Transcranial Pulse Stimulation (TPS)

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Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have shown effectiveness in enhancing brain functions in various neurological and psychiatric disorders. However, these techniques have some limitations, including spatial resolution constraints caused by electrical conductivity effects and the inability to target deep brain structures without affecting superficial layers.

In recent years, a promising non-invasive neuromodulation method known as low-intensity transcranial focused ultrasound (tFUS) has emerged as a potential solution to overcome these limitations. With a lateral resolution ranging from 3 to 7 mm, tFUS enables precise stimulation of specific brain regions. Building upon this advancement, a novel technique called transcranial pulse stimulation (TPS) has been introduced. TPS utilizes single ultrashort ultrasound pulses (3 μs) repeated at intervals of 200–300 ms, offering a lateral resolution comparable to tFUS and enabling distinct spatial brain stimulation.

TPS can reach deep brain structures, such as the thalamus, which is located at a distance of 5 to 6.5 cm from the scalp. Unlike tFUS, TPS avoids the potential risks associated with tissue warming. The utilization of very short pulses in TPS prevents unintended secondary stimulation peaks, enhancing spatial specificity. Notably, TPS is the first ultrasound-based non-invasive brain stimulation technique to receive approval for clinical applications with a CE marking. Additionally, TPS can be personalized to an individual’s brain anatomy and monitored in real-time using magnetic resonance imaging (MRI) for precise neuronavigation.

Initial clinical feasibility studies have demonstrated promising outcomes for TPS. For instance, in patients with Alzheimer’s disease, repeated TPS stimulation targeting specific cognitive networks has led to improvements in memory and verbal functions that persisted for up to three months. These improvements were accompanied by increased activation, enhanced functional connectivity, and cortical thickening in brain regions associated with mnemonic functions. TPS also shows potential in other conditions such as chronic fatigue syndrome, autism spectrum disorder, and treatment-resistant depression.

As a European TPS Center of Excellence, BRAIN-NM offers specialized expertise and comprehensive services in this innovative neuromodulation technique.

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