Transcranial Pulse Stimulation in Alzheimer's: Long-Term Feasibility and a Multifocal Treatment Approach

Area of Science:

• Neuromodulation
• Neuroscience
• Geriatric Medicine

Background:

• Alzheimer's disease (AD) poses a significant challenge, with limited effective long-term treatments.
• Neuromodulation techniques, including Transcranial Pulse Stimulation (TPS), are being explored as potential therapeutic interventions.
• Long-term efficacy and safety data for TPS in AD patients are crucial for clinical adoption.

Purpose of the Study:

• To assess the one-year feasibility, safety, and cognitive effects of TPS as an add-on therapy in Alzheimer's disease patients.
• To evaluate TPS's impact on memory, speech, orientation, visuo-construction, and depressive symptoms.
• To gather preliminary data on TPS tolerability and adverse events in a long-term AD treatment context.

Main Methods:

• A prospective study analyzing data from ten Alzheimer's disease patients completing one year of TPS.
• TPS protocol: initial sessions followed by monthly boosters over twelve months.
• Neuropsychological assessments included ADAS, MMSE, MoCA, and BDI-II; adverse events were systematically monitored.

Main Results:

• TPS demonstrated significant short-term cognitive improvements, particularly in memory, speech, and mood, which were maintained over one year.
• Adverse events were infrequent (<1% of sessions) and generally mild, including localized pain or transient sensations.
• Cognitive test results showed significant improvement after the initial stimulation cycle (ADAS total improved significantly after the first stimulation cycle (M_pre = 28.44, M_post = 18.56; p = 0.001, d = 0.80, 95% CI (0.36, 1.25)), with stable scores across all domains over one year.

Conclusions:

• Transcranial Pulse Stimulation (TPS) appears to be a safe and feasible add-on treatment for Alzheimer's disease.
• Careful patient selection and monitoring are advised due to potential adverse events and dropouts.
• Further research, potentially using multifocal stimulation (F-TOP2), is suggested to broaden cognitive domain benefits.