Wrist-Worn TAPS Neuromodulation Reduced Bilateral Tremor Severity in Essential Tremor

Transcutaneous afferent patterned stimulation (TAPS) delivered by a wrist-worn neuromodulation device (Cala TAPS; Cala Health, San Mateo, CA) produced statistically significant bilateral reductions in upper limb tremor in adults with essential tremor (ET). An analysis of data from a series of prospective, randomized trials presented at the 2026 American Academy of Neurology (AAN) Annual Meeting examined 3 TAPS stimulation modes—standard, burst frequency variation (BFV), and pulse frequency variation (PFV)—all of which achieved statistically significant improvements on clinician-rated tremor scales, supporting TAPS as a flexible noninvasive treatment option for ET. Unilateral stimulation improved tremor in both the treated and untreated arms, consistent with a centrally mediated effect.

The findings come from randomized 6-week crossover studies that enrolled 78 adults with functionally limiting ET, 28 of whom had completed all treatment periods at the time of analysis. Participants received each of the 3 TAPS modes for 2 weeks, with effectiveness assessed using the Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS) performance subscale and the Bain and Findley Activities of Daily Living (BF‑ADL) questionnaire. Bilateral TETRAS scores were obtained before and after stimulation, and a prespecified ≥1-point improvement threshold was used to define clinically meaningful benefit.

Key Findings

• All 3 TAPS modes produced statistically significant reductions in tremor severity on clinician-rated TETRAS performance scores.
• BFV-TAPS increased the proportion of participants achieving a ≥1-point TETRAS improvement compared with standard TAPS (89.3% vs 80.4%; odds ratio [OR], 4.6; P=.049).
• Across stimulation modes, unilateral TAPS produced significant mean TETRAS improvements on both the stimulated (2.7±0.4) and contralateral (1.3±0.3) sides (P<.001), with no significant therapy-by-side interaction (P=.551).

Source

Lu C, Reitmaier S, Kent A, Rosenbluth K. Optimizing transcutaneous afferent patterned stimulation therapy: comparison of variable waveforms reveals increased responder rates and bilateral tremor improvement in essential tremor. Presented at: American Academy of Neurology Annual Meeting; April 18-22, 2026; Chicago, IL.