Transcranial Pulse Stimulation (TPS) as an innovative treatment option for Alzheimer’s dementia: An exploratory study
TPS shockwave therapy investigated as a safe and effective additional treatment for Alzheimer’s patients
Treatment methods using non-invasive brain stimulation (NIBS) are increasingly coming to the fore in the treatment of neurodegenerative diseases such as Alzheimer’s dementia or Parkinson’s disease. The shock wave method Transcranial Pulse Stimulation (TPS) is also showing clear potential to expand current treatment options in increasingly extensive scientific studies and investigations. The TPS method is based on the delivery of low-energy, focused shock waves and is being investigated as a promising treatment option for Alzheimer’s dementia, as it can influence vascular, metabolic and neuroplastic processes.
Prof. Lars Wojtecki from Heinrich Heine University Düsseldorf (HHU), who is researching various brain stimulation methods in the field of neuromodulation with his team at the Hospital zum Heiligen Geist in Kempen, has also come to this conclusion.
The new exploratory study led by Prof. Wojtecki aims to gain insights into the neurophysiological effects in just one session of Transcranial Pulse Stimulation (TPS) in Alzheimer’s patients and how the effects of TPS shock waves are reflected in electroencephalographic measures, such as spectral power, coherence, Tsallis entropy (TE) and frequency coupling (cfc).
The study documents changes in power (frontal and occipital), coherence (frontal, occipital and temporal) and TE (temporal and frontal) and changes in cfc (parietal-frontal, parietal-temporal, frontal-temporal). The results emphasize the role of electroencephalographic measurements as possible markers for the neurophysiological effect of TPS.
Special mechanism of action: TPS can penetrate deep into the brain with high precision
In their paper, Prof. Wojtecki and team first highlight the research results to date, which show that Transcranial Pulse Stimulation (TPS) offers several advantages over other brain stimulation methods: Compared to other techniques, TPS can penetrate deeper into the brain without damaging the surrounding tissue, as the method is highly precise.
Unlike related techniques, such as ultrasound, TPS combines short shock waves with slightly longer pulses, creating a unique effect characterized by high pressure with low mechanical stress. The effects of the treatment are thought to be due to changes in blood vessels, nerve tissue and the brain’s energy requirements after stimulation.
Methodology of the study: TPS in Alzheimer’s patients
The present study by Wojtecki et al. investigated the effect of Transcranial Pulse Stimulation (TPS) in ten Alzheimer’s patients (two women, eight men) whose cognitive impairment varied from mild to severe. The patients each received a single TPS session in which the shock waves were applied specifically to brain regions such as the precuneus and the frontal, parietal and temporal cortex areas. In order to measure the neurophysiological changes, EEG recordings were made before and after the TPS treatment. These EEG data enabled the analysis of brain activity, including power spectral density, neuronal coherence, Tsallis entropy and cross-frequency coupling (CFC).
Result: Significant changes after the TPS treatments
The results showed a significant increase in beta and gamma power in both the frontal and occipital regions of the brain. These high-frequency oscillations are closely linked to cognitive processes such as attention, memory and executive functions. The increase in these frequencies suggests that Transcranial Pulse Stimulation (TPS) has the potential to positively influence these cognitive abilities.
In addition, altered coherence between different brain regions was observed. Coherence, which is a measure of synchronization between different brain areas, increased particularly in the temporal regions in the alpha and beta areas. This increased coherence could indicate improved communication within the brain, especially between the regions responsible for memory and information processing. At the same time, however, a decrease in theta coherence between the parietal and frontal regions was observed, which could be interpreted as a sign of altered neuronal dynamics.
Tsallis entropy, a measure for assessing the complexity of brain activity, also showed an increase in the fronto-polar and temporal regions. This entropy increase could indicate improved neuronal flexibility and efficiency, which is particularly important in patients with neurodegenerative diseases such as Alzheimer’s dementia.
Finally, an increased coupling between low-frequency and high-frequency brain activity, particularly in the gamma-theta range, was observed. This so-called cross-frequency coupling (CFC) occurred in fronto-temporal and parietal-frontal networks and is crucial for learning and memory processes. These results suggest that TPS may have a positive effect on cognitive functions by improving neuronal synchronization in these important networks.
Influence of TPS shock waves could go beyond functional electrical networks
Regarding the reported effects on gamma oscillations, the authors note that the influence of shock waves could go beyond purely functional electrical networks. It has already been described that an increase in gamma power after gamma tACS was found in association with decreased beta-amyloid levels in the hippocampus in Alzheimer’s patients. Therefore, TPS changes in gamma networks should be monitored with particular interest as shock waves could influence the glymphatic clearing system of the brain.
Significance of the results and mechanisms of Transcranial Pulse Stimulation (TPS)
The neurophysiological changes observed in this study suggest that TPS has a direct effect on neuronal networks. Of particular note is the increase in beta and gamma frequencies, which are associated with cognitive functions, as well as the improvement in coherence in temporal regions, which are crucial for memory processes. The results suggest that TPS not only affects superficial areas of the brain, but also reaches deeper structures that are important for cognitive processing.
Conclusion: TPS as a future option for Alzheimer’s therapy
The present results support the assumption that TPS is a promising non-invasive treatment method for Alzheimer’s dementia. In particular, its ability to stimulate deeper brain regions and thereby positively influence neuronal networks makes TPS a promising addition to existing therapies.
Even though the present study only examined a single TPS session, the changes observed in the EEG measurements provide further evidence of the potential of this technique. Future studies should investigate the long-term effect of multiple TPS sessions and further explore the association with clinical improvements in cognitive abilities, Prof. Wojtecki and team recommend.
Source:
https://link.springer.com/article/10.1007/s11357-024-01305-x
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