Lo Heidi Ka-Ying, Fong Tommy Kwan-Hin, Cheung Teris, Ngan Sze-Ting Joanna, Lui Wai-Yan Vivian, Chan Wai-Chi, Wong Corine Sau-Man, Wong Teenie Kwan-Tung, Cheng Calvin Pak-Wing
Department of Psychiatry, The University of Hong Kong, Hong Kong, China.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
Biomedicines. 2024 Sep 12;12(9):2081. doi: 10.3390/biomedicines12092081.
Existing pharmacological treatments for mild neurocognitive disorder (NCD) offer limited effectiveness and adverse side effects. Transcranial pulse stimulation (TPS) utilizing ultrashort ultrasound pulses reaches deep brain regions and may circumvent conductivity issues associated with brain stimulation. This study addresses the gap in TPS research for mild NCD during a critical intervention period before irreversible cognitive degradation. Our objective was to explore the effectiveness and tolerability of TPS in older adults with mild NCD. In an open-label study, 17 older adults (including 10 females and 7 males) with mild NCD underwent TPS for two weeks with three sessions per week. Cognitive evaluations and fMRI scans were conducted pre- and post-intervention. The results indicated changes in functional connectivity in key brain regions, correlating with cognitive improvement at = 0.087 (CI, 0.007-0.167; = 0.038). However, cortical thickness measurements showed no significant differences. Here we show that TPS can enhance cognitive function within mild NCD. This proof-of-concept study suggests that TPS has potential as a non-invasive therapy used to attenuate cognitive decline, encouraging further investigation in larger randomized trials. The findings could influence clinical practice by introducing TPS as an adjunctive treatment option and potentially impact policy by promoting its inclusion in new treatment strategies for mild NCD.
现有的针对轻度神经认知障碍（NCD）的药物治疗效果有限且存在不良副作用。利用超短超声脉冲的经颅脉冲刺激（TPS）可作用于脑深部区域，且可能规避与脑刺激相关的导电性问题。本研究填补了在轻度NCD不可逆认知衰退前的关键干预期内TPS研究的空白。我们的目标是探究TPS对患有轻度NCD的老年人的有效性和耐受性。在一项开放标签研究中，17名患有轻度NCD的老年人（包括10名女性和7名男性）接受了为期两周、每周三次的TPS治疗。在干预前后进行了认知评估和功能磁共振成像扫描。结果表明关键脑区的功能连接发生了变化，在α = 0.087（置信区间，0.007 - 0.167；p = 0.038）时与认知改善相关。然而，皮质厚度测量结果显示无显著差异。在此我们表明，TPS可增强轻度NCD患者的认知功能。这项概念验证研究表明，TPS有潜力作为一种用于减轻认知衰退的非侵入性疗法，这鼓励在更大规模的随机试验中进行进一步研究。这些发现可能会通过将TPS作为辅助治疗选择引入临床实践，以及通过推动将其纳入轻度NCD的新治疗策略中而影响政策。
