Functional Specificity of TPS Brain Stimulation Effects in Patients with Alzheimer’s Disease: A Follow-up fMRI Analysis

Dörl, Gregor; Matt, Eva; Beisteiner, Roland

doi:10.1007/s40120-022-00362-8

Cited by 15 publications

(16 citation statements)

References 26 publications

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“…Except for figural capacity, the memory and verbal capacity of AD patients improved significantly after TPS treatment and remained stable for 3 months. 25 A study by Dörl et al 27 also demonstrated a trend in declining visuo-constructive capabilities (CERAD figural score) and correspondingly global efficiency when the important visuoconstructive network nodes were omitted during TPS. This decline was compatible with the natural progression of the disease.…”

Section: Cognitive Improvement In Admentioning

confidence: 97%

Transcranial pulse stimulation in Alzheimer's disease

Chen

You

et al. 2023

CNS Neurosci Ther

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BackgroundTranscranial pulse stimulation (TPS) is a novel noninvasive ultrasonic brain stimulation that can increase cortical and corticospinal excitability, induce neuroplasticity, and increase functional connectivity within the brain. Several trials have confirmed its potential in treating Alzheimer's disease (AD).ObjectiveTo investigate the effect and safety of TPS on AD.DesignA systematic review.MethodsPubMed, Embase via Ovid, Web of Science, Cochrane Library, CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), and WanFang were searched from inception to April 1, 2023. Study selection, data extraction, and quality evaluation of the studies were conducted by two reviewers independently, with any controversy resolved by consensus. The Methodological Index for Nonrandomized Studies was used to assess the risk of bias.ResultsFive studies were included in this review, with a total of 99 patients with AD. For cognitive performance, TPS significantly improved the scores of the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) test battery, Alzheimer's Disease Assessment Scale (cognitive), Montreal Cognitive Assessment, and Mini‐Mental Status Examination. For depressive symptoms, TPS significantly reduced the scores of the Alzheimer's Disease Assessment Scale (affective), Geriatric Depression Score, and Beck Depression Inventory. By functional magnetic resonance imaging, studies have shown that TPS improved cognitive performance in AD patients by increasing functional connectivity in the hippocampus, parahippocampal cortex, precuneus, and parietal cortex, and activating cortical activity in the bilateral hippocampus. TPS alleviated depressive symptoms in AD patients by decreasing functional connectivity between the ventromedial network (left frontal orbital cortex) and the salience network (right anterior insula). Adverse events in this review, including headache, worsening mood, jaw pain, nausea, and drowsiness, were reversible and lasted no longer than 1 day. No serious adverse events or complications were observed.ConclusionsTPS is promising in improving cognitive performance and reducing depressive symptoms in patients with AD. TPS may be a safe adjunct therapy in the treatment of AD. However, these findings lacked a sham control and were limited by the small sample size of the included studies. Further research may be needed to better explore the potential of TPS.Patient and Public InvolvementPatients and the public were not involved in this study.

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Section: Cognitive Improvement In Admentioning

confidence: 97%

Transcranial pulse stimulation in Alzheimer's disease

Chen

You

et al. 2023

CNS Neurosci Ther

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“…Using the MR technique of asymmetric spin echo labeling, Nicodemus et al [26] report a local perfusion increase after sonication with a non-focal diagnostic system. Beisteiner et al, [6] Popescu et al, [27] Matt et al [28] and Dörl et al [29] applied task-based functional magnetic resonance imaging (fMRI), resting-state fMRI and MRI cortical thickness [24] Diagnostic system (GE-LOGIQe) Inferolateral frontal lobe 31 patients with chronic pain Pain reduction in back pain patients, affect improvement…”

Section: Clinical Effects With Ultrasound Neuromodulationmentioning

confidence: 99%

“…[ 28 ] and Dörl et al. [ 29 ] applied task‐based functional magnetic resonance imaging (fMRI), resting‐state fMRI and MRI cortical thickness analyses. They report brain activation increases in task specific brain areas, connectivity increases within the diseased brain network, and reduced brain atrophy in disease specific brain areas.…”

Section: Clinical Effects With Ultrasound Neuromodulationmentioning

confidence: 99%

“…Target specificity is important and minor differences in targeting and delivery may also produce different results. [ 29 ] The extensive variables offer a lot of research options but also a lot of interdependencies and difficulties for effect interpretations. With TPS, there are only two parameters, which may be changed: single pulse energy and single pulse frequency.…”

Section: Perspectives For Ultrasound Neuromodulation As a New Brain T...mentioning

confidence: 99%

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Ultrasound Neuromodulation as a New Brain Therapy

2023

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Within the last decade, ultrasound has been “rediscovered” as a technique for brain therapies. Modern technologies allow focusing ultrasound through the human skull for highly focal tissue ablation, clinical neuromodulatory brain stimulation, and targeted focal blood‐brain‐barrier opening. This article gives an overview on the state‐of‐the‐art of the most recent application: ultrasound neuromodulation as a new brain therapy. Although research centers have existed for decades, the first treatment centers were not established until 2020, and clinical applications are spreading rapidly.

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“…The first clinical study with highly focused navigated pulses has been performed with the TPS technology [ 13 ]. In this multicenter clinical study with Alzheimer patients, TPS was shown to be safe and specifically improve cognition, memory and depression scores [ 13 , 17 , 18 ]. Later, navigated FUS studies investigated patients with disorders of consciousness [ 19 , 20 ], Alzheimer’s disease [ 21 ] and epilepsy [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Safety of Clinical Ultrasound Neuromodulation

et al. 2022

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Transcranial ultrasound holds much potential as a safe, non-invasive modality for navigated neuromodulation, with low-intensity focused ultrasound (FUS) and transcranial pulse stimulation (TPS) representing the two main modalities. While neuroscientific and preclinical applications have received much interest, clinical applications are still relatively scarce. For safety considerations, the current literature is largely based on guidelines for ultrasound imaging that uses various physical parameters to describe the ultrasound pulse form and expected bioeffects. However, the safety situation for neuromodulation is inherently different. This article provides an overview of relevant ultrasound parameters with a focus on bioeffects relevant for safe clinical applications. Further, a retrospective analysis of safety data for clinical TPS applications in patients is presented.

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Functional Specificity of TPS Brain Stimulation Effects in Patients with Alzheimer’s Disease: A Follow-up fMRI Analysis

Cited by 15 publications

References 26 publications

Transcranial pulse stimulation in Alzheimer's disease

Transcranial pulse stimulation in Alzheimer's disease

Ultrasound Neuromodulation as a New Brain Therapy

Safety of Clinical Ultrasound Neuromodulation

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