Advanced evidence on TPS: High significance in depression
Effect of Transcranial Pulse Stimulation (TPS) in adults with depressive symptoms
The number of depressive disorders has risen sharply worldwide in recent years, similar to dementia. The COVID-19 pandemic is an additional factor favouring the development of neurophysiological diseases, as has already been shown in numerous studies. In view of these challenges, research and science are more in demand than ever to find and test solutions and therapeutic options.
Recently, Prof. Ulrich Sprick from the Heinrich Heine University Düsseldorf and his team published an observational study on Transcranial Pulse Stimulation (TPS) and its positive effect on cognitive deficits, depressive symptoms and therapy-resistant depression. Now another randomised controlled trial has been published by the University of Hong Kong on the effect of Transcranial Pulse Stimulation in adults with depression.
Efficacy of Transcranial Pulse Stimulation in Adults with Depression Investigated in Controlled, Randomised Trial
The research team, led by Teris Cheng of Hong Kong Polytechnic University and in collaboration with the Department of Psychiatry and Rehabilitation Sciences of the Chinese University of Hong Kong, investigated the effectiveness of Transcranial Pulse Stimulation in adults with major depressive disorder. The aim of the study was to provide an evidence-based treatment option for people with major depressive disorder (MDD).
The baseline study, labelled as a pilot study, was a randomised, controlled, single-blind trial with a study design that conformed to the Consolidated Standards of Reporting Trials (CONSORT) statement and best practice guidelines.
Randomised controlled trials (RCTs) are already the gold standard for evaluating and assessing medical therapies. However, in order to avoid misinterpretation and to give the reader a complete, objective and transparent impression of the study, the authors of the CONSORT statement not only present their work in a standardised way, but also explicitly describe all aspects of the content and background.
Study design, materials and methods of the new Hong Kong study on TPS
The study was conducted as a single-blind, randomised controlled trial with two-way repeated measures at the Interactive Health Clinic, Hong Kong Polytechnic University. A randomised controlled trial is a special type of experimental study that allows the benefits or harms of a treatment to be investigated. Study participants are randomly assigned to different groups, so it is not possible to predict who will be in which group.
The TPS trial used a two-arm design in which a subject intervention group was treated with TPS and its effect was compared with a wait-list control group that did not receive TPS therapy. The study included a total of 30 ill subjects (aged between 18 and 54 years, 73% female) who were previously selected according to strict and demanding criteria. The participants in both groups were blinded as to their group membership, i.e. they did not know whether they were actually being treated or only ostensibly.
Both groups were examined at the beginning of the study immediately before the first treatment session, which was followed by five more treatments within two weeks. Three months after the last treatment session, both groups were examined again. The 17-item Hamilton Rating Scale for Depression (HDRS-17), a globally recognised and reliable method for measuring depressive symptoms and mood, was used to measure depressive symptoms and mood, along with other examination and testing instruments.
Study result: TPS effectively and sustainably reduces depression in adults
The researchers found a significant reduction in the severity of depressive symptoms compared with the wait-list control group (mean difference = -6.60, p = 0.02 and Cohen’s d = -0.93), indicating a significant intervention effect by TPS. These very good results held consistently at three-month follow-up, showing that TPS is effective in reducing depression not only acutely but also in the long term.
As in all other previous studies on Transcranial Pulse Stimulation, only marginal and short-term side effects were seen in this study. Only 4% of the participants felt mild, short-lasting headaches, which, however, did not require taking a painkiller. One person complained of nausea and vomiting after the first TPS treatment, but these subsided after two hours. After that, there were no more complaints.
The researchers from Hong Kong also evaluate Transcranial Pulse Stimulation as an effective, safe and sustainable treatment option, especially for treatment-resistant depression. In their opinion, TPS can and should become one of the leading therapy methods in clinical psychiatry for the treatment of depression in the future. Further double-blind, sham-controlled and randomised studies should be conducted to filter out placebo effects in larger samples.
The full study publication can be viewed at:
https://www.mdpi.com/1660-4601/20/3/2333
as well as at: