-onset tremor disorder. There is marked heterogeneity in the site of tremor, in the occurrence of
non-tremulous symptoms, and in the response to different drugs, alluding to the fact that ET may have several
undefined subtypes or is a family of disorders rather than one sole distinguishable disease. Current diagnosis
solely depends on subjective clinical measurements, such as the Fahn-Tolosa-Marin Tremor Rating Scale. Once
diagnosed, ET can be treated pharmacologically, but for patients unresponsive to medication or with severe
tremor, surgical options become viable. Deep brain stimulation (DBS) of the motor nucleus in the thalamus is
proven to ameliorate tremor; however, DBS operates in a continuous fashion, leading to adverse effects from
unspecific stimulation, rapid battery depletion of the implantable neurostimulator (INS), and impersonalized
stimulation paradigms, thus, causing suboptimal clinical outcomes. The current methodology is an inefficient
solution especially for patients with tremor, which can dynamically change throughout the day. The objective of
this application is to establish physiologic correlates of movement and to characterize the neuromuscular
mechanics of tremor throughout the upper extremities using electromyography (EMG) signals in a cohort of
humans with ET. This research will lead to a deeper understanding of both the pathological basis of tremor within
the extremities, and DBS as well as its mechanisms of action. Our central hypothesis is that wearable sensors,
specifically those that measure EMG, can detect correlates of movement that will provide the control signal for
responsive DBS in a targeted and personalized manner. Since tremor is paroxysmal and only occurs during
movement in ET, responsive DBS only initiates once a movement is detected and then ceases stimulation once
movement ends. In Aim 1, we will identify and characterize physiological correlates of tremor throughout the
upper limb using EMG signals. In Aim 2, we will establish and clinically validate a responsive DBS system that
utilizes physiological correlates of movement to initiate and terminate stimulation in humans with ET. We will
initiate responsive DBS based on both the presence of movement and phase of tremor. This research is
significant and innovative because it will provide improved tremor suppression through personalized DBS
paradigms, reduce adverse effects associated with continuous stimulation, and prolong battery life of the INS,
subsequently decreasing the frequency of surgical procedures needed to replace these devices. Additionally,
this research has the potential to uncover other uncertainties about ET, including its neuromuscular origin,
propagation, and distribution, and to develop an objective measurement of tremor severity, which is an unmet
clinical need. Lastly, a sensor-b...

## Key facts

- **NIH application ID:** 10160652
- **Project number:** 5F31NS115363-02
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** Stephanie Lynn Cernera
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $10,012
- **Award type:** 5
- **Project period:** 2020-05-15 → 2021-08-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10160652

## Citation

> US National Institutes of Health, RePORTER application 10160652, Wearable-Sensor Driven Responsive Deep Brain Stimulation for the Improved Treatment of Essential Tremor (5F31NS115363-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10160652. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*