Transcranial Pulse Stimulation (TPS) for Alzheimer's patients: new publication describes protocol and discusses potential as an adjunct treatment
The newly released video publication on Transcranial Pulse Stimulation (TPS) for patients with Alzheimer’s disease by Cont et al., led by TPS expert and key opinion leader Prof. Lars Wojtecki, has recently been published by »Journal of Visualized Experiments (JoVE)« in the Neuroscience section. This innovative format combines hands-on methodology with scientific context, offering a practical demonstration of the TPS treatment protocol alongside a concise overview of the most representative clinical data published to date. The key message: TPS provides several distinct advantages and holds strong potential as a complementary therapeutic option for patients with Alzheimer’s disease.
TPS for Alzheimer: New Study Highlights Therapy Potential
TPS is a non-invasive neuromodulation therapy for the treatment of patients with Alzheimer's disease (AD). In several studies it has shown promising effects on cognitive function. A recently released video paper on TPS for patients with Alzheimer’s disease by Cont et al., led by TPS expert and key opinion leader Prof. Lars Wojtecki, describes the treatment protocol and provides a brief overview of the representative clinical results published to date1. The authors conclude that TPS offers several distinct advantages and has the potential to complement the treatment of Alzheimer's patients.
TPS protocol explained in detail
The authors provide an excellent overview of the TPS treatment protocol and explain all the important steps. The following points are covered in detail: patient selection and preparation, neuropsychological testing, preparation of the device and environment, high voltage test, handpiece preparation, calibration for new patients, treatment region setup, conducting the treatment, and post-treatment procedures.
Representative results: best improvement in a patient was 40%
In the following section of the paper, the authors present representative results from a total of 11 patients with AD that were treated with TPS (nine men, two women, age range 59-77 years, M = 69.82). Treatment was administered in six initial sessions over 2 weeks as the first treatment cycle. The treatment protocol during stimulation involved 4 Hz, 0.20 mJ/mm2, and 6000 pulses. Three out of 11 patients (27%) reported adverse events (jaw pain, nausea, drowsiness) in three out of 75 total sessions (4%). However, none of these lasted more than 24 h, and not all could be directly attributed to the stimulation as adverse device events (ADEs).
A significant difference was observed in the post-stimulation ADAS (Alzheimer Disease Assessment Scale) total score compared to the baseline, with an improvement from 30.2 to 25.8 (p = 0.01), and in the ADAS-Cog score, which improved from 25.8 to 23.3 (p = 0.04). While some patients only showed minor improvements, the best improvement in a patient was 40%, leading to an overall improvement of 15.76% in the ADAS total score and 8.65% in the ADAS Cog score. Furthermore, a significant difference in depressive symptoms was detected in a self-reported subscale of the ADAS test.
A subjective rating scale was completed before and after the treatment period of two weeks. This scale allows patients to report their symptom severity and any perceived adverse events on a numeric rating scale (NRS) of 0 to 10, with higher numbers indicating greater symptom intensity. The mean subjective improvement of the symptom severity, as measured by the NRS, was from 5.7 to 3.4 (p = 0.023).
Discussion: TPS has potential as an adjunct treatment for Alzheimer's patients
In the discussion section of their article, the authors write that TPS shows promise as a therapeutic approach. The stimulation process is user-friendly, allowing operators to define target areas and visualize pulse applications during treatment. Key steps in the TPS protocol include precise device placement over the targeted brain regions, pulse intensity and frequency management, and patient response monitoring. The data published to date has demonstrated clinical cognitive improvements, increased cortical thickness in several brain areas, and positive mood changes.
Compared to other non-invasive brain stimulation methods, TPS offers several distinct advantages. First, it combines mechanical shock waves with precise neuro-orientation, allowing targeted application to affected brain regions. Unlike transcranial magnetic stimulation (TMS), which typically only stimulates superficial cortical layers, TPS’s depth of penetration makes it particularly suited for treating neurodegenerative diseases like Alzheimer's, where deeper brain structures are involved. Additionally, TPS appears to have a favourable safety profile, with minimal and transient side effects reported in only 4% of treatment sessions, indicating that it may be a more tolerable option for patients with moderate-to-severe AD.
The authors conclude that TPS has potential as an adjunct treatment for Alzheimer's patients when used in a controlled, scientifically guided setting. In the future, randomized controlled trials with a larger number of patients should be conducted to rule out any placebo effects. In addition, clinical research should focus on identifying optimal stimulation parameters, evaluating the influence of patient-specific factors (e.g. stage of AD) on therapeutic outcomes and investigating the long-term effects of TPS therapy.
1 Cont C, Reinboth BS, Schütz C, et al. Transcranial Pulse Stimulation for Alzheimer's Patients. J Vis Exp. 2025;(218):10.3791/67176. Published 2025 Apr 4. doi:10.3791/67176
