Therapeutic potential of TPS-Therapy confirmed once again
TPS in Science: New Meta-Analysis of Transcranial Pulse Stimulation (TPS) and Focused Ultrasound (FUS) Published
Alzheimer’s dementia and other brain diseases are among the fastest growing health problems of our era. Despite the lack of effective drugs, a remarkable increase in therapeutic potential is emerging in physical neurostimulation.
A new study in the prestigious scientific journal Advanced Science now confirms that novel therapeutic approaches, and in particular Transcranial Pulse Stimulation (TPS), can significantly expand the range of treatment options.
We can subscribe to this as well: In our practices Prof. Dr. med. Musa Citak we have meanwhile treated more than 700 patient:s, mostly suffering from Alzheimer’s dementia, but also from other forms of dementia, Parkinson’s disease, depression or post covid syndromes, with Transcranial Pulse Stimulation and have been able to achieve success with almost every one of them – and this without significant side effects.
In a new publication by Beisteiner et al. the scientists evaluate the current developments in the field of innovative ultrasound neuromodulation methods. The authors’ review focuses on Transcranial Pulse Stimulation (TPS) and Focused Ultrasound (FUS). It also highlights their potential advantages over traditional electromagnetic methods.
Modern Technologies: Navigated, highly focused systems with precise targeting capability
In their work, the researchers emphasize the great importance of navigated, highly focused systems in ultrasound neuromodulation for the treatment of brain diseases, which, thanks to rapid methodological and clinical advances, open up entirely new therapeutic perspectives. According to the researchers, these systems allow precise targeting of specific brain regions, which is hardly possible with electromagnetic methods. Indeed, precise targeting is therapeutically crucial, as each brain is individual and brain diseases can lead to severe morphological (structural and shape) changes.
Differences between TPS and FUS
The author:s compare Transcranial Pulse Stimulation (TPS) and focused ultrasound (FUS) in their different approaches. Incidentally, they include TPS among ultrasound neuromodulation methods factually because both methods use sound waves based on the propagation of pressure changes in a medium.
The advantage of TPS over FUS is that TPS can produce a stronger mechanical stimulation with its ultrashort pressure pulses (about 3 μs). In addition, TPS is easy for patients to perform, and patients can move freely during the approximately 30-minute therapy. FUS is a method that must be performed in a magnetic resonance imaging (MRI) scanner and usually takes three to four hours.
TPS and FUS: Clear advantages over electromagnetic methods
The paper highlights three main advantages of ultrasound neuromodulation methods TPS and FUS over electromagnetic techniques: high precision in targeting small brain areas, noninvasive, selective, and focal brain stimulation in depth, and less interference from changes in brain conductance.
Clinical outcomes of TPS and FUS assessed: clear benefit and safety attested
The author:s report 16 clinical trials of TPS and FUS, 14 of which showed significant clinical effects. Most studies describe positive outcomes for patients, such as improvements in cognitive scores, reduction in depression symptoms, and atrophy reduction.
Transcranial Pulse Stimulation (TPS) clinical trials have reported the following clinical effects:
- Improvement in cognitive scores (CERAD) over 3 months; atrophy reduction; depression reduction. Neuropsychological results are supported by morphological, task, and resting-state functional MRI.
- Improvement in cognitive scores (ADAS, ADAS-Cog) immediately after treatment.
- Significant improvements on the Hamilton Depression Rating Scale-17 (HDRS-17).
The publication also shows that neuromodulation with TPS and FUS is considered safe. None of the studies reported serious adverse events (SAEs) in patients:in. With Transcranial Pulse Stimulation (TPS), which is much more common than FUS, more than 15,000 treatment sessions have been performed without any SAEs.
Great Therapeutic Prospects: Wide range of indications possible
TPS and FUS, the researchers:concluded, open new and significant therapeutic perspectives for a wide range of brain diseases. In addition to Alzheimer’s dementia, other forms of dementia disorders, and Parkinson’s disease, these neuromodulation techniques are expected to be applicable in the future to conditions such as epilepsy, depression, schizophrenia, opioid abuse, post-traumatic stress disorder, anxiety disorders, obsessive-compulsive disorder, brain tumors, essential tremor, pain, headaches, and mild cognitive impairment such as post-covid.
The researchers now recommend conducting further studies with higher subject:ing numbers under sham (placebo) conditions and independent neurophysiologic measurements (MRI, electrophysiology) to provide even more accurate information about the clinical effects of TPS and FUS.
The article by Beisteiner et al highlights the promising therapeutic potential of ultrasound neuromodulation, particularly Transcranial Pulse Stimulation (TPS) and focused ultrasound (FUS), for the treatment of various brain disorders. The study highlights the advantages of these technologies over traditional electromagnetic methods, such as higher precision and the possibility of noninvasive, selective, and focal deep brain stimulation. In addition, the safety and simple treatment structure of TPS without significant side effects for the patient:s should be emphasized.
Thus, the clinical results to date are very promising, and further studies may help to further explore and exploit the potential of these new treatments.
It is hoped that this work can also help to provide patients with easier access to the noninvasive and outpatient therapeutic procedure Transcranial Pulse Stimulation (TPS).
Beisteiner R, Hallett M, Lozano A.M. Ultrasound Neuromodulation as a New Brain Therapy. Adv Sci. 2023; Mar 24: 2205634. DOI: 10.1002/advs.202205634 (link: https://doi.org/10.1002/advs.202205634)