Treatment of mild neurocognitive disorders (NCD)

New study assesses safety and effectiveness of Transcranial Pulse Stimulation (TPS)

In a new study, researchers from The University of Hong Kong assess the effectiveness of Transcranial Pulse Stimulation (TPS) in patients with mild neurocognitive disorder (NCD).¹ Based on the results, the authors conclude that TPS has great potential to delay the deterioration of cognition in older adults.

In the introduction, the researchers emphasize that mild NCD is a golden period for intervention before cognitive decline progresses and may lead to the development of a major NCD (dementia). Given the limitations of the pharmacological approach (limited effectiveness, potential side effects), non-invasive brain stimulation (NIBS) methods such as TPS could be a potential alternative in the treatment of mild NCD.

Methods

The open-label study recruited 27 older adults with mild NCD to receive neuro-navigated TPS intervention for two weeks. All participants underwent the treatment-as-usual (TAU) period for 12 weeks. The intervention lasted for two weeks with three sessions per week. A total of six TPS sessions (6000 pulses each) were delivered. Cognitive status was assessed at baseline, after TAU periods, immediately after the intervention, and 12 weeks after the intervention. Assessments included detailed cognitive assessments, APOE genotype, and brain-derived neurotrophic factor (BDNF).

Results and conclusion

19 participants completed the whole TPS interventions with 100% treatment adherence. None of the participants reported severe side effects.

Repeated measures ANOVA showed statistically significant effects of time on HK-MoCA (F (3, 54) = 4.99, P = 0.004), 30-sec interval of Verbal Fluency Test (F (3, 54) = 2.94, P = 0.041), Stroop interference (F (3, 54) = 3.46, P = 0.023), and Chinese IADL (F (3, 54) = 2.78, P = 0.050) after receiving the intervention. Bonferroni post hoc comparisons on HK-MoCA showed a significant improvement after intervention. There was no significant change in serum BDNF level.

In the discussion section, the authors conclude that TPS significantly improved the overall cognition of patients and that the effect persisted for at least three months after the intervention. The results show that TPS has a beneficial effect not only in older adults with major NCD, but also in older adults with mild NCD. To support the findings, the authors recommend a larger-scale, randomized, sham-controlled trial.

Source:

¹ Fong TKH, Cheung T, Ngan STJ, et al. Transcranial pulse stimulation in the treatment of mild neurocognitive disorders. Ann Clin Transl Neurol. 2023 Aug 21. https://doi.org/10.1002/acn3.51882