Transcranial Pulse Stimulation (TPS^®)¹ for the stimulation of brain regions in patients with Alzheimer’s disease

Applied knowledge in neurology – The TPS^® method of action

The key mechanism induced by TPS^® is mechanotransduction. The stimulation of growth factors, primarily VEGF^3,4, not only improves cerebral blood flow, but also promotes the formation of new blood vessels (angiogenesis) and nerve regeneration. An additional effect is the release of nitric oxide (NO)⁵, which leads to direct vasodilation and improved blood circulation.

TPS^® enables targeted stimulation of cerebral regions.

Biological effects of TPS^®

• Mechanotransduction⁶
• Increase in cell permeability⁷
• Stimulation of mechanosensitive ion channels⁶
• Release of nitric oxide (NO)⁵, which leads to vasodilation, increased metabolic activity and angiogenesis and has an anti-inflammatory effect
• Stimulation of vascular growth factors (VEGF)^3,4
• Stimulation of BDNF⁸
• Migration and differentiation of stem cells^4,6

TPS^® can stimulate deep cerebral regions, reaching as much as 8 cm into the brain. Owing to the short duration of the TPS^® stimulation, tissue heating is avoided. The pulses applied to the treatment area thus develop their maximum clinical effectiveness. TPS^® treatment is performed through the closed skull. The patient is not immobilized during the treatment and able to move freely. TPS^® treatment has been shown to significantly improve CERAD test performance and to reduce Beck’s depression index in patients with mild to moderate dementia. Over 1500 treatments have already been performed using the NEUROLITH^® system.

Advantages of TPS^®

• 6 treatment sessions in 2 weeks
• Outpatient treatment (30 minutes/session)
• Painless and without side effects
• Personalized treatment based on MRI data
• Adjuvant cognitive training not required
• Shaving of the scalp not required
• No immobilization of the patient during treatment

BodyTrack^® – Treatment documentation in real time

Real-time tracking of the handpiece position enables automatic visualization of the treated regions. The use of personalized MRI data allows specific characteristics of the patient’s brain to be taken into account. Every time the handpiece position changes, the visualization of the target regions in the loaded MRI scans is automatically updated. The energy applied is highlighted in colour. The BodyTrack^® software is a unique tool for the visualization and control of the TPS^® pulses applied and of treatment progress.

Real-time visualization of TPS^® treatment

Advantages of the BodyTrack^® software

• Use of personalized MRI data
• Visualization of MRI data in 3 planes (axial, coronal, sagittal)
• Coloured visualization of the treatment region
• Real-time visualization of TPS^® pulse distribution
• Continuous visualization and documentation of the energy applied and of treatment progress

NEUROLITH^® – The perfect solution to facilitate Alzheimer’s treatment

NEUROLITH^® – an innovative system with convincing design features! The special ergonomic shape of the TPS^® handpiece minimizes hand fatigue to facilitate treatment working directly on the patient. The coupling surface adapts easily to any shape of head, making the treatment with focused pulses simple and efficient. The NEUROLITH^® software includes patient management functionalities with retrievable data and recommended treatment parameters.

3D camera with patient and handpiece position detection / Calibration probe and tracking glasses with markers / TPS^® handpiece with markers

Advantages of the NEUROLITH^®

• Focused stimulation of deep cerebral regions
• Personalized 3D visualization of patient’s head
• 3D infrared camera system for precise cerebral tracking
• USB interface for MRI data import
• Patient database

Publications:
¹Beisteiner, R. et al.: Transcranial Pulse Stimulation with Ultrasound in Alzheimer’s Disease—A New Navigated Focal Brain Therapy, Adv. Sci. [online ahead of print], DOI: 10.1002/advs.201902583, 2019
³Yahata, K. et al.: Low-energy extracorporeal shock wave therapy for promotion of vascular endothelial growth factor expression and angiogenesis and improvement of locomotor and sensory functions after spinal cord injury, J Neurosurg Spine, Vol. 25(6), Pages 745–755, 2016
⁴Hatanaka, K. et al.: Molecular mechanisms of the angiogenic effects of low-energy shock wave therapy: roles of mechanotransduction, Am J Physiol Cell Physiol, Vol. 311(3), C378–C385, 2016
⁵Mariotto, S. et al.: Extracorporeal shock waves: From lithotripsy to anti-inflammatory
action by NO production, Nitric Oxide, Vol. 12(2), 89–96, 2005
⁶d´Agostino, M. C. et al.: Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction, Int J Surg., Dec. 24(Pt B), 147-153, 2015
⁷López-Marín, L. M. et al.: Shock wave–induced permeabilization of mammalian cells, Phys Life Rev., 26-27:1-38, 2018
⁸Wang, B. et al.: Low-Intensity Extracorporeal Shock Wave Therapy Enhances Brain-Derived Neurotrophic Factor Expression through PERK/ATF4 Signaling Pathway, Int J Mol Sci., Feb 16;18(2). pii: E433, 2017

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