How a Non-invasive Tourette’s Device Moved from Lab Insight to a Daily Wearable

Tourette’s syndrome is still widely misunderstood. Public awareness often settles on the outward tic, even though the condition can shape confidence, comfort, and day-to-day life in ways that are far less visible to others.

For years, support options remained narrow and difficult to access, with medication, cognitive behavioral therapy, and experimental invasive brain stimulation offering a limited set of routes forward. Individuals with Tourette’s stressed that they want a home-based solution they could use as and when they wanted.

This need led researchers at the University of Nottingham to ask: Could median nerve stimulation become a non-invasive home-based treatment? The work that followed became the basis for Neurotherapeutics Ltd. (Neupulse), a University of Nottingham spin-out focused on adapting research into wearable, commercially available devices.

The aim for a Tourette’s device was not to remove symptoms altogether but to increase control when it becomes hardest to manage tics and urges.

“Many adults feel that Tourette’s is part of their identity, so they don’t want to get rid of it. What they want is some control,” said Dr. Barbara Morera, founder, director, and chief research officer at Neupulse.

That shaped the development brief from the outset. The task was to turn a promising treatment into something people could use discreetly in everyday life.

Condensing Complex Laboratory Science into a Functional Prototype

The foundational research showed that rhythmic electrical stimulation at the right wrist could influence the brain activity linked to tic suppression. The stimulation was designed to entrain mu-band brain activity associated with movement suppression^1,2. The underlying mechanism is important, but the practical challenge was converting that lab insight into a wearable device people could use on their own.

The early setup was highly complex and required overcoming several specific technical barriers:

• The power source: Participants had to be attached to bulky pulse generators plugged directly into mains power, so they could not move around.
• The conductive interface: Participants were tethered by dangling cables, and their skin was coated in a messy, wet gel to ensure low-impedance electrical contact.
• The human operator: A trained researcher had to position the electrodes carefully and calibrate intensity for each participant individually by watching for a thumb twitch before selecting the target level.

If the team could not solve this productization challenge, a clinically meaningful therapy would remain locked away in a university lab. Neurotherapeutics partnered with Ensera Design, a healthcare innovation consultancy, to navigate this transition and generate concrete clinical trial data rapidly to secure its next round of investor funding.

“Part of the challenge was moving from a research project into full product development, with all the documentation, testing and market requirements that come with a device intended for clinical trials and eventual public use,” said Kerry Briggs, VP design and development Europe at Ensera Design.

Building the Device Around Real Use

Ensera Design brought together electronics, software, and human factors expertise to translate the therapy from lab equipment into a usable wearable device. The immediate objective was to build an initial batch of Medicines and Healthcare products Regulatory Agency (MHRA)-approved clinical trial devices.

To achieve this, the engineering team focused exclusively on the core therapeutic mechanism, stripping out non-essential consumer features like Bluetooth. Transferring the technology to a consumer wearable demanded rigorous human factors engineering. The physical activation of the device presented an immediate behavioral complication. Early feedback suggested that a visible button could itself trigger the urge to press it, so the team engineered a deliberate three-second hold activation sequence instead. This required intentional, sustained physical pressure, making accidental activation far less likely.

Designing for Daily Life: A Discreet and Independent Daily Therapy

The final device gives users more control over how they use the therapy in daily life. Session length and stimulation intensity can be adjusted to suit different routines and different levels of need. Usage will vary significantly between individuals, with some users choosing to use the device continuously throughout the day, while others will only activate it in specific situations where they want immediate control over their tics. Beyond active use, the device can also deliver strong residual benefits, leading individuals to wear it regularly even when the stimulation is turned off to help maintain long-lasting relief.

Because the device had to sit on the inside of the wrist and fit into everyday life, the team had to balance therapeutic function with wearability, discretion, and visual appeal. It also had to cope with normal situations such as splashes of water during household tasks.

“We did so much work to slim it down and make it as small as possible, but the reality is it’s delivering a real therapeutic benefit, and it didn’t need to be a millimeter thin,” said James Holmes, Head of Electronics and Software at Ensera Design. “It needed enough design appeal that people would feel comfortable wearing it, but we were not trying to compete with a smartwatch.”

The work was carried out side-by-side with the university and Neupulse teams, with condition-specific insight feeding directly into Ensera Design’s recommendations on usability, product development, and manufacturability.

From Clinical Proof to Commercial Traction

The prototype hardware engineered by Ensera Design on behalf of Neupulse facilitated a pivotal clinical trial featuring 135 participants, making it the largest neuromodulation study of its kind for Tourette’s syndrome. At that scale, the study design had to be especially robust, which is challenging for electrical stimulation studies where participants can feel the output. Because participants could physically feel the stimulation, the sham-control design had to be highly sophisticated to preserve blinding as far as possible.

To maintain blinding, the sham-control device delivered 15 seconds of active stimulation before dropping to 50% of the active level, which users could still feel but which was not strong enough to produce the therapeutic effect.

The trial showed a statistically significant reduction in tic frequency and severity³. A Continuous Performance Task (CPT) study also ruled out the theory that the reduction in tics was simply a result of the physical stimulation distracting the user¹. Just as importantly, the data demonstrated that using the device had no negative impact on the user’s attention, cognitive function or ability to execute normal, volitional movements. Separate analysis also found a positive correlation, revealing that the reduction in tic frequency accounted for around 56% of the variance in self-estimated urge-to-tic.

The clinical results helped support a £2.5 million seed funding round led by Scottish impact investor Eos Advisory alongside a consortium of U.S. investors⁴. The funding success reflected confidence in the company’s progress and gave the team more room to move the prototype device toward a commercial unit for launch.

“Funding is challenging, trying to get investment interest, and we’ve managed to do that,” said Ben Garland, eCommerce operations officer for Neupulse. “It shows real confidence in what we’re doing and where we are.”

To ensure the therapy would be accessible to the Tourette’s syndrome community, the engineering team strictly controlled manufacturing costs. By removing non-essential hardware components early in the design phase, they ensured the final device could reach patients at a target cost of approximately £500. This approach prioritizes user access, providing a financially viable alternative to expensive neurological treatments.

What’s Next: Expanding Access Beyond the UK

The commercial launch of the Neupulse device is scheduled for June 2026, with pre-orders having opened on October 10, 2025. The BAFTA award-winning film I Swear, based on the life of Tourette’s campaigner John Davidson and starring Robert Aramayo, also features the device and has helped raise awareness of both Tourette’s syndrome and the therapy behind Neupulse. The strategic commercial roadmap for Neupulse extends far beyond the initial UK rollout, with preparations underway to expand access to individuals in Europe and the U.S. The team also sees wider potential in the underlying science, but for now, the immediate focus is getting the Tourette’s syndrome device into people’s hands.

“Bringing a therapy of this magnitude to life requires more than just an engineering vendor,” said Paul Cable, CEO at Neurotherapeutics Ltd. “Ensera Design was a critical partner with a shared vision, ensuring our clinical breakthrough translated into a tangible reality for users.”

References
¹ Morera Maiquez, Barbara, et al. “Entraining Movement-Related Brain Oscillations to Suppress Tics in Tourette Syndrome.” Current Biology. 30 (2020): 1-9. 
² Houlgreave, Mairi S., et al. “The Oscillatory Effects of Rhythmic Median Nerve Stimulation.” bioRxiv. (2020).
³ Morera Maiquez, Barbara, et al. “A double-blind, sham-controlled, trial of home-administered rhythmic 10-Hz median nerve stimulation for the reduction of tics, and suppression of the urge-to-tic, in individuals with Tourette syndrome and chronic tic disorder.” Journal of Neuropsychology.  17(3), (2023): 540-563
⁴ Ensera Design. “Neupulse: world’s first wearable device to tackle Tourettes Syndrome takes step forward.” Ensera Design News. 2024.