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 VEGF3,4, 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.

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 cells4,6

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)
  • Safe and uncomplicated
  • 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® treatmentReal-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.

Transcranial Pulse Stimulation (TPS®) in Alzheimer’s Disease3D 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

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


Experiences with the NEUROLITH® 

Dr. Teris Cheung»I am very satisfied with TPS as it is very user-friendly and has a real-time treatment visualization. More importantly, TPS has proved to be effective and safe in the treatment of my patients. I consider TPS to be a breakthrough in brain treatment and stimulation!« Dr Teris Cheung, Hong Kong

Prof. Dr. Musa Citak»The first few patients treated with Transcranial Pulse Stimulation (TPS) are making very good progress. Their relatives are very surprised and pleased by the positive effect of TPS .« Prof Dr Musa Citak, Hamburg, Germany

Dr. Karin Freitag»I am convinced of the biological effect of shock waves and therefore co-founded the Spanish Society for Shock Wave Therapy in 2011. It relies in our hands to focus on research and support new therapies. The treatment of patients with Alzheimer with shock waves - called »Transcranial Pulse Stimulation« (TPS) is showing promising results in neurology and therefore, I felt the excitement from the very beginning.

We stimulate selected brain regions with the NEUROLITH in our Alzheimer's patients and see significant improvements: The patients are more attentive, in a better mood and can express themselves verbally with more clarity. Moreover, this treatment can slow down the initial cognitive deterioration in mild Alzheimer's disease. The improvements achieved with NEUROLITH also impact the quality of life of the patient´s family, which are ultimately the greatly affected by the neurodegenerative diseases of their loved ones.« Dr Karin Freitag, Madrid, Spain

Dr. Matthias Geisler»Laughing and happiness: it's a matter of course for healthy people. But I've noticed during my TPS treatments that this is not really the reality for my patients. Many become sad and withdrawn, which is understandable, because they can't do things the way they used to. That's why I am all the more pleased when relatives call or write to me after the first TPS treatments with the NEUROLITH to let me know that their loved ones are now laughing more. They're glowing again, and you're a little happier as a result.
This affects everyone: the patients, their relatives, their environment. And me! Time and time again.« Dr Matthias Geisler, Vienna, Austria

Dr Alfred Spieker, Achern, Germany»Since March 2021, we have been one of the first practices in Germany to use TPS for treatments. Compared to alternative therapies, the results so far have been outstanding, and more consistent than average. Our patients feel extremely comfortable during the treatment due to the well-thought-out therapy concept and the comfortable application in a sitting position. For us, a qualitative improvement in how patients cope with everyday life is the primary goal of the therapy, which is something we are usually very able to achieve. In our view, TPS therapy will revolutionise the treatment of Alzheimer’s dementia.« Dr Alfred Spieker, Achern, Germany

Prof. Dr. med. Lars Wojtecki»TPS is a new therapy for Alzheimer’s disease, which is, in my experience, very well tolerated.
My first treatments showed amazingly positive effects in patients. There is initial scientific evidence of the clinical benefits in humans and of the effects on network connectivity in the brain.« Prof. Dr med. Lars Wojtecki, Kempen, Germany


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