Transcranial Pulse Stimulation (TPS) as non-invasive brain stimulation in Parkinson’s Disease
Current state of research and perspectives for patients
The treatment of neurodegenerative diseases poses major challenges for patients, their families, and the medical community. In addition to pharmacological therapies, non-invasive, complementary approaches are therefore gaining increasing importance. One of these approaches is Transcranial Pulse Stimulation (TPS), which has already been used in patients with Alzheimer’s disease.
Recent studies from the USA and Italy are now focusing on Parkinson’s disease. Initial results suggest that TPS in Parkinson’s disease may potentially influence both motor symptoms such as tremor and bradykinesia, as well as non-motor symptoms including sleep disturbances or mood fluctuations.
Transcranial Pulse Stimulation (TPS) in Parkinson’s Disease: New impulses from research
TPS is already used as an adjunctive therapy in neurological patients with Alzheimer’s disease. Studies indicate that cognitive functions may be stabilised or improved¹ and that mood and general well-being can also be positively affected²˒³. These clinical experiences have led to TPS now being scientifically investigated in other neurodegenerative diseases – including Parkinson’s disease. After Alzheimer’s disease, Parkinson’s disease is one of the most common neurodegenerative disorders, affecting more than 10 million people worldwide. In addition to motor symptoms such as tremor, muscle rigidity, or slowed movements, many patients also suffer from non-motor symptoms, for example:
- Sleep disturbances
- Exhaustion and fatigue
- Mood fluctuations or depressive symptoms
- Reduced quality of life
With the recently published studies⁴⁻⁶ from the USA and Italy, the first published data on the use of TPS in patients with Parkinson’s disease are now available. Leading institutions included Spaulding Rehabilitation Hospital and Harvard Medical School in Boston under the direction of Prof. Felipe Fregni, as well as the University of Trieste under the direction of Prof. Paolo Manganotti. These new research findings mark an important step in the scientific advancement of TPS and provide the basis for further investigations in this indication. Currently, the use of TPS in Parkinson’s disease is still considered off-label* – that is, an application for an indication that has not yet received official approval. The aim of the current pilot studies is to collect preliminary scientific data that may support future regulatory assessments.
What effects were observed in the individual studies?
In the studies published to date, the following effects were reported; these were assessed using standardised Parkinson’s scales that measure motor function, activities of daily living, mood, and sleep (e.g., UPDRS, NMSS, PDQ-39, BDI-II, PDSS-2):
- Improvements in motor symptoms, including resting tremor⁶
- Improvements in non-motor symptoms such as mood and sleep quality⁵
- Improvements in cognitive performance⁵
- Improvements in quality of life⁵˒⁶
Notably, the observed effects in the US study persisted beyond the actual treatment period⁵. At the same time, it should be emphasised that these findings originate from early clinical studies. Sample sizes are limited, and further randomised controlled trials are required to more precisely define efficacy, duration of possible effects, and suitable patient groups.
Conclusion: TPS in Parkinson’s Disease – An emerging field of research
Transcranial Pulse Stimulation (TPS) is increasingly being investigated as an adjunctive approach in neurodegenerative diseases. Initial studies on TPS in Parkinson’s disease show potential effects on both motor and non-motor symptoms.
Additional studies are necessary to gain further insights and to achieve official approval for the use of TPS in patients with Parkinson’s disease.
1 Cont, C., et al. (2025). Transcranial Pulse Stimulation in Alzheimer’s: Long-Term Feasibility and a Multifocal Treatment Approach. Brain Sciences, 15(8), 830. https://doi.org/10.3390/brainsci15080830
2 Matt, E., et al. (2022). Transcranial pulse stimulation (TPS) improves depression in AD patients on state-of-the-art treatment. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 8(1), e12245. https://doi.org/10.1002/trc2.12245
3 Chen, X., et al. (2024). Transcranial pulse stimulation in Alzheimer’s disease. CNS Neuroscience & Therapeutics, 30(2), e14372. https://doi.org/10.1111/cns.14372
4 Gianlorenço, F., et al. (2025).Study Protocol: Investigating the Effects of Transcranial Pulse Stimulation in Parkinson’s Disease. Bioengineering, 12(7), 773;. https://doi.org/10.3390/bioengineering12070773
5 Gianlorenco, A. C., et al. (2026). Neuromodulation in Parkinson’s disease with transcranial pulse stimulation: Evidence of clinical efficacy and cortical oscillatory changes. Journal of Neurology, 273(1), 52. https://doi.org/10.1007/s00415-025-13558-3
6 Manganotti, P., et al. (2026). Effects of Transcranial Pulse Stimulation (TPS) as a potential “add-on” intervention in patients with Parkinson's disease. Parkinsonism Relat Disord. 142:108128. https://doi.org/10.1016/j.parkreldis.2025.108128
* Off-label use refers to the application of CE-certified medical devices outside their (medical) intended purpose or approved indication(s). This may occur on the basis of an individual physician’s decision (medical freedom of therapy) in a specific patient case or within the framework of scientific investigations or clinical studies.
At this stage, no conclusions can be drawn regarding the clinical benefit, safety, or performance for the non-CE-marked indication »Parkinson’s disease«. The information provided is intended solely for scientific purposes and is not meant to influence clinical use.
Neurolith is currently approved for the treatment of the central nervous system in patients with Alzheimer’s disease.
