EPP366
Treating Depression in Dementia-patients with transcranial-pulse stimulation: an observational study
A. R. Günes 1,*, M. Rahimi 1, P. Wisniowski 1, M. Beglau 1, M. Köhne 2, C. Schmidt-Kraepelin 2, U. Sprick 1
1Center of Neurostimulation, 2Alexius/ Josef Clinic, Neuss, Germany
Introduction: Depression plays a significant role in Alzheimer's-type dementia(AD) and affects approximately one in five patients1 (Asmer MS et al. J Clin Psychiatry. 2018 Jul 31;79). On the other hand, depression is a risk factor for the development of dementia. Despite years of research and the discovery of numerous pathophysiological factors in their mutual influence, there is still no sufficiently reliable therapeutic approach2 (Lyketsos CG et al. Alzheimers Dement.2011;7:5) . As a non-invasive brain stimulation method, transcranial pulse stimulation (TPS) is a novel procedure based on shock-waves and whose effects on cognition in AD patients show promising results in current studies3(Günes AR et al. Eur.J.N.2024;1468-1331), furthermore beneficial influence on affective symptoms were reported4 (Sprick U et al. Brain Stimul.2025;439).
Objectives: In our observational study, we investigated the effects and safetiness of TPS on depressive symptoms in 100 patients who met the criteria for AD.
Methods: Each of the 100 patients (mean age: 73,5 years; gender ratio: 5:7 (m:f)) received a total of 6 treatments within 14 days (each session with 6000 pulses, energy level 0.25 mJ/mm² and frequency 4 Hz). On the basis of individual MRI scans neuro-navigation was used to apply pulses bilaterally in the frontal (including the dorsolateral prefrontal cortex) and parietal lobe as well as the precuneus area (Image 1). Written consent and the approval of an ethics committee were obtained for all patients. Before, during and immediately after the TPS intervention, the antidepressant medication of all patients remained unchanged. To assess the intensity of depressive symptoms the Beck Depression Inventory II (BDI-II) was used before the first and after the last treatment session.
Results: 36 patients had a score above 5 points in BDI-II which represents the lower threshold with an average of 18,1 points within this group, which corresponds to a mild depression. The BDI-II total score in the pre-post comparison showed a reduction in the mean value from 18,1 to 5,9 points indicating a score almost below the lower threshold (Image 2). 26 patients reported temporary mild side effects such as fatigue or a local feeling of pressure in the treated areas. There were no serious adverse effects detected in any patient.
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Conclusions: To our knowledge, this trial is the largest study to systematically investigate the effects of TPS on depressive symptoms in AD patients so far. The positive impact on depressive symptoms may be based in part on stimulation of the dorsolateral prefrontal cortex, which is a well established target region in the treatment of major depressive disorder using transcranial magnetic stimulation. TPS seems to be a safe approach to treat depressive symptoms in patients with AD. Further studies with a larger study population are necessary to confirm the safety and effectiveness of this novel method.
Disclosure of Interest: None Declared