Neuromodulation Strategies for Treatment-Resistant Essential Tremor Using Chronos™ DBS

NCT ID: NCT07302867

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

5 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-04-01

Study Completion Date

2028-04-01

Brief Summary

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The goal of this observational study is to learn whether a new way of programming Deep Brain Stimulation (DBS) can improve and maintain tremor control in adults with essential tremor (ET) who stopped responding to standard DBS therapy.

The main questions it aims to answer are:

* 1\. Can advanced DBS settings, using varied stimulation patterns, frequencies, and pulses, restore tremor control in people with ET who lost benefit from standard Ventral Intermedius Deep Brain Stimulation (VIM-DBS)?
* 2\. Do these advanced settings provide more stable, longer-lasting tremor improvement over time?

Researchers will compare six different stimulation settings to see if any of them can improve tremor symptoms when standard DBS programming no longer works.

Participants will:

* Complete a clinic visit where they try six different DBS stimulation settings using specialized Chronos software.
* Be randomly assigned to one of these settings to use at home.
* Receive a follow-up phone call at 4 weeks to check on symptoms and device use.
* Return to the clinic at 3 months for a full tremor evaluation.
* Have the option to return for an additional follow-up visit at 1 year.

This study will include 5 participants with essential tremor who previously lost benefit quickly after receiving standard VIM-DBS treatment.

Detailed Description

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* Purpose: To test whether new DBS programming patterns can restore and sustain tremor control in essential tremor (ET) patients who lose benefit quickly after standard Vim-DBS.
* Hypothesis: Novel stimulation paradigms - like high-frequency, microburst, cycling, and scheduling - can overcome early habituation and provide lasting tremor improvement.
* Justification: Some ET patients experience rapid loss of benefit despite correct DBS placement. Standard programming does not help them, creating a disabling condition. Advanced programming may offer a safe, non-surgical solution.
* Objectives:
* 1\. Determine if Chronos™ software programs maintain tremor improvement beyond one month.
* 2\. Assess safety, tolerability, and identify the most effective stimulation parameters.
* Research Design: Prospective, single-center cohort study of 5 early-habituating ET patients. Patients trial six stimulation paradigms in clinic, then are randomized to one program for home use. Follow-up occurs at 4 weeks, 3 months, and optionally 1 year.
* Statistical Analysis: Descriptive statistics due to small sample size. Outcomes include tremor ratings, patient-reported benefit, and recurrence of habituation.

Conditions

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Essential Tremor

Keywords

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Deep Brain Stimulation Essential Tremor

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

This is a prospective, single-center, single-group assignment interventional study. All enrolled participants undergo a structured trial of six experimental DBS stimulation paradigms delivered through Chronos™ software. Participants are then randomized to one stimulation program for at-home use. There is no comparison group; all participants receive active intervention. Follow-up occurs at 4 weeks, 3 months, and optionally at 1 year to assess tremor response, durability of benefit, and safety.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Single Experimental Arm

All participants will test six different experimental DBS stimulation programs in the clinic using Chronos™ software. After trying all six programs, each participant will be randomly assigned to one of the six stimulation patterns to use at home for the study period. There is no control or placebo group; all participants receive an active DBS programming intervention.

Group Type EXPERIMENTAL

Continuous

Intervention Type OTHER

DBS setting: 185 Hz, 60 µs pulse width, optimized amplitude

Continuous + High Frequency Cycling

Intervention Type OTHER

DBS setting: Alternates 30s at 185 Hz and 30s at 1000 Hz

High Frequency

Intervention Type OTHER

DBS setting: 1000 Hz continuous, 60 µs, optimized amplitude

Microburst

Intervention Type OTHER

DBS setting: 900 Hz intraburst, 80 Hz interburst, 6 pulses per packet

Scheduling

Intervention Type OTHER

DBS setting: Two or three effective programs on alternating schedules

Cycling

Intervention Type OTHER

DBS setting: 30s on / 5s off cycle without ramp, subthreshold stimulation

Interventions

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Continuous

DBS setting: 185 Hz, 60 µs pulse width, optimized amplitude

Intervention Type OTHER

Continuous + High Frequency Cycling

DBS setting: Alternates 30s at 185 Hz and 30s at 1000 Hz

Intervention Type OTHER

High Frequency

DBS setting: 1000 Hz continuous, 60 µs, optimized amplitude

Intervention Type OTHER

Microburst

DBS setting: 900 Hz intraburst, 80 Hz interburst, 6 pulses per packet

Intervention Type OTHER

Scheduling

DBS setting: Two or three effective programs on alternating schedules

Intervention Type OTHER

Cycling

DBS setting: 30s on / 5s off cycle without ramp, subthreshold stimulation

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults with essential tremor who have undergone standard Vim-DBS surgery
* Demonstrated rapid (early) habituation to standard programming.
* Ability to provide informed consent and attend follow-up visits.

Exclusion Criteria

* Inability to attend programming visits.
* Cognitive or language impairment precluding consent.
* Other neurological conditions confounding tremor assessment.
Minimum Eligible Age

19 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role collaborator

University of British Columbia

OTHER

Sponsor Role lead

Responsible Party

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Christopher Honey

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Vancouver General Hospital

Vancouver, British Columbia, Canada

Site Status

Countries

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Canada

Central Contacts

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Danielle A Pietramala

Role: CONTACT

Phone: 604-875-4111

Email: [email protected]

Facility Contacts

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Danielle A Pietramala

Role: primary

Other Identifiers

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H25-03800

Identifier Type: -

Identifier Source: org_study_id