Transcranial Pulse Stimulation (TPS) for patients with Alzheimer’s disease

Transcranial Pulse Stimulation (TPS) is a new treatment with a very different mode of action from current approaches, since it uses “shock waves”.

High-energy shock waves have been used for many years in cardiology, rheumatology and orthopaedics. TPS, however, uses low-energy waves that are similar in some ways to ultrasound, but without the side-effects, especially without the risk of heating up the areas treated.

TPS is a complement to the usual treatment for Alzheimer’s disease. The treatment is carried out on an outpatient basis, does not require anaesthesia as it is painless, does not involve changing or stopping medication beforehand, and has no known interactions.

TPS is used to treat patients with mild to moderate Alzheimer’s disease who have previously been diagnosed by a specialist and already had a brain MRI scan (with images available on a USB key or CD, for example).

Other indications are currently being studied, including depression and autism.

TPS acts on several levels:

• Increases cell permeability and metabolism and stimulates vascular growth factors
• Reduces amyloid plaques
• Increases neuroplasticity
• Normalizes functional connectivity in areas involved in cognitive disorders

What effects can be expected?

• Moderate improvement in specific cognitive areas (memory, verbal skills), which may persist for up to 3 months after treatment.
• Reduction in depressive symptoms associated with Alzheimer’s disease
• Reduction in apathy
• Temporary slowing of cognitive deterioration

The patient is comfortably seated in an armchair and can move freely, as the head is not restrained. At the start of each session, markers will be placed on the patient’s head to help determine the areas to be treated using the neuronavigation device, which is based on the brain MRI scan.

TPS is performed on the surface of the skull with a special probe, ultrasound gel having been applied to the hair beforehand. Each pulse can be followed on the computer screen and the treated area visualised. The treatment is completely painless but noisy, and hearing protection will be provided.

A session lasts approximately 45 minutes, with 15 minutes of preparation and 30 minutes of treatment. The treatment includes 3 sessions per week for 2 consecutive weeks, for a total of 6 sessions. It may be repeated if necessary.

The first session is always carried out by a doctor, and subsequent sessions can be carried out by a healthcare professional trained in TPS.

TPS is a particularly well-tolerated treatment, with very few side effects. The most frequently described side effects are a painless feeling of pressure on the head, more rarely a slight headache, jaw pain or nausea.

The following conditions contraindicate treatment with TPS (non-exhaustive list):

• Thrombosis
• Tumour in the treated area
• Cortisone treatment up to 6 weeks prior to the first TPS session 
• Presence of metallic objects in the head
• Blood coagulation disorders (haemophilia)

TPS is currently not reimbursed by either basic or complimentary insurances schemes. The sessions are therefore paid for entirely by the patient.

More information about costs and payment terms is available upon request

The neuronavigator is a device equipped with special infrared cameras. Data from the MRI of the patient’s brain is entered. This allows the neuronavigator to target the areas to be treated, in a personalised and reproducible way, from one session to the next.