Upper Limb Tremor Reduction in Essential Tremor Patients

Not Applicable

Completed

Brief Summary: This study is designed to demonstrate the safety and tolerability of the Encora Therapeutics Tremor Mitigation Device in subjects with upper limb tremor caused by Essential Tremor.

Detailed Description: A prospective, randomized, blinded clinical trial. Subjects meeting all inclusion criteria will have five days of treatment with each of the three arms, received in a randomized order. Subjects will complete two rounds of assessments each day.

Arm 1: Inactive stim Arm 2: Stim therapy utilizing a specific dermatome Arm 3: Stim therapy utilizing a tailored frequency

Recruitment & Eligibility

Inclusion Criteria

Between the ages of 22 and 80 years of age
A diagnosis of essential tremor (definite or probable based on TRIG criteria)
At least one hand exhibiting tremor > 2 as assessed by the Essential Tremor Rating
Assessment Scale (TETRAS) finger to nose task, duck wing task, OR Archimedes Spiral completed during the Screening visit
Stable tremor medications for at least 30 days prior to enrollment and the ability to maintain stable medications through the duration of the study

Randomization Inclusion Criteria

During the Baseline evaluation period, a median tremor score of > 2 on at least one hand as assessed by the TETRAS finger to nose task, the duck wing task, OR the Archimedes Spiral AND
During the Baseline evaluation period, a median score of > 3 on any one of the subject-assessed items of the Bain & Findley Activities of Daily Living Scale (BF-ADL)

Exclusion Criteria

Previous surgical interventions for tremor reduction on the upper limb being used for inclusion in this study (eg, thalamotomy procedure, including Stereotactic Thalamotomy, Gamma Knife Radiosurgical Thalamotomy, or focused ultrasound)
Use of botulinum toxin for treatment to hand tremor within six months of enrollment
Suspected or diagnosed epilepsy or other seizure disorder
Other possible causes of tremor, including Parkinson's disease, drug-induced tremor, or dystonia
Pregnant
Swollen, infected, inflamed areas, or skin eruptions, open wounds, or cancerous lesions of skin at stimulation site
Numbness, tingling or pain affecting the tested upper extremity (eg, suspected or confirmed peripheral neuropathy, carpal tunnel syndrome)
Known allergy to silicone
Subjects are unable or unwilling to comply with the protocol requirements
Subject is part of a vulnerable population who is unable to give Informed Consent for reasons of incapacity, dementia, immaturity, adverse personal circumstances or lack of autonomy. This may include individuals with mental disability, persons in nursing homes, children, impoverished persons, persons in emergency situations, homeless persons, nomads, refugees, and those incapable of giving informed consent.
Vulnerable populations also may include members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of the Sponsor, members of the armed forces, and persons kept in detention.

Arm && Interventions

Group	Intervention	Description
Arm 3	Encora Therapeutics Tremor Reduction Device	treatment with the wearable device set to frequency-match the subject's tremor, duty cycle of and amplitude are set
Arm 2	Encora Therapeutics Tremor Reduction Device	Treatment with the wearable device set to a specific dermatome, duty cycle and amplitude
Arm 1	Encora Therapeutics Tremor Reduction Device	Inactive stimulation - device is powered on, but motors are inactive and amplitude is set to 0%

Primary Outcome Measures

Name	Time	Method
Tolerability (Rate of Subject-Assessed Comfort with Stimulation)	At the end of the 5-day treatment period in all randomization arms	The rate of subject-assessed comfort with stimulation, on a Subject Stimulation Tolerance Questionnaire as measured by % of patient who tolerated the treatment either none of the time, some of the time or all of the time.
Safety (Rate of Adverse Events)	At the end of the 5-day treatment period in all randomization arms	The rate of occurrence of adverse events (AEs) as both total numbers of AEs experienced throughout the study and percentage of subjects who experienced an AE.

Secondary Outcome Measures

Name	Time	Method
Tremor power as measured by gyroscope	At the end of the 5-day treatment period in all randomization arms	Objective, sensor-based metric for tremor measurement.
Bain & Findley Activity of Daily Living (BF-ADL) #2	At the end of the 5-day treatment period in all randomization arms	Use a spoon to drink soup: assess ability to perform task, score ranges from 1 (without difficulty) to 4 (cannot do by yourself).
BF-ADL #4	At the end of the 5-day treatment period in all randomization arms	Pour milk from a carton: assess ability to perform task, score ranges from 1 (without difficulty) to 4 (cannot do by yourself).
BF-ADL #17	At the end of the 5-day treatment period in all randomization arms	Dial a telephone: assess ability to perform task, score ranges from 1 (without difficulty) to 4 (cannot do by yourself).
BF-ADL #21	At the end of the 5-day treatment period in all randomization arms	Insert an electric plug into a socket: assess ability to perform task, score ranges from 1 (without difficulty) to 4 (cannot do by yourself).
Patient Global Impression of Change (PGI-C)	At the end of the 5-day treatment period in all randomization arms	Measures change in condition as compared to baseline, score ranges from 1 = Very much improved to 7 = Very much worse.
Clinician Global Impression of Change (CGI-C)	At the end of the 5-day treatment period in all randomization arms	Measures change in condition as compared to baseline, score ranges from 1 = Very much improved to 7 = Very much worse.