Cala Trio wrist-worn medical device for tremor improvement in patient with Spinocerebellar Ataxia-12
Syed Mehdi Husaini1, Ahmad Almelegy1, Gian Pal1
1Rutgers-Robert Wood Johnson Medical School
Objective:

To describe a case of a 67-year-old right-handed female who presented for evaluation of Spinocerebellar Ataxia-12 (SCA-12) with a bothersome postural and kinetic tremor that responded to the Cala Trio, a wrist-worn device approved for treating essential tremor (ET).

Background:

SCA-12 is an autosomal dominant neurodegenerative condition caused by expansion of CAG repeats in the PPP2R2B gene resulting in often debilitating ataxia, head/hand tremor, and other neurological deficits.

Cala Trio generates electrical impulses along the median and radial nerves to decrease signals generated in the ventral intermediate nucleus of the thalamus, serving as a neuromodulator that mitigates tremor while adjusting to the wearer’s individual tremor pattern and severity.

Design/Methods:

A 67-year-old right-handed female patient with SCA-12 with bothersome postural and kinetic tremor despite pharmacological treatment with Propranolol.  Given that her tremor fit under the ET phenotype, the Cala Trio device was prescribed.  Improvement in tremor symptoms was monitored over the course of one year using the device’s native data collection function was used to aid in tracking tremor severity with time.

Results:

The patient reported subjective improvement in her ability to conduct her ADLs with less tremor impact when using Cala Trio in conjunction with pharmacological intervention.  Over the course of 434 days, the device was used for a total of 854 sessions with an average duration of usage of 28 minutes.  The device measured a mean improvement of 76% in the patient’s tremor.

Conclusions:

This case demonstrates the utility of the Cala Trio in a patient with genetically confirmed SCA-12.  It also highlights the utility of the Cala Trio in patients with bothersome postural and kinetic tremor who do not fit the typical ET phenotype.  

10.1212/WNL.0000000000204166