Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
CNS Neurosci Ther. 2024 Feb;30(2):e14372. doi: 10.1111/cns.14372. Epub 2023 Jul 20.
Transcranial pulse stimulation (TPS) is a novel noninvasive ultrasonic brain stimulation that can increase cortical and corticospinal excitability, induce neuroplasticity, and increase functional connectivity within the brain. Several trials have confirmed its potential in treating Alzheimer's disease (AD).
To investigate the effect and safety of TPS on AD.
A systematic review.
PubMed, Embase via Ovid, Web of Science, Cochrane Library, CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), and WanFang were searched from inception to April 1, 2023. Study selection, data extraction, and quality evaluation of the studies were conducted by two reviewers independently, with any controversy resolved by consensus. The Methodological Index for Nonrandomized Studies was used to assess the risk of bias.
Five studies were included in this review, with a total of 99 patients with AD. For cognitive performance, TPS significantly improved the scores of the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) test battery, Alzheimer's Disease Assessment Scale (cognitive), Montreal Cognitive Assessment, and Mini-Mental Status Examination. For depressive symptoms, TPS significantly reduced the scores of the Alzheimer's Disease Assessment Scale (affective), Geriatric Depression Score, and Beck Depression Inventory. By functional magnetic resonance imaging, studies have shown that TPS improved cognitive performance in AD patients by increasing functional connectivity in the hippocampus, parahippocampal cortex, precuneus, and parietal cortex, and activating cortical activity in the bilateral hippocampus. TPS alleviated depressive symptoms in AD patients by decreasing functional connectivity between the ventromedial network (left frontal orbital cortex) and the salience network (right anterior insula). Adverse events in this review, including headache, worsening mood, jaw pain, nausea, and drowsiness, were reversible and lasted no longer than 1 day. No serious adverse events or complications were observed.
TPS is promising in improving cognitive performance and reducing depressive symptoms in patients with AD. TPS may be a safe adjunct therapy in the treatment of AD. However, these findings lacked a sham control and were limited by the small sample size of the included studies. Further research may be needed to better explore the potential of TPS.
Patients and the public were not involved in this study.
经颅脉冲刺激（TPS）是一种新型的无创超声脑刺激方法，可增加皮质和皮质脊髓兴奋性，诱导神经可塑性，并增加大脑内的功能连接。几项试验已经证实了其在治疗阿尔茨海默病（AD）方面的潜力。
研究 TPS 治疗 AD 的效果和安全性。
系统评价。
通过 Ovid 中的 PubMed、Embase、Web of Science、Cochrane 图书馆、中国知网（CNKI）、维普及万方数据库检索，检索时间从建库至 2023 年 4 月 1 日。由两名评审员独立进行研究选择、数据提取和质量评估，任何争议均通过共识解决。采用非随机研究方法学指数评估偏倚风险。
本综述纳入了 5 项研究，共纳入 99 例 AD 患者。在认知表现方面，TPS 显著改善了 CERAD（建立阿尔茨海默病登记册联盟）测试组合、阿尔茨海默病评估量表（认知）、蒙特利尔认知评估和简易精神状态检查的评分。在抑郁症状方面，TPS 显著降低了阿尔茨海默病评估量表（情感）、老年抑郁量表和贝克抑郁量表的评分。通过功能磁共振成像，研究表明 TPS 通过增加海马、海马旁皮质、楔前叶和顶叶皮质的功能连接以及激活双侧海马的皮质活动，改善 AD 患者的认知表现。TPS 通过降低腹侧网络（左侧额眶皮质）和突显网络（右侧前岛叶）之间的功能连接，减轻 AD 患者的抑郁症状。本综述中的不良反应包括头痛、情绪恶化、颌痛、恶心和嗜睡，这些不良反应是可逆的，持续时间不超过 1 天。未观察到严重不良反应或并发症。
TPS 有望改善 AD 患者的认知表现和减轻抑郁症状。TPS 可能是 AD 治疗的一种安全辅助治疗方法。然而，这些发现缺乏假对照且受到纳入研究样本量小的限制。可能需要进一步的研究来更好地探索 TPS 的潜力。
本研究未涉及患者和公众。
