Original Investigation

Transcutaneous Peripheral Nerve Stimulation for Essential Tremor

JAMA Neurology 10.1001/jamaneurol.2025.3905

October 20, 2025 at 11:00 AM EDT

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Is an artificial intelligence (AI)–driven TPNS device superior to a sham device in reducing essential tremor?In this randomized clinical trial that included 125 adults with essential tremor, use of the TPNS device reduced the modified Activities of Daily Living score of the Essential Tremor Rating Assessment Scale by a clinically meaningful 6.9 points at 90 days, significantly more than the 2.7-point reduction seen in the sham-treated group.The TPNS device improved activities related to upper limb tremor at 90 days and could be an effective noninvasive treatment for essential tremor.

Corresponding Author: William G. Ondo, MD, Houston Methodist Hospital, 6560 Fannin, Ste 802, Houston, TX 77030 (wondo@houstonmethodist.org).

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